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Biomedical subjects

Haluk Kaplan

Publications and source records attributed to Haluk Kaplan.

7 recordsLinked to original sources

Comparison of outcomes of two different surgeries in regarding to complications for chronic anterior shoulder instability.

INTRODUCTION: The purpose of this study is to compare the early clinical results of two techniques in regarding to complications in the patients who suffered from chronic anterior traumatic isolated shoulder instability. METHOD: Eighty-five patients underwent reconstructive procedures due to chronic isolated traumatic shoulder instability in our clinic between 1990 and 2002. Sixty-four patients in whom preoperatively Bankart lesion were detected with MRI and who participated in the regular follow-up were included in the study. Thirty-four patients were treated with Bankart repair (Group I) and 30 patients were treated with Modified Bristow procedure (Group II). Mean follow-up period was 25 (24-39) months for group I and 28 (24-96) months for group II. All cases were evaluated preoperatively and postoperatively according to Rowe scoring system. RESULTS: Mean Rowe scores were 90 and 88.1 for group I and II, respectively. Due to recurrent dislocation, four revision surgeries (one in group I, three in group II) were performed. Surgical complications were encountered in group II, just as fracture at the bone block in four cases, nonunion in five cases and removal of loose screw in one case. DISCUSSION: According to clinical outcomes, both the techniques are useful and feasible for the treatment of the chronic traumatic isolated anterior shoulder instability; however, complication rate is higher in the Modified Bristow technique and, Bankart repair is directed to the anatomic repair of the original pathology.

Adult↗

Treatment of rupture of the Achilles tendon with fibrin sealant.

BACKGROUND: The optimal management strategy for acute Achilles tendon ruptures is controversial. These injuries historically were treated by nonoperative methods (cast immobilization, bandaging); however, operative repair of the ruptured tendon has become popular. METHODS: Thirty-two patients who had rupture of the Achilles tendon were treated operatively with use of fibrin sealant, and clinical and functional performance measures were assessed after a mean followup of at least 6 months between November, 1998, and July, 2003. All of the patients were male. Average age was 38.18 (30 to 45) years. All of the patients were followed for at least 18 months after surgery. Average followup time was 22.4 (18 to 56) months. We evaluated all patients according to the scoring system of Thermann et al. RESULTS: Our results were excellent in 24 patients and good in eight patients. One patient had rerupture 3 weeks after surgery. CONCLUSION: Fibrin sealants are biologically compatible, hemostatic agents derived from human plasma that can be used instead of suture or suture support. We think that the treatment of rupture of the Achilles tendon with fibrin sealant is a useful treatment, and there is less risk of complications, such as deep infection, than in other operative procedures. We had no wound closure problems, the incision size was small, and the operating time was short. However, it must be remembered that the risk of disease transfer by fibrin sealant application is still present.

Achilles Tendon↗

Humeral shaft fractures secondary to throwing.

Twenty-seven male military recruits with humeral shaft fractures that occurred during throwing of a hand grenade were analyzed to determine the causes and contributing factors of this fracture in recreational pitchers. Average patient age was 22 years (range: 19-27 years). Objective criteria included type and fracture site on radiographs. Subjective data such as throwing style, previous pitching experience, and prodromal arm pain were obtained. The recruits' throwing style was deemed faulty. Analysis of the fracture configurations indicated an external rotation mechanism.

Adult↗

[Evaluation of biomechanical rigidity of K-wire configurations in transverse osteotomies: a comparison of four-point bending test results].

OBJECTIVES: Four-point bending test was performed in transverse osteotomies of chicken humerus in order to assess biomechanical rigidity of fixation techniques that are commonly used in transverse unstable fractures of the tubular bones of the hand. METHODS: Thirty chicken humeral bones were transversely osteotomized and then randomly assigned to six fixation groups equal in number. Osteotomized bones were fixed with the use of two crossed (2 groups) or intramedullary (2 groups) K-wires; in the remaining two groups, crossed K-wires were used in combination with tension band wiring. The sizes of the crossed and intramedullary K-wires were 0.035-inch and 0.045-inch in paired groups, respectively. Biomechanical rigidity was measured by four-point bending test on an Instron testing machine. RESULTS: The most rigid configuration was obtained with 0.045-inch K-wires, followed by 0.035-inch K-wires used in combination with tension band wiring. These techniques provided significantly increased rigid fixations than those obtained by non-supplemented crossed and intramedullary K-wire fixations. CONCLUSION: In the transverse fractures of the tubular bones of the hand, dorsally applied tension band wiring around two crossed K-wires provides adequate rigidity that allows early active motion in the postoperative period.

Animals↗

Primary bipolar hemiprosthesis for unstable intertrochanteric fractures.

Between 1997 and 2001 we treated 54 elderly patients with unstable intertrochanteric fractures by primary hemiarthroplasty using a cemented bipolar prosthesis. Mean patient age was 75.6 (64-91) years and mean follow-up was 22.3 (5-48) months. Seven patients died before the fourth post-operative month. Thirty-three patients were able to walk with a walker in the first post-operative week. There were no dislocations or aseptic loosening. One deep infection was encountered after 1 year. Acetabular erosion was seen in one patient and non-union of the greater trochanter was seen in four. Five patients experienced leg-length discrepancy. We obtained 17 excellent and 14 good results after 12 months according to the Harris hip-scoring system. We observed that the inner motion of the bipolar head decreased over time.

Aged↗

Proximal oblique crescentic osteotomy in hallux valgus.

Twenty-six patients with moderate-to-severe hallux valgus deformities were evaluated before and after treatment. All of the patients had incongruent great toe joints. The patients underwent modified proximal crescentic osteotomy, which was termed proximal oblique crescentic osteotomy. The results were evaluated at an average follow-up time of 55 weeks. Objective criteria were hallux valgus angle, intermetatarsal angle, shortening of the first metatarsal, and angulation at the osteotomy site. Clinical evaluation was made according to the rating system of the American Orthopaedic Foot and Ankle Society. The mean correction of the hallux valgus and intermetatarsal angles was 22.1 degrees and 9.9 degrees, respectively. Short-term results indicate that proximal oblique crescentic osteotomy is effective in the treatment of hallux valgus; its advantages over other procedures include its technical ease and low rate of complications.

Combined Modality Therapy↗