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Biomedical subjects

I Turan

Publications and source records attributed to I Turan.

At least 19 recordsLinked to original sources
PubMed2000

Neuropeptide- and tyrosine hydroxylase-immunoreactive nerve fibers in painful Morton's neuromas.

We examined the expression of three neuropeptides that have been implicated in nociceptive transmission, and the sympathetic nerve fiber marker tyrosine hydroxylase, in 11 painful human Morton's neuromas, using immunohistochemistry. Antibodies against the neural markers RT97 and PGP 9.5 were used to map the general nerve fiber organization of the neuromas. Four specimens of normal human peripheral nerves were used as controls. Substance P, calcitonin gene-related peptide, and neuropeptide Y immunoreactivities were more pronounced in neuroma tissue than in control nerves. Neuropeptide immunofluorescence was seen both in larger nerve fiber trunks and in masses of disorganized axon profiles dispersed in loose connective tissue. Tyrosine hydroxylase immunoreactivity was present at varying levels of expression in neuroma nerve fiber trunks, in connective tissue nerve fiber bundles, and around some blood vessels. Our findings suggest that neuropeptides are involved in the response to injury in Morton's neuromas and that they could play a role in initiation or modulation of pain. In addition, pain from Morton's neuromas could be influenced by sympathetic nerve fibers.

Adult↗
PubMed1997

Tarsal tunnel syndrome. Outcome of surgery in longstanding cases.

Cases of longstanding (median, 60 months) tarsal tunnel syndrome were decompressed surgically in 14 female and four male patients. Patients reported intermittent dysesthesia, paresthesia, or anesthesia at the medial plantar aspect of the foot. Symptoms were aggravated by physical activities. Previous trauma was noted in four patients. Tinel's sign was positive in 16 patients. Magnetic resonance imaging was performed in 10 patients but was conclusive in only two. At surgery, the posterior tibial nerve or one of its branches was found to be entrapped in 15 patients. Entrapments were observed isolated or in combination within the fascial septa (n = 5), varicose veins (n = 6), scar tissues (n = 4), tenosynovitis and edema (n = 1), or within the abductor hallucis muscle (n = 1). Two neuromas were excised. In three patients no obvious entrapments were found. Clinical followup was performed a median 18 months after surgery. Relief of symptoms was reported as long as 1 year after surgery. All symptoms were relieved in 11 (61%) patients. Three (17%) patients with previous trauma had relatively severe pain after surgery and were considered to have failed results. Surgical decompression was beneficial in most patients with longstanding tarsal tunnel syndrome.

Activities of Daily Living↗
PubMed1996

A study of intrinsic factors in patients with stress fractures of the tibia.

We aimed to study intrinsic factors in 29 consecutive patients with well-documented unilateral stress fractures of the tibia. Anthropometry, range of motion, isokinetic plantar flexor muscle performance, and gait pattern were analyzed. The uninjured leg served as the control. A reference group of 30 uninjured subjects was compared regarding gait pattern. Anterior stress fractures of the tibia (N = 10) were localized in the push-off/ landing leg in 9/10 athletes, but were similarly distributed between legs in posteromedial injuries (N = 19). Ten (30%) of the stress fracture subjects had bilateral high foot arches, similar to those found in the reference group. There were no other systematic differences in anthropometry, range of motion, gait pattern, or isokinetic plantar flexor muscle peak torque and endurance between injured and uninjured legs. No other differences were found between anterior and posteromedial stress fractures. We conclude that anterior stress fractures of the tibia occur mainly in the push-off/landing leg in athletes. Within the limitations of our protocol, no registered intrinsic factor was found to be directly associated with the occurrence of a stress fracture of the tibia.

Adolescent↗
PubMed1995

Arthroscopic ankle arthrodesis in rheumatoid arthritis.

