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Biomedical subjects

Ulunay Kanatli

Publications and source records attributed to Ulunay Kanatli.

16 recordsLinked to original sources
PubMed2006

Absence of the medial sesamoid bone associated with metatarsophalangeal pain.

Pain at the first metatarsophalangeal (MTP) joint can result from inflammation, chondromalacia, flexor hallucis brevis tendinitis, osteochondritis dessecans, fracture of a sesamoid bone, avascular necrosis of sesamoids, inflamed bursae, intractable keratoses, infection, sesamoiditis, gout arthropathy, and rheumatoid arthritis. Congenital absence of a sesamoid bone is extremely rare. We present a 17-year-old male patient with pain at the plantar aspect of the right MTP joint associated with congenital absence of the medial sesamoid. There was tenderness and the range of motion was minimally restricted. He described the pain as necessitating changes in his social life. On radiographs, the medial hallucial sesamoid was absent on the right side. The MTP joint was also evaluated using magnetic resonance imaging (MRI). A metatarsal pad was prescribed and the patient was satisfied with the treatment at the 2 months follow-up period. MRI revealed no pathological tissue at the medial sesamoid site. Hallucial sesamoids absorb pressure, reduce friction, protect the tendons, act like a fulcrum to increase the mechanical force of the tendons, and provide a dynamic function to the great toe by elevating first metatarsal head. Congenital absence of these bones is very rare but we must consider it in a patient with MTP joint pain.

Adolescent↗
PubMed2006

The relationship between the hindfoot angle and the medial longitudinal arch of the foot.

INTRODUCTION: The relationship of hindfoot valgus and the medial longitudinal arch (MLA) is a well-known parameter for the evaluation of the foot deformities. In this study, we evaluated the relationship between the hindfoot angle and the MLA and the effect of these parameters on the development and general joint laxity of the subjects. METHODS: Two-hundred-sixty-one volunteers who had no foot pain or major foot deformity were examined. The age range of the volunteers was 4 to 20 years. For each subject, the right foot was evaluated for the clinical hindfoot angle and footprint analysis. General ligamentous laxity also was recorded. Arch index and valgus index were used for the evaluation of the footprint analysis, and the valgus angle was measured clinically. RESULTS: The average heel valgus angle for all subjects was 5.2 (SD 3.3) degrees. The means of valgus index and arch index were 3.34 (SD, 5.6) and 0.7 (SD, 0.2), respectively. Although there was a positive correlation between the valgus angle and valgus index (p = 0.027), the arch index was not found to be correlated with these values. Positive correlation between joint laxity and arch height also was demonstrated (p < 0.05). CONCLUSIONS: We concluded that the hindfoot angle and MLA height must be considered separately in clinical practice, particularly in the management of childhood pes planus.

Adolescent↗
PubMed2005

[Anatomy, biomechanics, and pathophysiology of instability of the glenohumeral joint].

The stability of the shoulder is dependent on both static and dynamic anatomic restraints. In most cases, there must be insufficiency of more than one restraint for the shoulder joint to become instable. Although the role of these restraints is largely known in maintaining shoulder stability, our information on their interactions is insufficient. This article reviews the anatomy and biomechanics of the shoulder and conditions causing instability of the glenohumeral joint.

Biomechanical Phenomena↗
PubMed2005

[Shoulder instability: classification and methods of clinical examination].

The shoulder is a complex joint whose stability relies on both dynamic and static factors. Dysfunction of one of these components gives rise to shoulder problems. Diagnosis of shoulder instability depends on a detailed history and appropriate physical examination. Despite the presence of many tests, none has proved to be purely diagnostic for shoulder instability. Therefore, these tests should be regarded as a part of the diagnostic procedure rather than a referral to diagnosis itself. Tests performed to assess laxity and instability are different in nature; thus, positive laxity tests do not necessarily show instability unless supported by further evidence. The reliability of the tests for superior labrum anterior-posterior lesions has not been adequately validated by clinical studies and few anatomical studies have examined the effect of these tests on the superior labral complex.

Humans↗
PubMed2005

[Open surgical treatment of recurrent anterior instability of the shoulder].

Recurrent anterior gleonohumeral instability is the most frequent joint instability of the body. Because of the complex stability mechanisms and diverse instability patterns of the glenohumeral joint, most cases present with more than one anatomic cause. Thus, the treatment of recurrent anterior instability of the shoulder should be designed to treat these pathologies. Although arthroscopic repair has outweighed the use of open surgical methods especially for the first dislocations, recurrent dislocations still require open repair techniques to overcome capsular laxity accompanying a Bankart lesion.

