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Biomedical subjects

Ibrahim Tuncay

Publications and source records attributed to Ibrahim Tuncay.

12 recordsLinked to original sources
PubMed2006

The pain associated with intraarticular hyaluronic acid injections for trapeziometacarpal osteoarthritis.

Trapeziometacarpal osteoarthritis predominantly affects middle-aged women. Most cases with rhizarthrosis can be managed successfully by conservative means. The purpose of this prospective study was to evaluate pain and tolerability of viscosupplementation therapy with hyaluronic acid (HA) for trapeziometacarpal osteoarthritis. Groups A and B consisted of eight patients each with Eaton stage 3 or 4 rhizarthrosis, who underwent one cycle of three injections of (one per week) 0.3 cm3 sodium hyaluronate. The injections for group A were under fluoroscopy control, but fluoroscopy was not used in group B. Pain and tolerability of both groups A and B were measured and compared. The patients of the groups were also asked to evaluate the tolerability of the treatment. The results suggested that HA injection in the carpometacarpal joint is a tolerable procedure but the patients complained of pain and discomfort during the injections. The pain in group A was much greater than in group B. Viscosupplementation for the treatment of trapeziometacarpal osteoarthritis is a viable treatment option for stages 3 and 4 patients when they do not want to be operated on. It is a tolerable but not a painless procedure especially when it is done without fluoroscopy control. We recommend giving injections under fluoroscopy control.

Fluoroscopy↗
PubMed2006

Linburg-Comstock anomaly in musicians.

Anomalous tendon connections from the flexor pollicis longus to the index finger flexor digitorum profundus cause lack of independent excursion of the flexor pollicis longus, first described in 1979 by Linburg-Comstock. This anatomical variation is potentially problematic for musicians. The purpose of this study was to evaluate the incidence of this anomaly in musicians and to operate on the symptomatic patients with a limited incision with the help of magnetic resonance imaging. We studied the incidence of the anomaly among 136 musician volunteers. A lower incidence rate of the anomaly was determined in this study. One of the symptomatic musicians was operated on and the tendinous connection was excised. Clinical examination of 136 volunteers suggested that the anomaly was present in 13% of the volunteers; unilateral in 9% and bilateral in 4%. Follow-up of the patient who was operated on revealed full pain-free function without any complaint. Surgical treatment although rarely necessary, is simple and effective.

Adult↗
PubMed2006

Anatomic localization of the popliteal artery at the level of the knee joint: a magnetic resonance imaging study.

PURPOSE: The anatomic localization of the popliteal artery in the mediolateral plane at the level of the joint line was investigated on axial knee magnetic resonance imaging (MRI) scans to study anatomic variations. METHODS: The transverse and central axes were described on axial MRI scans of 334 knees. The distance between the popliteal artery and central axis was measured; the course of the central axis bisected the posterior cruciate ligament in almost all of the cases. The differences in popliteal artery localization according to sex and side were analyzed. RESULTS: Whereas popliteal artery localization was lateral to the central axis in 94.3% of cases, it was on the central axis in 5.7%. The popliteal artery localization was not seen on the medial side of the central axis. There was no significant effect of sex and side. CONCLUSIONS: Arthroscopic surgeons performing posterior cruciate ligament reconstruction or interventions on the posterior horns of the menisci should bear in mind that the risk of arterial complication may be greater for cases having the popliteal artery on the central axis. In conclusion, preoperative evaluation of the popliteal artery with MR axial scans, especially in pericapsular arthroscopic procedures, may prevent popliteal artery injuries. LEVEL OF EVIDENCE: Level III, diagnostic study of nonconsecutive patients.

Adolescent↗
PubMed2005

A comparison of effects of fluoroquinolones on fracture healing (an experimental study in rats).

BACKGROUND: The objective of the present study was to test and compare the effect of fluoroquinolones on fracture healing as assessed histopathologically. METHODS: A total of twenty five Wistar rats were arbitrarily assigned to five groups with five animals each. Bilateral closed femoral fracture was constructed manually in all groups. The first group did not receive any drug as control (C). The 2nd, 3rd, 4th, and the last group were treated with norfloxacin (N), ofloxacin (O), pefloxacin (P) and ciprofloxacin (Ci) respectively. Antibiotic administration was started on the 7th day after the fracture incident. All the treatments were discontinued twenty days after the incident all the rats were sacrificed , and the fracture calluses together with affected femurs were resected en bloc at the fourth week after fracture. RESULTS: Average healing grades of control group was higher than all the other antibiotic groups. Mean healing grades of control ( 5 ; n:8), ofloxacin (4.1; n:7), ciprofloxacin (3.9; n:8), norfloxacin (3.4 ; n:9) and pefloxacin groups (2.6 ; n:10) were recorded. Statistically significant differences between antibiotherapy groups ( excluding. norfloxacin) and the control group were detected. CONCLUSIONS: The current histopathological study has shown that all the studied fluoroquinolones retarded fracture healing in rats.

