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    A New Anatomical Plate for Extra-Articular Distal Humeral Fractures: Biomechanical Study
    (Atha Comunicacao & Editora, 2022) Mutlu, Harun; Polat, Abdulkadir; Çetin, Mehmet Ümit; Mutlu, Serhat; Demir, Teyfik; Parmaksizoglu, Atilla Sancar
    Introduction: We compared the mechanical properties of two fixation techniques for the treatment of extra-articular distal third humeral fractures. Materials and Methods: Two groups were created from twenty-four humeri. Group 1 was instrumented using a new, precontoured, 8-hole (3.5-mm-diameter) locking compression plate (LCP) placed anterolaterally. Group 2 was instrumented using an 8-hole (3.5-mm-diameter) precontoured posterolateral LCP plate placed on the distal humerus. Four-point bending tests and torsion tests were performed until the specimens broke. Results: The four-point bending stiffness test showed that the stiffness of anterolaterally fixed humeri was significantly higher than that of posterolaterally fixed humeri (p<0.05). Torsion testing revealed that posterolateral fixation was associated with better yield strength (p<0.05), but the torsional stiffness did not differ significantly between the two plates (p>0.05). Conclusions: The anterolateral plate exhibited higher bending stiffness and torsional yield strength than the posterolateral plate. Anterolateral plate fixation can thus be used to manage extra-articular distal humeral fractures. Multiaxial locking screws ensure rigid fixation, allow early elbow motion without olecranon fossa impingement, and prevent iatrogenic injury of the triceps muscle. Level of Evidence I, Therapeutic Studies Investigating the Results of Treatment.
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    Gözden Kaçan Perilunat Karpal Dislokasyonda Dorsal Yaklaşım ve Geçici Tespit Prosedürünün Orta-Uzun Dönem Sonuçları
    (2021) Sarı, Abdülkadir; Çetin, Mehmet Ümit; Özçelik, İsmail Bülent; Polat, Abdulkadir; Fidan, Fırat
    Amaç: Çalışmadaki amacımız, perilunat çıkıklı olgularda dorsal yaklaşımla açık redüksiyon, K-teli uygulaması ve skafolunat ligaman tamiri sonrasıorta-uzun dönem fonksiyonel ve radyolojik sonuçlarımızı sunmaktır.Gereç ve Yöntem: 2014-2018 yılları arasında perilunat çıkık nedeniyle başvuran, en az 18 aylık takibi olan 11 hasta çalışmamıza dahil edildi. Buolgularda, skafolunat açı, skafolunat gap, artroz ve avasküler nekroz varlığı değerlendirildi. Hastaların el bileği fleksiyon-ekstansiyon ve pronasyon-supinasyon hareket açıklığı gonyometre ile ölçüldü. Jamar dinamometresi ile el bileği kavrama gücü değerlendirildi. Olgular fonksiyonel olarak Kol,Omuz ve El Sorunları Anketi (DASH) skorlaması ve Herzberg klinik skorlama sistemine göre değerlendirildi.Bulgular: Ortalama yaş 41,1 (28-64), ortalama takip süresi 3,8 (1,5-6) yıldı. Ortalama skafolunat açı 49,1±8,7 (37,3-70,4) derece, skafolunat interval2,0±0,5 (1,2-2,8) mm, fleksiyon-ekstansiyon arkı 131±17,5 (90-155) derece, pronasyon-supinasyon arkı 155,4±6,1 (140-160) derece olarak ölçüldü.DASH skoru ortalama 5,6±3,2 (0-10,9), Herzberg klinik skoru ortalama 89,1±9,4 (70-100) olarak bulundu.Sonuç: Perilunat çıkıklarda tedavinin erken dönemde ve uygun şekilde yapılması prognozdaki ana belirleyicidir. Bu yaralanmaların olasıkomplikasyonlar açısından minimum 18 aylık yakın takibi son derece önemlidir.