Humans↗
PubMed2005

[Multidirectional shoulder instability and open surgical procedures].

The principles and procedures for multidirectional instability do not substantially differ from those for anterior instability. Correct diagnosis is difficult, but it is important for a successful treatment. Conservative treatment should be attempted before surgery. Open surgical treatment using the inferior capsular shift procedure is the gold standard. It can be carried out either anteriorly or posteriorly. We prefer a laterally-based capsular shift because it facilitates capsular plication.

Humans↗
PubMed2004

Proximal humeral fractures with minimal displacement treated conservatively.

We reviewed 27 patients with a minimally displaced proximal humeral fracture treated conservatively after a mean follow-up of 25 (12-34) months. All fractures had united. Patients were evaluated using the Constant-Murley scoring system, and isokinetic muscle strength was tested using a Cybex dynamometer. Finally, all shoulders were examined ultrasonographically. The mean Constant score for all patients were 81 (54-100). Twenty-three patients had no or only mild pain, while three had moderate and one severe pain necessitating regular use of oral analgesics. Twenty patients were able to perform all activities of daily living, but seven had mild trouble in overhead activities and weight carrying. Only in one patient, the abduction peak torque equalled the one of the opposite shoulder. In all other patients, the peak torque was lower than, and in 14 patients below, 50%. In nine patients, rotator cuff tears were seen at ultrasonography.

Adult↗
PubMed2004

Screening for developmental dysplasia of the hip: results of a 7-year follow-up study.

BACKGROUND: Screening for developmental dysplasia of the hip (DDH) is widely recommended for all infants to prevent disability from late diagnosis of dislocation of the hip. The present study evaluates the results of screening for developmental dislocation of hip in a clinic in Turkey over the course of 7 years. METHODS: Hospital records of 5798 infants who were examined regularly until walking age at Gazi University well child clinics between January 1995 and December 2001 were reviewed. Infants with known risk factors for DDH such as breech presentation, family history of DDH or swaddling, and of infants with physical examination findings suggestive of DDH, were referred to orthopedic surgeons for diagnosis. Based on this final diagnosis, sensitivity, specificity, positive and negative predictive values of risk factors and physical examination findings were calculated. RESULTS: Of the 5798 infants, risk factors were detected in the medical history of 111 infants, and in 14 infants a musculoskeletal deformity was detected. In 606 infants the physical examination findings were suggestive of DDH. Ten patients were subsequently diagnosed with DDH. The sensitivity, specificity, positive predictive value and negative predictive values of having a risk factor for DDH in history were 10.0%, 98.1%, 0.9%, 99.8%, and having abnormal hip examination findings were 100.0%, 88.9%, 1.6% and 100.0%, respectively. CONCLUSIONS: A careful history and physical examination is the cornerstone of DDH screening. Serial hip examinations performed during health examination visits provide an opportunity to identify DDH cases. The sensitivity of risk factors in history and physical examination findings together is high enough to be accepted as a screening tool.

Bone Diseases, Developmental↗
PubMed2003

Evaluation of the transverse metatarsal arch of the foot with gait analysis.

BACKGROUND: The existence of the transverse metatarsal arch (TMA) of the foot is a point of controversy. According to Kapandji, TMA of the foot elevates the 2(nd) to 4(th) metatarsal heads. Some authors suggest the existence of TMA, while others suggest that there is no functional metatarsal arch of the foot. In this study, we evaluated the existence of TMA of the foot and weight distribution on the metatarsal heads with the EMED-SF (Novel H, Munich, Germany) plantar pressure analysis system. METHODS: The test was performed with 16 volunteers. According to the three functional columns of the foot, the metatarsal region of pressure picture obtained from the EMED-SF system was divided into three regions called 'masks'. Mean pressures in the masks were calculated at the mid-stance phase. RESULTS: The highest mean pressure recorded was located at the 2nd to 3rd metatarsal heads (7.96 N/cm(2)), and the second highest pressure was at the heel (6.55 N/cm(2)). The pressures of the 1st metatarsal and 4th-5th metatarsal heads were 4.86 and 6.26 N/cm(2), respectively. The difference between the pressure distributions under metatarsal heads was statistically significant ( p=0.000). CONCLUSION: According to our results, TMA of the foot does not exist as described by Kapandji.

Adult↗
PubMed2003

The relationship between accessory navicular and medial longitudinal arch: evaluation with a plantar pressure distribution measurement system.

