Biomedical subjects

Mehmet Subaşi

Publications and source records attributed to Mehmet Subaşi.

10 recordsLinked to original sources

PubMed2005

[The use of local anesthesia in endoscopic release of the carpal tunnel].

OBJECTIVES: We evaluated the early results of endoscopic carpal tunnel release with the use of local anesthesia. METHODS: Endoscopic carpal tunnel release was performed in 14 hands of 10 patients (8 females, 2 males; mean age 43 years; range 35 to 58 years) using the two-portal Chow technique following local anesthesia described by Wood and Logan. Involvement was in the right hand in five patients, in the left in three, and in both hands in two patients. Electromyography showed moderate or severe compression of the median nerve in the carpal tunnel and the Tinel's and Phalen's signs were positive in all the patients. There was no previous history of metabolic diseases such as diabetes mellitus, gout, or hypothyroidism, nor a coexisting pregnancy. The decision for surgery was given at the end of an unsuccessful conservative treatment for a month. The mean follow-up period was 16 months (range 10 to 24 months). RESULTS: Two patients (14.3%) required further anesthesia with local anesthetic agents and sedation in the incision area. No complaints of paresthesia were seen during injections. Injection-associated problems such as increased thickness of the synovial layer or decreased endoscopic view did not occur. No instances of tendon or nerve injury, hematoma, or sympathetic dystrophy were seen. One patient developed neuropraxia in the third and forth fingers postoperatively. Early postoperative pain was observed in two wrists, appearing 10 days and two months after surgery, respectively. During the follow-up period, all the patients were free of preoperative complaints and no recurrences were encountered. CONCLUSION: Local anesthesia is a rapid and reliable technique in carpal tunnel surgery, enabling hospitalization confined to the same day.

Adult↗

PubMed2005

[Minimally invasive plate osteosynthesis in the treatment of femur fractures due to gunshot injuries].

OBJECTIVES: The results of treatment with minimally invasive plate osteosynthesis were evaluated in open comminuted femur fractures due to high-velocity gunshot injuries. METHODS: Seventeen patients (15 males, 2 females; mean age 34 years; range 15 to 67 years) with open comminuted femur fractures due to high-velocity gunshot injuries were included. The fractures were classified according to the AO system. Timing of minimally invasive percutaneous plate fixation was determined according to the classification of open fractures in the Gustilo-Anderson system. There were seven subtrochanteric, seven supracondylar, and three diaphyseal fractures. During surgical exploration, two patients underwent vascular repair for related pathologies. No exploration was performed in two cases with neurological damage. Seven patients were operated on in the early period (mean 1.3 days; range 1 to 2 days) and 10 patients in the late period (mean 11.1 days; range 7 to 15 days). The mean follow-up was 25 months (range 14 to 42 months). RESULTS: Union was obtained in a mean of 4.4 months (range 2.5 to 7 months) in 16 patients. Autogenous grafting was performed in four patients who presented with a cavitation and defect in the late period and in one patient due to delayed union in the postoperative fourth month. Complications included superficial infection in one patient (5.9%), deep infection in one patient, and leg length discrepancy (0.5 cm to 2 cm) with a varus-valgus angulation (mean 5 degrees , range 3 to 8 degrees ) in eight patients (47.1%). No refractures occurred during the follow-up period. CONCLUSION: Minimally invasive percutaneous plate fixation can be considered an alternative technique in type IIIA and IIIB open fractures resulting from high-velocity gunshot injuries.

Adolescent↗

PubMed2004

Early prophylactic autogenous bone grafting in type III open tibial fractures.

The authors report the results achieved in patients with type III open tibial fractures who underwent primary autogenous bone grafting at the time of debridement and skeletal stabilisation. Twenty patients with a mean age of 35.8 years (range, 24-55) were treated between 1996 and 1999. Eight fractures were type IIIA, 11 were type IIIB, and 1 was type IIIC. At the index procedure, wound debridement, external fixation and autogenous bone grafting with bone coverage were achieved. The mean follow-up period was 46 months (range, 34-55). The mean time to fixator removal was 21 weeks (range, 14-35), and the mean time to union was 28 weeks (range, 19-45). Skin coverage was achieved by a myocutaneous flap in 2 patients, late primary closure in 4, and split skin grafting in 14. One (5%) of the patients experienced delayed union, and 1 (5%) developed infection. In tibial type III open fractures, skin coverage may be delayed, using the surrounding soft tissue to cover any exposed bone after thorough débridement and wound cleansing. Primary prophylactic bone grafting performed at the same time reduces the rate of delayed union, shortens the time to union, and does not increase the infection rate.

