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Biomedical subjects

I Günal

Publications and source records attributed to I Günal.

At least 19 recordsLinked to original sources
PubMed2003

Autoerythrocyte sensitization (Gardner-Diamond) syndrome mimicking compartment syndrome.

We report a case with an unusual manifestation of autoerythrocyte sensitization syndrome (Gardner-Diamond syndrome). The patient had the clinical signs of compartment syndrome of the forearm requiring fasciotomy. Dermatological signs identical to Gardner-Diamond syndrome should alert the physician to avoid unnecessary fasciotomy, as these patients respond well to psychiatric treatment as in the present case.

Adult↗
PubMed2003

Do orthopaedic journals provide high-quality evidence for clinical practice?

BACKGROUND: In the hierarchy of research designs, randomized controlled trials and meta-analyses are considered to be evidence of the highest grade, and scientific journals are the main source of scientific information. METHODS: Using the National Library of Medicine Medline database, all randomized controlled trials and meta-analyses from 1966 to 1999 were retrieved from the journals indexed in the core list of the Science Citation Index in 1999, dedicated primarily to orthopaedics. The abstracts of the articles were reviewed independently by each author and classified by the year, journal name and subject. RESULTS: The total number of articles was 36,293, of which only 671 were randomized controlled trials (1.85%) and 12 were meta-analyses (0.03%). Although there was a progressively increasing trend for randomized controlled trials, more than half of them (81.9%) were published in four journals. Of the randomized controlled trials, 66% was about arthroplasty, and hip and knee arthroplasties covered 90.7%. CONCLUSION: Although the number of randomized controlled trials and meta-analyses is tending to increase, the conclusion of this study is that the high-quality evidence provided by the major orthopaedic journals is quite low, and more randomized controlled trials and meta-analyses are needed for evidence-based orthopaedic practice.

Evidence-Based Medicine↗
PubMed2002

Medium-term results of trapezio-lunate external fixation for scaphoid fractures.

We treated 36 scaphoid fractures in 34 patients with trapezio-lunate external fixation. According to the Herbert and Fisher classification, there were 16 type B1, 14 type B2, four type B3 and two type B4 fractures. Trapezial and lunate pins broke in three patients and these were rated as failures. The remaining 33 fractures were followed-up for 3 years and all had excellent outcomes, without signs of arthritis, avascularity or instability.

Adolescent↗
PubMed2002

Local injection treatment for lateral epicondylitis.

In a prospective randomized study of lateral epicondylitis, 120 patients were treated with 2 mL lidocaine (Group A, n=60) or 1 mL lidocaine combined with 1 mL triamcinolone (Group B, n=60). All injections were done using the peppering technique: after inserting the needle the tender area was peppered with 40 to 50 injections by injecting, withdrawing, redirecting, and reinserting without emerging from the skin. All patients were followed up for 1 year. Fifty-six patients in Group A and 57 patients in Group B had excellent results. There was statistically no difference between the groups. Both groups had excellent results and because the injection of local anesthetics is known to have no long-term effect in the treatment of lateral epicondylitis, the peppering technique seems to be a reliable method of treatment.

Adult↗
PubMed2001

Normal range of scapular elevation and depression in healthy subjects.

The scapular elevation (shoulder shrug), depression, and total elevation-depression motion in 30 healthy subjects were measured by goniometer under standardized conditions. Mean values were 37.74, 8.39, and 44.60 deg, respectively. The intraobserver variation was calculated as 1.3 deg, and the interobserver variation was 1.8 deg. There was no difference between the sides. This previously unreported values may be used in the evaluation of shoulder and neck disorders.

Adolescent↗
PubMed2001

Effect of preoperative chemotherapy on the outcome of surgical treatment of vertebral tuberculosis: retrospective analysis of 434 cases.

A retrospective analysis of 434 patients with vertebral tuberculosis who were treated surgically was performed with special reference to the preoperative duration of chemotherapy. Of these, 376 underwent 4 weeks of a chemotherapy regimen with isoniazid, rifampin and ethamburol, and in 2 re-activation of the disease was observed. The remaining 58 underwent operation for neurological impairment with 6-18 h of the same chemotherapy regimen, and in no case did re-activation occur. These results suggest a shorter duration of chemotherapy may be utilised in all patients undergoing surgical treatment for vertebral tuberculosis, providing a thorough debridement is performed, leaving no necrotic or infected tissue behind.

Adolescent↗
PubMed2001

The droopy shoulder syndrome.

Droopy shoulder syndrome (DSS) is characterized by a depression of the shoulders that stretches the brachial plexus, thus causing pain without any signs of neurological impairment. We describe ten patients with DSS; all had been treated for different diagnoses before. Contrary to previous reports, three patients had unilateral involvement, and five had accompanying disease of the cervical-shoulder region. All patients responded well to conservative treatment in 2-10 weeks. DSS must be kept in mind in the differential diagnosis of pain in the cervical-shoulder region, to prevent unnecessary medication.

Adolescent↗
PubMed2001

The association of HLA-DR4 antigen with juvenile chronic arthritis and slipped capital femoral epiphysis.