Animals↗
PubMed2003

Posterior interosseous artery flap in traumatic hand injuries.

INTRODUCTION: Nineteen cases of posterior interosseous artery (PIOA) flap were reviewed. The patients' mean age was 24 (range 14-53) years. MATERIALS AND METHODS: Nine patients were operated on as emergencies, and 10 patients were treated electively. Mean time of delay after trauma was 7.8 h (range 2-20 h) in emergency cases. Nine of them were non-replantable amputations. Skin defects were between 1.9 x 2.4 cm and 5.0 x 12.0 cm. Mean hospitalization time was 2.2 (range 1-5) days. RESULTS: Mean flap sensation was evaluated as 2.83-6.65 with the Semmes-Weinstein evaluation scale (only 2 patients scored less than 3.61). Five patients presented with discoloration and coolness. Average subjective evaluation was 8.2/10. Mean web opening after first web reconstruction was 40 degrees. One posterior interosseous neuropraxia ( recovered in 4 months), one distal flap necrosis, and one flap lost (due to infection) occurred as early complications. Mean follow-up was 12.8 months (range 15 days to 30 months). CONCLUSIONS: PIOA flap applications have reduced the need for lateral arm and radial forearm flaps and also shortened hospitalization time in clinical practice.

Adolescent↗
PubMed2003

Morphologic evaluation of the ulna.

Intramedullary ulnar nailing may be technically difficult. We used various methods and measurements to determine the ideal nail entry point and the shape, length, diameter and curvature of the medullary canal in 44 human cadaver ulnas. We found that the ideal nail entry point was, on average, 7 mm proximal and 3 mm lateral to the most prominent area of the olecranon. A nail of 3 mm diameter could easily be inserted through a hole at the proximal-lateral side of the most prominent part of the olecranon, but only 20% of all nails could be easily inserted through a hole in the middle of the olecranon. We found that correct selection of a nail of proper length and diameter, as well as an ideal nail entry point on the olecranon are essential to successful nailing.

Adult↗
PubMed2003

A morphometric study on the humerus for intramedullary fixation.

In recent years, the popularity of intramedullary humeral nailing is on the rise in spite of its handicaps. There are many problems in intramedullary humeral stabilization because of the anatomic structure of the bone. We performed various methods and measurements to determine shape, length and diameter and curvature of the medullary canal of the humerus in 57 human dry cadaver bones. Anterior angulation with an average of 21 cm apart from greater tubercle was found at 1/3 distal part. Mean degree of angulation was 9 degrees (max: 15, minutes: 5, S.D.: 2.84). Humerus bones with septal aperture (supratrochlear foramen) at the fossa coronoidea were observed to have very narrow medullary canal. The best point for nail insertion was found to be an area on the line from greater tubercle anteromedially to caput humeri. This study revealed that carefully evaluated structure of humeral medullary canal and various congenital constructions such as septal aperture, and correct selection of a nail with proper length and diameter are essential for successful nailing.

Adult↗
PubMed2002

[Preliminary results for treatment of tibial plateau fractures with the Ilizarov technique of ligamentotaxis].

BACKGROUND: The results of the eight patients who admitted to emergency room with tibial plateau fractures and treated with Ilizarov technique, were retrospective evaluated both clinically and radiologically. METHODS: Seven (87%) men and one (13%) woman ranging in age from 23 to 38, were evaluated. All the cases were between type IV to VI according to Hohl classification preoperatively. Closed indirect reduction by ligamentotaxis was attempted in all fractures, no open technique was performed. RESULTS: Three (38%) cases had open fractures (type I according to Gustilo-Andersen Classification) preoperatively. Six (75%) traffic accident and two (25%) falling from a height were detected as etiology. The cases, whose average follow up was 14 (6-28) months, were evaluated according to Iowa knee score scale and seven (87%) cases were good and excellent. Both clinical and radiological solid fusion were obtained in all cases after removing the frame. Although all the cases had minimal to moderate pin tract infection, all were resolved with dressing and oral antibiotherapy without removing the wires. CONCLUSIONS: Closed reduction with Ilizarov technique is appropriate for treatment of plateau tibia fractures with minimal morbidity.

Adult↗
PubMed2002

Foucher's first dorsal metacarpal artery flap for thumb reconstruction: evaluation of 21 cases.