Adult↗

PubMed2003

[The floating knee in adults: twenty-four cases of ipsilateral fractures of the femur and the tibia].

OBJECTIVES: We evaluated the presenting features of ipsilateral femoral and tibial fractures in adults, and the effects of both fracture type and severity of skeletal injury on the results. METHODS: The study included 24 patients (22 men, 2 women; mean age 38 years; range 17 to 75 years). According to the classification by Letts et al., the types of the fractures were as follows: type A (7), type B (2), type C (5), type D (7), and type E (3). Femur fractures were treated by locked intramedullary nails, AO plates, plate-screws, unilateral external fixator, or dynamic condylar screws, and tibia fractures by external fixator, plate-screws, locked intramedullary nailing, or with conservative methods. Amputation at the fracture level was required in a patient with type 3C open tibia fracture. The mean follow-up was 3.2 years (range 1.3 to 7 years). RESULTS: According to the criteria by Kalström and Olerud, the results were excellent in three patients, good in nine patients, fair in five patients, and poor in six patients. The mean skeletal injury scores were 4.4 and 3 in patients having fair and poor results and in those with good and excellent results, respectively. Fair and poor results corresponded to type A (1 patient), type C, type D, or type E fractures. Five patients with type 3 open fractures had fair or poor results. Thirteen patients (54%) had at least one complication. CONCLUSION: Patients with type C, D, or E fractures and those with greater skeletal injury scores are more likely to have fair or poor results due to the open nature of the fracture and to increased involvement of the knee joint. Although there is not an ideal method, rigid internal fixation seems to be more appropriate in fractures other than type 3 open tibia fractures.

Adolescent↗

PubMed2003

[Comparison between the results of intramedullary nailing and compression plate fixation in the treatment of humerus fractures].

OBJECTIVES: The results of open reduction and internal fixation of humeral shaft fractures by either an intramedullary nail or a dynamic compression plate were compared. METHODS: The study included 60 patients (43 males, 17 females; mean age 38 years; range 19 to 61 years) with humerus fractures. Thirty-three patients were treated with intramedullary nails and 27 patients with dynamic compression plates. Functional results were evaluated according to the Stewart and Hundley's criteria. The two methods were compared. The mean follow-up period was 42 months (range 28 to 72 months). RESULTS: Healing times did not differ between the two treatment groups (p>0.05). Radial nerve palsy occurred only in the dynamic compression plate group, with four patients being affected. On the other hand, the rate of non-union was significantly higher in patients treated with intramedullary nailing (p<0.05). CONCLUSION: No ideal fixation technique exists in the treatment of humerus fractures. Despite higher non-union rates, intramedullary nailing may be the method of choice in the treatment of humerus fractures because of such advantages as low morbidity, small dissection of soft tissues, and greater ease of application.

Adult↗

PubMed2002

Frontal cephalometric analysis in the evaluation of facial asymmetry in torticollis, and outcomes of bipolar release in patients over 6 years of age.

BACKGROUND: The aim of this study was to investigate the mid-term results of bipolar release in congenital muscular torticollis patients over 6 years of age, and the efficacy of frontal cephalometric analysis in the determination and follow-up of facial asymmetry. METHODS: Twelve patients (9 boys, 3 girls) from 7 to 12 years of age were included in the study. Bipolar release was performed, followed by 5-7 days of traction and 3 months of physiotherapy. Posteroanterior cephalometric radiography was performed at the beginning of and after therapy. The postural symmetry angle (PSA) was used to determine the presence and severity of facial asymmetry. A modified version of Lee et al.'s system was used in evaluating the results. RESULTS: The average follow-up period was 3 years and 5 months. According to the congenital muscular torticollis evaluation system, the outcome was excellent in 2 of the patients, good in 6, fair in 2 and poor in 2. Asymmetry was not severe in all patients at the beginning of therapy according to PSA values, being insignificant in 2, mild in 6, and severe in 4. The PSA results of the last examination indicated that severe facial asymmetry persisted in 3 patients. In 2 of them, PSA values remained within the limits of severe asymmetry despite a slight angular correction. DISCUSSION: Congenital muscular torticollis patients can benefit from surgical treatment over the age of 6 years. Bipolar release is an adequate and complication-free method. Moreover, PSA may be used as an objective method in the determination and follow-up of facial asymmetry in torticollis patients.