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    Is arthroscopic intervention-assisted fragment-specific fixation technique superior to volar plating in distal radius fractures involving the middle column?
    (Cukurova Univ, Fac Medicine, 2022) Çetin, Mehmet Ümit; Polat, Abdulkadir; Fidan, Fırat
    Purpose: In this study, the clinical and radiological results of volar plating and arthroscopic intervention-assisted fragment-specific fixation techniques used in patients operated for AO Type B-C distal radius fracture in which the medial colon is affected were compared. Materials and Methods: X-ray and clinical records of 98 patients who underwent surgical treatment for radius distal end (DER) fracture between April 2011 and January 2017. The patient groups treated with arthroscopy-assisted fragment-oriented fixation (Group A) and plate screw fixation with a volar approach without arthroscopic intervention (Group B) were compared in terms of joint range of motion, grip strength, and clinical scores. Flexion and extension, ulnar deviation, radial deviation, pronation, and supination angles measured with a standard goniometer were recorded in the joint range of motion measurement. Grip strength was measured with a Jamar dynamometer for power measurement. DASH score was used in clinical evaluation. Results: When the operated wrists of both patient groups were compared, there was no significant difference between the DASH score, grip strength, palmar flexion, and pronation angles of motion. A statistically significant difference was observed between the mean dorsiflexion angles of 55 degrees in group A and 44 degrees in group B, mean radial deviation angles of 25 and 19 degrees, and the mean supination angles of 87 and 80 degrees, respectively. Conclusion: Although arthroscopic-assisted fragmentspecific fixation is technically a laborious procedure that requires a learning curve in patients with intra-articular distal radius fractures, it may be beneficial to provide better postoperative results, especially in young patients with high range of motion expectations.
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    Tranexamic acid in knee arthroplasty: the effect of preoperative intravenous administration of together with postoperative intravenous maintenance and periarticular administration on bleeding, transfusion, and hospitalization time – a retrospective cohort study
    (2022) Dinçel, Yaşar Mahsut; Başılgan, Seçkin; Polat, Abdulkadir; Özbey Büyükkuşçu, Mehmet; Yağmurlu, Mehmet Fırat
    Objective: To compare patients who received preoperative intravenous (IV) plus postoperative maintenance IV tranexamic acid (TXA) therapy and perioperative periarticular TXA to those who did not receive TXA during total knee arthroplasty (TKA) in terms of blood loss, transfusion requirements, and length of hospital stay. Material and Method: Data from 194 patients who underwent TKA between 2016 and 2019 were reviewed. A total of 106 patients were included. Twenty-one patients were male, and 95 were female. The patients were divided into three groups: Group 1 (n=37) that did not receive perioperative TXA, Group 2 (n=35) that received preoperative IV and postoperative maintenance TXA therapy, and Group 3 (n=34) that received preoperative IV and perioperative periarticular TXA. The groups were similar regarding demographic data. Statistical comparisons between the groups were made concerning the decrease in hemoglobin levels on postoperative days 1 and 3, the need for transfusion, and the length of hospital stay. Results: The mean decrease in hemoglobin on the postoperative first and third days were 1.69(±1.13) and 2.94(±1.14)g/ dl, in Group 1, 1.41(±0.99) and 2.44(±1.28)g/dl, in Group 2, and 1.24(±0.83) and 2.21(±0.84)g/dl in Group 3 respectively. The statistical comparison of the hemoglobin decrease revealed a significant difference between Groups 1 and 3 on the postoperative first day(p<0.05). There was no other significant difference between the remaining group pairs. There was a statistically significant difference in the length of hospital stay and the amount of erythrocyte suspension used between Groups 1 and other groups (p<0.05). In Group 1, prolonged wound discharge was observed in four patients. No additional surgical intervention was performed in any of the three groups due to infection, and no vascular thrombosis or embolism was observed. Conclusion: Our results showed that IV and periarticular TXA applications in TKA effectively reduced bleeding and bleeding- related complications without causing additional complications.