BACKGROUND: Coverage of part of a soft tissue defect in the thumb, without bone shortening and without long-lasting immobilization in an inappropriate position leading to stiffness, is difficult to achieve OBJECTIVES: To report our experience using Foucher's modification of the first dorsal metacarpal artery flap for thumb reconstruction in 21 cases. METHODS: Foucher's flap is based on the neurovascular structures of the first dorsal metacarpal artery flap and radial nerve-sensitive branches on the dorsum of the second metacarpal and proximal phalanx. The cause of injury was work-related in all 21 cases. The patients mean age was 37 (range 17-68 years), and mean follow-up was 19 months (range 12-31). Emergency surgery was performed in 13 patients with a time delay after injury of 4-12 hours. The minimum defect was 12 x 18 mm and the maximum 20 x 40 mm. Pedicular length was 55-95 mm. A skin bridge was left intact in 16 cases. In two cases of early postoperative venous congestion and flap loss, a cross-finger flap was performed as a salvage procedure. RESULTS: Subjective satisfaction score was 8.37/10 (range 4-10); cold intolerance was experienced in 60% and dysesthesia in 33%. All except one patient are able to use their thumb in daily activity. Loss of mobility in the proximal interphalangeal joint of the index finger was less than 20 degrees. Semmes-Weinstein sensitivity evaluation score was 3.61-4.31 on the flap and 0-6.65 on the donor site. Two-point discrimination was 10.8 mm (range 8-20). Grip strength was reduced by 15% compared to the unaffected hand (hand dominance was not taken into consideration). Rehabilitation was not consistent as almost all the patients were living in another location. CONCLUSIONS: First DMCA pedicle flap is a successful thumb reconstruction method, especially in patients not disturbed by its cosmetic appearance.

Accidents, Occupational↗
PubMed2002

[Comparison between fixation with Herbert screws and Kirschner wires in the treatment of scaphoid pseudoarthrosis].

OBJECTIVES: To compare the treatment results of patients with scaphoid pseudoarthrosis, who were treated by autogenous cancellous bone grafting followed by fixation with Herbert screws or Kirschner wires. METHODS: The study included 19 men (mean age 28 years, range 20 to 41 years) who were treated for scaphoid pseudoarthrosis and had a minimum follow-up of 12 months. Treatment was comprised of autogenous cancellous bone grafting and fixation with Herbert screws (n=10) or Kirschner wires (n=9). Fifteen right and four left hands were affected. The mean duration between the traumatic event and surgery was 20 months (range 3 to 72 months). Fractures were localized in the proximal pole (n=4, 21%), waist (n=13, 68%), and in the distal pole (n=2, 11%). The mean follow-up was 16 months for Herbert screws, and 21 months for Kirschner wires. RESULTS: None of the patients exhibited a loss in range of motion of 10 degrees or more. The mean time to union was six months (range 3 to 20 months) with Herbert screws and eight months (range 4 to 22 months) with Kirschner wires. All patients had union with Kirschner wires, whereas non-union occurred in three patients with Herbert screws, two of whom had had proximal pole fractures. Radiologic outcome was significantly different between the two groups (p<0.01). CONCLUSION: Because of good vascularity and union potential, scaphoid pseudoarthrosis can be successfully treated by an appropriate surgical technique using autogenous cancellous grafting independent of fixation materials.

Adult↗
PubMedDate not supplied

Effects of hyaluronic acid on postoperative adhesion of tendo calcaneus surgery: an experimental study in rats.

Adhesions are a significant problem after tendon surgery. The effects of hyaluronic acid on adhesion formation of the tendo calcaneus were investigated in this study. Twenty Wistar rats were utilized. Both tendo calcanei were incised transversely, and then repaired. Hyaluronic acid (0.2 cc) was injected into peritendinous tissue on the right side, while the same amount of normal saline was injected to the left side as a control. The animals were sacrificed 40days after the experiment. Both the right and left tendon adhesions were evaluated both macroscopically and microscopically for the presence of adhesions (grading scale 0-4). Throughout the experimental period, there was no difference in range of motion of the ankle between the two groups. Macroscopically, there were fewer adhesions in the experimental group (mean 0.6 +/- 0.8) compared to the controls (mean 1.1 +/- 0.2). This difference was not statistically significant (p = .096). Histopathologically, these parameters were similar in both the experimental (mean 1.15 +/- 0.98) and the control groups (mean 1.9 +/- 1.25). This difference was significant (p = .043). Hyaluronic acid may be effective for prevention of adhesions in the tendo calcaneus though this effect could not be demonstrated experimentally.

Adjuvants, Immunologic↗