Adolescent↗

PubMed2002

[The treatment outcomes of children with Gustilo-Anderson grade II and grade III open fractures of the long bone].

BACKGROUND: We evaluated the treatment results in thirty-two children who had grade 2 and 3 open fractures according to classification of Gustilo-Anderson. METHODS: There were 21 (%65) male and 11 female (%35) patient and the mean age was 9 years (range, 4-14 years). There were 18 (%56) grade-2, 7 (%22) grade-3A, 5 (%15) grade-3B, and 2 (%6) grade-3C open fracture. All fractures were irrigated and debrided, and then fixed with external fixators. The average duration of follow-up was 11 months (range, 6-28 month). RESULTS: All fractures healed. Inadequate recovering was detected in four patients who had nerve injury, in addition the joint limiting contracture occurred on six patients. CONCLUSION: Fracture union without segmental bone loss is not a significant problem in open fractures in children, and that joint contractures, compartment syndrome and nerve injuries negatively affect the late outcomes.

Adolescent↗

PubMed2002

[Treatment of femoral shaft fractures with interlocking intramedullary nailing].

OBJECTIVES: Fractures of the femoral shaft are one of the most common fractures and may result in extensive disability, prolonged morbidity, or mortality unless appropriate treatment is applied. There are several treatment alternatives. In this study, we evaluated early results of interlocking intramedullary nailing in patients with femoral shaft fractures. METHODS: Femoral fractures of 42 patients (34 males, 8 females; mean age 32 years; range 16 to 67 years) were treated with interlocking intramedullary nailing. The mean follow-up was 14.4 months (range 8 to 32 months). Radiologic and clinical results were evaluated. RESULTS: Union was obtained in all but one patient within a mean duration of 18.2 weeks. Discrepancy of leg length was measured as 10 mm in six patients, and 25 mm in one patient. One patient (2.38%) developed deep infection. Knee flexion was more than 120 degrees in 95.23%. According to Thoresen's criteria, the results were excellent and good in 89% of patients. CONCLUSION: Interlocking intramedullary nailing proved an acceptable alternative in the treatment of femoral shaft fractures.

Adolescent↗

PubMedDate not supplied

Floating knee in children.

The outcomes of 18 ipsilateral displaced femoral and tibial fractures in 17 children are assessed and a new classification system is proposed. Average age was 8.75 years, and follow-up averaged 3.2 years. In the modified Bohn and Durbin classification used, eight cases were type I, four were type II, three were type IIIa, one was type IIIb, and two were type IV. In tibial fractures there was angulation in three cases, and in femoral fractures there were dislocation and angulation in four cases, refracture in one case, leg length discrepancy in four cases, and asymptomatic knee ligament injury and meniscal tearing in five cases. According to Yue et al's criteria, seven outcomes were excellent, eight were good, two were fair, and two were poor. The cases with poor outcomes were those with open knee injury, and those with fair outcomes were those with angulation. It was concluded that knee ligament injuries do not affect the outcome of floating knee trauma in children, although they do in adults, but that open knee injuries do affect the outcome, and operative treatment of the femoral fracture is the treatment of choice for all ages.

Adolescent↗

PubMedDate not supplied

Anthropometric study of patients treated for clubfoot.

The anthropometric characteristics of patients treated for clubfoot were used to investigate whether the dimensions of the foot were affected by the method of treatment. A total of 68 patients followed up for an average of 9 years were divided into three groups: group 1, conservatively treated; group 2, surgically treated; group 3, conservatively treated on one side and surgically treated on the other. The following average discrepancies in foot length were obtained: group 1, 0.91 cm; group 2, 1.5 cm; group 3, 1.09 cm. Toe lengths were shorter to the same extent as the other dimensions of the foot. These discrepancies were statistically significant. The following average discrepancies in foot width were obtained: group 1, 0.05 cm; group 2, 0.37 cm; group 3, 0.054 cm; these were insignificant. The authors believe that the degree of discrepancy may depend not solely on the method, but on the severity of the deformity as well.

Adolescent↗