Several techniques for ankle arthrodesis have been described. Many of them are not suitable in patients with severe rheumatoid arthritis because of multiple joint involvement, osteoporosis, and increased risk of infection caused by poor skin conditions. The arthroscopic technique described in this article has been used in 7 patients with seropositive rheumatoid arthritis and 1 patient with seronegative rheumatoid arthritis (10 ankle joints; 2 patients surgically treated bilaterally). All patients successfully obtained ankle joint arthrodesis. The mean time to fusion was 10 weeks (range, 6-12 weeks). There was a 100% fusion rate without any complication.

Aged↗
PubMed1992

The effect of weight-bearing pressure on the plantar circulation in diabetes mellitus.

Patients with diabetic neuropathy are prone to ulceration on the sole of the foot, especially in areas with high weight-bearing pressure. The relationship between weight-bearing pressure and nutritive skin circulation in the plantar region was studied. Gait analysis was performed with the EMED Gait Analysis System and the skin circulation was measured by fluorescein flowmetry in ten neuropathic diabetic patients and in eight healthy controls. The critical plantar foot pressure above which nutritional blood flow in the skin was arrested was 3 N cm-2 or more in both diabetic and control subjects. Below 3 N cm-2 the blood flow was independent of weight-bearing pressure both in diabetic and control subjects (correlation coefficient r = -0.01 and -0.19, respectively). Thus, our results indicate that the nutritional blood flow in the plantar region is not decreased in patients with diabetic neuropathy.

Adult↗
PubMed1991

Surgical treatment of forefoot deformity with special reference to polyarthritis.

Among 523 patients consecutively treated for forefoot pain and deformity, 64 had inflammatory arthritis. Most patients no longer had difficulties finding shoes that fit after the deformities were surgically corrected. Although about one half of the patients had some residual symptoms after treatment, 57 (89%) were satisfied with the operation. If the deformities are corrected early, joint resections can be avoided and toe function preserved.

Adolescent↗
PubMed1987

Compression-screw arthrodesis of the first metatarsophalangeal joint of the foot.

The function of the foot is disturbed by a stiff, painful great toe. This problem can be overcome with a new technique for fusing the first metarsophalangeal joint at the desired angle with the joint surfaces conservatively resected with parallel, oblique cuts. The bones are then approximated and fixed in 20 degrees-30 degrees of dorsoflexion with two compression screws. The operation should shorten the toe 1.0 to 1.5 cm and give it a moderately valgus orientation. No additional fixation is used. Twenty patients were treated in a prospective study, and all fusions healed. After one year, 13 patients were free of symptoms, five had minimal symptoms, and two still had pain; poor results may be related to the malposition of the fused joint. The technique was simple, involved limited discomfort for the patient, and generally produced a functioning forefoot.

Adult↗
PubMed1983

A new operation for hallux valgus.

A distal oblique osteotomy on the first metatarsal, with lateral displacement of the metatarsophalangeal joint and internal fixation with a compression screw, was performed. No splint or plaster was used. The operation is relatively simple and effective. Pain and discomfort during a short healing period are minimal. Forty-nine feet were operated on in 42 patients by eight surgeons. The patients were advised to bear full weight after six weeks. Return to unlimited work was possible after six weeks. The complications were superficial infection in one case and screws entering the metatarsophalangeal joint in two cases. One patient complained of metatarsalgia after the operation, but all other patients were satisfied after follow-up periods ranging from three months to six years.

Adolescent↗
PubMedDate not supplied

Dislocation of the tibialis posterior tendon: diagnosis and treatment.

Traumatic dislocation of the tibialis tendon occurred from minor ankle sprains in a 37-year-old male and a 53-year-old female. Both complained of local pain at the medial malleolus, and both walked with a limp. The diagnosis was suspected by clinical examination, in one case with 2 months' delay, and verified by ultrasound, computed tomography, and magnetic resonance imaging. The male patient was initially treated for an "uncomplicated ankle sprain." For various reasons surgery was delayed 4 months. During this interval the male patient complained of pain and severe dysfunction, requiring analgesic treatment. A medial Achilles tendon flap was used to support the repositioned tendon. The female patient was operated on within 1 week from injury, by resuturing of the retinaculum over the tendon. Postoperatively, both patients were immobilized with below-knee casts for 6 weeks, allowing full weightbearing, followed by strength and stretching exercises. They were free of symptoms 2 and 3 months, respectively, after surgery. At follow-up 1 year postoperatively, both were asymptomatic and participated in activities like those before their injuries.

