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Biomedical subjects

I Gürkan

Publications and source records attributed to I Gürkan.

6 recordsLinked to original sources
PubMed2001

Arthroscopic fixation of intercondylar eminence fractures using a 4-portal technique.

PURPOSE: We report an easy-to-use 4-portal technique for arthroscopic treatment of intercondylar eminence fractures and compare results of 2 groups of cases, adolescents and adults, and 2 types of internal fixation, sutures and screws. TYPE OF STUDY: Surgical technique and retrospective study. METHODS: The study was carried on 2 groups of patients, adolescents and adults, with intercondylar eminence fractures who were treated arthroscopically. For internal fixation, sutures were used in 8 adolescents and screws were used in 13 adults. In the technique we describe, anteromedial superior and inferior, and anterolateral superior and inferior portals were used. RESULTS: The average follow-up period for the adolescents was 27.3 months (range, 11 to 57 months), and for the adults was 19.6 months (range, 7 to 71 months). We did not encounter any cases of nonunion. There were only 3 complications, 1 of arthrofibrosis resulting from a delay of rehabilitation due to a vascular compromise and 2 cases of tenderness over the screw that responded well to its removal. Union occurred earlier in adolescents, but rehabilitation was easier in adults. CONCLUSIONS: Beside satisfactory results obtained by arthroscopic treatment of intercondylar eminence fractures, arthroscopy also provides the possibility to determine and treat associated pathologies. With the experience we gained, the procedure with the 4-portal technique in treating these fractures became much easier as a routine approach.

Adolescent↗
PubMed2000

Arthroscopic resection of bucket-handle tears with the help of a suture punch: a simple technique to shorten operating time.

We describe a surgical technique that has been used successfully for excising bucket-handle tears. The technique is routinely used in our department and has been found to shorten operating time. A suture punch is used to pass the suture through the bucket-handle tear. Manually maneuvering the free suture ends, it is always possible to cut the posterior or anterior attachment of the tear under direct visualization without the need for an additional portal and without the risk of losing the excised fragment in the joint. In our experience, the technique is simple, inexpensive, and reliable, but more importantly, it has shortened operating time significantly.

Arthroscopy↗
PubMed1999

Surgical treatment of malignant tumours of the sacrum.

AIMS: We assessed the results of surgical treatment of malignant sacral tumours and aimed to supply information on incidence and distribution of these lesions. METHODS: Forty-six malignant cases out of 65 tumours of the sacrum were assessed retrospectively. Three of the patients did not accept treatment. Surgical treatment was applied to 23 (65.2%) of the remaining 43 patients. Surgical techniques used were resection and PMMA (polymethylmethacrylate) application through a posterior approach, sacral reconstruction, and resection through a combined posterior and anterior approach. RESULTS: Twelve of the lesions were primary while 34 were secondary. Among the primary sacrum tumours, the most common was chordoma (six cases, forming 9.2% of all the sacral lesions). Of a secondary sacral lesions, nine cases of breast carcinoma were found, forming the most common group. The recurrence rate was 23.3%. CONCLUSIONS: Chordoma was the most common primary sacral tumour, but found no incidence of giant cell tumour which has been previously reported as the second most common primary sacral tumour. We believe the posterior approach for resection of the tumour is sufficient in most instances and lumbopelvic instability must be prevented by reconstructive procedures.

Bone Neoplasms↗
PubMed1999

Anterior instrumentation for the treatment of spinal tuberculosis.

BACKGROUND: Kyphosis and neurological impairment are the major residual problems of spinal tuberculosis after the microorganism has been eradicated with use of appropriate medications. Spinal instrumentation is needed to support anterior strut grafts in patients who have kyphosis that affects more than two levels. Most surgeons use posterior instrumentation. Anterior instrumentation, despite its advantages, has not been widely accepted, partly because of concerns about introducing foreign material into infected tissue. The purpose of the current study was to address those concerns. METHODS: Twenty-two patients who had tuberculosis of the spine with moderate-to-severe localized kyphosis and sixteen patients who had more than two involved levels had stabilization with anterior instrumentation. Antituberculous medication was used postoperatively according to a standardized regimen. The patients were followed to determine if there was any recurrence of the disease and if the correction had been maintained. RESULTS: The twenty-two patients who had involvement of one or two levels had an average correction of the deformity of 64 percent (range, 58 to 90 percent), and the sixteen patients who had more than two levels of involvement had an average correction of 81 percent (range, 75 to 97 percent). The correction was maintained in twenty-one patients, the maximum loss was 3 degrees in sixteen, and one patient died on the second postoperative day. There was no recurrence of the disease. CONCLUSIONS: We believe that anterior instrumentation is more effective than posterior instrumentation for reducing the deformity and stabilizing the vertebral column in patients who have kyphosis related to tuberculosis of the spine.

Adolescent↗
PubMed1995

[Hospital structure and control measures].

A new legislation concerning financial matters of hospitals in Germany requires fundamental changes and adjustment. Formerly grown structures of a high-grade centralization erode into a process of change. Despite hospitals will maintain their non-profit character in public health services, modifications of medical care processes will promote elements of cost-centres. All medical care units as well as hospital management are confronted with rising requirements concerning performance and transparency. Increasingly patients and social health insurances behave like self-confident customers not willing to accept rising costs. Public health services loose their character of a planned economy. Hospitals with features of health-entrepreneurship are on the incline. A process of quality-planning and efficient management has been evoqued.

Cost Control↗