Seventeen children who met the criteria for juvenile chronic arthritis (JCA) were reviewed. Throughout the study, the clinical examination, HLA phenotyping, and radiological assessment of the hips were performed by separate authors who were blinded to other data. At the end of the study, the results were also compared with 25 healthy, age- and sex-matched children. Six of the children with JCA also had radiological signs of slipped capital femoral epiphysis (SCFE; five with minimal slip pattern, one with moderate slip), and five of them had DR4 in their genotypes, in contrast to the remaining 11 patients who did not (p < 0.001). On the other hand, only 2 of 25 children in the control group had DR4 (p < 0.01). The difference was not significant when the patients without SCFE were compared with the control group (p = 1.0). The relative risk of cases with DR4 antigen for SCFE was 57.5, while it was below I for the other antigens. These results suggest that although DR4 is not specific for JCA, it is the common HLA antigen for those who have SCFE, and patients with JCA and HLA-DR4 antigen should be examined for evidence of SCFE, which was not reported before to exist with JCA.

Adolescent↗
PubMed2001

Prevention of heterotopic ossification after total hip replacement: a prospective comparison of indomethacin and salmon calcitonin in 60 patients.

We did a prospective consecutive study of prophylaxis for heterotopic ossification (HO) comparing indomethacin (100 mg/day) and salmon calcitonin (3 MRC-U/kg/day) for 14 days. Each group consisted of 30 patients. 19 patients in the indomethacin group and 2 in the calcitonin group developed HO. We conclude that use of calcitonin in the prophylaxis of HO after total hip replacement is more effective than indomethacin.

Aged↗
PubMed2001

Arthroscopic-assisted percutaneous stabilization of patellar fractures.

The authors did percutaneous, arthroscopic-assisted osteosynthesis of patellar fractures associated with skin abrasions and lacerations in 11 patients. Skin problems did not delay the operation and the rehabilitation. The average followup was 2.8 years. All fractures healed without complications and good results were obtained in all patients using the criteria of Levack et al. This technique avoids the problems of patellar fractures with skin abrasions and may be adapted to other fractures of the patella.

Adult↗
PubMed2001

Patellectomy: an overview with reconstructive procedures.

Patellectomy is a relatively old procedure and its effect on knee function has been a matter of controversy. Although indications for a patellectomy have been narrowed, patellectomy still is indicated as the last choice of treatment in certain situations including comminuted fractures, advanced chondromalacia or osteoarthritis, dislocations, infections, and tumoral conditions. Excision of the patella results in a decrease in the moment arm of the extensor mechanism, alteration of the forces acting on the tibiofemoral joint and instant center of motion, limitation of range of motion, anterior instability, loss of protection of the trochlea from injury, and poor cosmesis. A good technique of patellectomy should overcome all or at least some of these problems. Although comparison of various techniques of patellectomy is impossible because of the lack of prospective randomized trials, reinforcement techniques seem more logical than simple repair procedures.

Humans↗
PubMed2000

Inheritance of the accessory navicular bone.

The accessory navicular bone is one of the most symptomatic bones of the foot. Although it has been reported to be present in various members of the same family, there is a lack of knowledge about its inheritance in the literature. We examined three families and suggest that it has an autosomal dominant trait with incomplete penetrance.

Adolescent↗
PubMed2000

Rotational profile of the lower extremity and foot progression angle: computerized tomographic examination of 50 male adults.

Acetabular, femoral and tibial torsion of 50 normal adult male subjects were measured by computerized tomography and the relationship between these angles and foot-progression angle was examined. The mean acetabular anteversion was 15.6 degrees on the right and 15.8 degrees on the left, (range 3 degrees-30 degrees). The mean femoral torsion was 6.5 degrees on the right and 5.8 degrees on the left (range 14 degrees-28 degrees). The mean tibiofibular torsion was 30.9 degrees on the right and 29.1 degrees on the left (range 16 degrees-50 degrees). Although the normal range of torsional measurements of the lower extremity was very broad, subjects usually had out-toeing, with a mean foot-progression angle of 13.7 degrees on the right and 13.0 degrees on the left (range 6 degrees-21 degrees). No correlation was detected on the rotation between different levels of the lower limb. No difference was detected in the lower extremity rotational profile between right and left sides.

Acetabulum↗
PubMed2000

Interspinous distance in congenital dislocation of the hip.

We measured radiographically the interspinous distance in 50 normal children and in 50 children with congenital dislocation of the hip. The value increased proportionally with age in normal children, but not in those with congenital dislocation of the hip. Our results indicate that a bony parameter, rather than the age of the child, is suitable for the indication of lower age limit for Salter's innominate osteotomy.

Age Factors↗
PubMed2000

Evaluation of simple excision in the treatment of symptomatic accessory navicular associated with flat feet.

The results of 17 patients who had been treated by simple excision, for symptomatic accessory navicular were reviewed 2 to 5 years postoperatively. Although all patients had good or excellent results by subjective criteria, careful examination revealed difficulty in performing the "single-heel rise test" in 8 patients who also had preexisting flat feet. These results suggest the necessity for an objective evaluation system, as well as a different treatment approach, for the association of accessory navicular and flat foot.

Adolescent↗
PubMed2000

The relationship between the tibialis posterior tendon and the accessory navicular.

Out of a total of 116 cadaver feet, 29 specimens were selected by means of palpation of the tuberosity of navicular for a possible presence of the accessory navicular. They were then radiographed and the accessory navicular was detected in ten. Also three fresh amputation specimens with an accessory navicular were added to the study. A total of 13 legs was dissected and in nine of them, the tibialis posterior tendon inserted directly into the accessory navicular without extending to the sole of the foot. In these feet, the second part of the tibialis posterior tendon originated from the accessory navicular, extending to the normal insertions. There was no connection between these two parts and when traction was applied to either one, no movement was observed in the other. Also a fibrocartilaginous mass was detected in four specimens, probably formed to resist the friction between the tendon and the bone. These results may explain the pronated foot in the presence of the navicular, due to the loss of the function of the tibialis posterior tendon.

Aged↗