This study included 92 patients with an accessory navicular (AN) noted on an anteroposterior roentgenography. This group was selected from 860 patients admitted to the authors' gait analysis laboratory. The medial longitudinal arch was evaluated by using an "arch index" calculated from the pressure picture obtained from a pressure distribution measurement system. The average arch index was 0.15 and there was no significant correlation between AN types and arch index. The study concluded that the presence and type of AN are not correlated with the height of the medial longitudinal arch of the foot and that AN is not associated with pes planus.

Adolescent↗
PubMed2003

Bilobed flaps for nonhealing ulcer treatment.

Healing of round ulcers may be difficult particularly in the plantar area. Rigidity and thickness of the plantar skin do not allow fusiform excision and primary suturing. The bilobed flap is a simple reconstructive technique principally used to repair substantial defects in the facial region. The authors' experience with this local flap in the foot is presented with good short-term results. Between 1995 and 1998, five female and seven male neuropathic foot patients with round plantar ulcers were treated with bilobed flaps. The average age of the patients was 50 (range, 15-76). The average size of the ulcers was 1.6 cm (1-3.2 cm). Debridement and orthotic insoles were used at least for 3 months before considering bilobed flaps. Seven patients were diagnosed as type II diabetes mellitus, four patients had cerebral palsy, and another patient had meningomyelocele. The minimal follow-up period was 1 year (average, 19.5 months). The only complication was wound dehiscence at the lateral side of the heel in a type II diabetic. Subsequently, this complicated ulcer was managed with a sliding flap and skin graft without further problem. The study concluded that nonhealing foot ulcers can be effectively treated with a bilobed skin flap of healthy tissues rotated from nonweightbearing parts of the sole.

Adolescent↗
PubMed2003

[Open surgical techniques for subacromial impingement syndrome].

Various surgical techniques have been used for the treatment of subacromial impingement syndrome, ranging from complete acromionectomy to arthroscopic subacromial decompression. Following the recognition of the importance of the acromial arch in maintaining superior stability of the glenohumeral joint, attempts have been directed to minimize the amount of acromial excision. In this article, open surgical subacromial decompression techniques and the importance of the amount of acromial excision are discussed.

Acromion↗
PubMed2002

Modified and classic acromioplasty for impingement of the shoulder.

We compared the results of modified and classic anterior acromioplasty in order to identify the significance of the resected acromion. Fifty patients with shoulder impingement syndrome resistant to conservative therapy underwent surgical treatment. We treated 30 patients with classic Neer acromioplasty (group 1), and 20 patients with modified Neer acromioplasty (group 2). The patients were assessed according to pain and shoulder movement. Excellent or good results were achieved in 28/30 patients in group I and 19/20 patients in group 2. The results indicate that both surgical techniques are effective procedures in the treatment of shoulder impingement syndrome, and the type of bone resection does not influence the clinical outcome.

Acromion↗
PubMed2002

Subvastus versus medial parapatellar approach in total knee arthroplasty.

The subvastus approach for total knee replacement was compared with the standard medial parapatellar approach in terms of postoperative knee scores and quadriceps strength. Two groups of patients with similar characteristics were formed: the first group consisted of 12 knees of 9 patients who were implanted via the medial parapatellar approach, and for the second group the subvastus approach was used in 10 knees of 10 patients. The groups' knee scores and quadriceps strength were compared preoperatively and postoperatively at week 6, months 3 and 6. The knee scores improved similarly in both groups, but the change was more pronounced in the subvastus group. Quadriceps strength was greater in the subvastus group at postoperative week 6, but there was no significant difference between the groups in months 3 and 6. It was concluded that although the subvastus approach offers greater quadriceps strength in the early postoperative period, it has no significant advantage in this aspect over the medial parapatellar approach.

Aged↗
PubMed2002

[Evaluation of functional results in conservatively treated boxer's fractures].

OBJECTIVES: The aim of this study was to evaluate the effect of dorsal angulations up to 30 degrees on the grip strength in conservatively treated boxer's fractures. METHODS: The grip strength of 18 patients was evaluated with the Jamar dynamometer following conservative treatment for neck fractures of the fifth metacarpal. All the patients were males with a mean age of 30.5 years. The results were compared with those of intact hands and a control group of 18 subjects (mean age 31.2 years). The mean follow-up period was 20 months (range 4 to 48 months). RESULTS: The mean dorsal angulations before and after closed reduction were 46 degrees (range 35 degrees -55 degrees ) and 28 degrees (range 10 degrees -30 degrees ), respectively. Compared to the grip strength of intact hands and controls, no statistically significant functional loss was found in conservatively treated hands (p>0.05). CONCLUSION: Since no significant functional loss occurs in the fifth metacarpal neck fractures having an angulation less than 30 degrees, the appropriate treatment seems to be conservative whenever this range of reduction is likely to be achieved.

Adult↗