Adult↗
PubMedDate not supplied

Plantar fascia rupture: diagnosis and treatment.

Two patients with spontaneous medial plantar fascia rupture due to a definite injury with no prior symptoms, were referred to our institution. Clinically, there was a tender lump in the sole, and magnetic resonance imaging confirmed the diagnosis. Nonoperative treatment was sufficient in curing the acute total rupture. Endoscopic release was used on the partially ruptured plantar fascia, but it is probably more optimal in the acute phase. The literature provides no comparative data on operative or nonoperative treatment efficacy for this rare condition.

Adult↗
PubMedDate not supplied

Complications with infection and foreign body reaction after silicon implant arthroplasty in the second metatarsophalangeal joint in an adolescent: a case report.

A 21-year-old otherwise healthy male was referred to our clinic due to severe pain, deformation, development of fistules, and swelling of the second metatarsophalangeal joint of the right foot. He presented a history of two previous operations. At the age of 13, a 2-cm. resection of the distal part of the proximal phalanx was performed due to severe hammertoe deformity. At the age of 19, a partial phalanx resection and implantation of a silicon elastomer ball-shaped joint spacer was performed due to second metatarsophalangeal joint instability. After this operation, the patient suffered from fistules that appeared in the second metatarsophalangeal region. Following referral to our clinic, the patient was operated on. The proximal phalanx was removed along with the prosthesis which had slipped from the metatarsophalangeal joint into the proximal phalanx with the ends of the prosthesis perforating the skin. Debridement of infected tissue and implantation of gentamicin containing beads were performed. Bacterial specimens revealed growth of coagulase-negative staphylococci. Microscopic examination of the debrided tissue showed signs of acute and chronic inflammation. Postoperatively, the patient was treated with antibiotics and healing was uneventful. This case advocates the need for proper selection criteria and strict indications in patients with joint disease needing an arthroplasty.

Adolescent↗
PubMedDate not supplied

Ankle arthrodesis by the Heiple technique in rheumatoid arthritis.

The authors report on seven rheumatoid arthritic patients that successfully sustained ankle joint arthrodesis. They incorporated a chevron fusion technique previously described. Patients were followed an average of 44 +/- 11 months. They report a satisfactory result.

Aged↗
PubMedDate not supplied

Computed tomography for diagnosis of Morton's neuroma.

Fifteen patients suspected to have Morton's neuroma were examined by computed tomography, which revealed the neuroma in seven cases. All seven underwent surgery and had the diagnosis confirmed. If there is doubt about the diagnosis, it is possible to use computed tomography as shown here.

Adolescent↗
PubMedDate not supplied

Postoperative evaluation of Keller's arthroplasty and arthrodesis of the first metatarsophalangeal joint using the EMED gait analysis system.

The authors examined 10 patients who had arthrodesis at the first metatarsophalangeal joint and 10 patients who had Keller's arthroplasty operation. The EMED gait analysis was used to measure the pressure distribution over the sole of the foot during walking. Arthrodesis group had significantly increased maximum pressure in the first and third metatarsal regions. The Keller arthroplasty group had the lowest maximum pressure in the big toe but it was not significant.

Adult↗
PubMedDate not supplied

Gait analysis in hallux valgus.

The solar pressure zones were analyzed in the feet of 66 patients suffering from hallux valgus, together with 60 normal subjects. The EMED Gait Analysis System was used. In the hallux valgus group, the maximum pressure was found to be increased significantly in the small toe region and more proximally situated, close to the metatarsophalangeal joint. In the normal subjects, the maximum pressure was increased significantly in the first, second, third, and fourth metatarsal and heel regions. In general, the hallux valgus group had smaller contact areas compared to the control group. The increased pressure in the small toe region, together with the smaller contact areas manifested by the hallux valgus group, were interpreted in this work as being the possible causes of the metatarsalgia seen in patients with the deformity.

Female↗