TR Dizin İndeksli Yayınlar Koleksiyonu / TR Dizin Indexed Publications Collection
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14365/4
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Article Comparison of Conservative and Arthroplasty Treatment for 3 or 4 Part Proximal Humerus Fractures in the Elderly(2024-05-16) Akdemir, Mehmet; Biçen, Ahmet Çağdaş; Turan, Ahmet Cemil; Ekin, Ahmet; Kılıç, Ali İhsan; Ünal, MeriçAim: Proximal humerus fractures are common injuries in the elderly population. This study hypothesizes that arthroplasty is not superior to conservative treatment in the management of multi-part proximal humerus fractures in elderly patients. Material and Method: Patients aged 65 and above with 3–4-part proximal humerus fractures, treated either conservatively or with arthroplasty, were included in the study. The minimum follow-up period was set at 12 months. Functional evaluations of the patients were performed using the Quick Disabilities of Arm, Shoulder and Hand (Q-DASH) scoring system. Statistical analysis comparing the two groups was conducted using the SPSS software. The mean values of numerical data were analyzed using the Mann-Whitney U test, while categorical data were compared using the Chi-square test. A significant level of 0.05 was considered. Results: A total of 67 patients who received adequate clinical follow-up were included in the study (50 conservative 17 arthroplasty). The average age of the patients was 76.12 years, with 9 male and 58 female patients. The average follow-up period was 22.61 months (range: 12-82). There were no statistically significant differences in age, gender, side, follow-up period, and fracture type distribution between the two groups. However, a significant difference in Q-DASH scores was observed (p<0.05). Conclusion: In the treatment of proximal humerus fractures, even when they are multi-part fractures, conservative treatment should may be the first choice. We think that the early results of conservative treatment are better than arthroplasty.Article Evaluation of the Elasticity and Thickness of the Heel Fat Pad With Ultrasound in Plantar Fasciitis(2022-09-30) Yıldırım, Mahir Utku; Biçen, Ahmet Çağdaş; Ünal, Abdullah Meriç; Yıldırım, Utku Mahir; Unal, MericObjective The aim of this study was to evaluate thickness and elasticity of heel fat pad in patients with unilateral plantar fasciitis and to investigate the effects of age, sex, body mass index (BMI), and functional scores on plantar fasciitis. Material and Method 70 patients who had been suffering from unilateral plantar fasciitis longer than 6 months were enrolled in the study. The thickness and elasticity of fat pad were compared between the painful and healthy feet of the patients with ultrasound. For measurement of elasticity, shear wave elastography (SWE) was used. Comparative analysis was performed for thickness and elasticity variables between the painful and healthy feet with Mann–Whitney U and independent samples t-test. Results Average of age of the patients was 44±11.66. The average thickness of the heel fat pad was 17.9±3.1 mm on the affected side and 18.3±3.3 mm on the healthy side. The mean SWE value of the painful side was 23.9 m/s (range 9.3-32) and was 24.7 m/s (range 10.8-34) on the healthy side. Heel fat pad thickness was greater in the healthy feet than in the painful feet, but there was no statistical significance (p=0.448). The painful feet were stiffer, but the difference was statistically similar (p=0.347). BMI had a statistically significant impact on thickness of heel fat pad. Conclusion The results showed that a decrease in the heel fat pad thickness was a supporting finding of plantar fasciitis in patients with normal BMI but not in patients with BMI>25.Article Efficacy of Preoperative Mri in Detecting Biceps Tendon Pathologies in Rotator Cuff Tears: Correlation of Mri and Intraoperative Findings(2022-03-01) Biçen, Ahmet Çağdaş; Ünal, Abdullah Meriç; Ekin, Ahmet; Özkan, Mustafa; Unal, MericObjective The aim of this study is to evaluate the accuracy of magnetic resonance imaging (MRI) in detecting biceps lesions in patients with rotator cuff tears. Material and Methods A total of 168 patients operated on between January 2012 and February 2020 were included in the study. All the patients underwent arthroscopic surgery with the diagnosis of rotator cuff tears. All patients were operated on under general anesthesia and in the beach chair position. Demographic data and preoperative MRI findings were recorded. Arthroscopic findings were accepted as the standard reference and correlated with preoperative MRI records. Results In preoperative images, full-thickness rotator cuff tears were identified in 118 (70.2%) cases and partialthickness tears in 50 (29.8%) cases. Labrum/SLAP lesions were detected in 18 (10.7%) cases. Biceps disorders were reported in 51 (30.4%) cases. During the surgeries, we observed additional pathologies in 41 (24.4%) cases besides the preoperatively detected lesions. Rotator cuff and labrum/SLAP repairs were performed in the same surgical sessions. The majority of newly detected lesions were biceps lesions, being identified in 26 (15.5%) cases. In 41 (24.2%) cases tenodesis, tenolysis, or tenotomy were performed for biceps lesions. LHBT surgery was performed in 26 cases with negative MRI. Biceps lesions were confirmed in 77 (45.8%) cases intraoperatively; therefore, the accuracy of MRI in detecting these lesions was 66.2%. Conclusion Biceps lesions are among the common pathologies of the shoulder. Preoperative MRI is important in evaluation of the shoulder, but the efficacy of MRI may be limited in detecting biceps disorders. Arthroscopic surgery is crucial in diagnosis and treatment of LHBT lesions.Article Citation - WoS: 14Citation - Scopus: 12Analysis of Risk Factors Affecting Mortality in Elderly Patients Operated on for Hip Fractures: a Retrospective Comparative Study(Turkish Assoc Orthopaedics Traumatology, 2021-12-22) Biçen, Ahmet Çağdaş; Akdemir, Mehmet; Turken, Mehmet Aykut; Cekok, Kubra; Ekin, Ahmet; Turan, Ahmet Cemil; Biçen, Çağdaş; Çekok, Fatma KubraObjective: The aims of this study were (1) to investigate the effects of different demographic and perioperative modalities on mortality rates and (2) to compare mortality rates between different implants in elderly patients operated on for hip fractures. Methods: In this retrospective study, a total of 314 patients who were operated on for hip fractures were included study. Patients were then divided into four groups based in their implant types: long-stem cementless bipolar hemiarthroplasty (n = 124; 102 female, 22 male; mean age = 84.2 +/- 6.4 years), standard-stem cementless bipolar hemiarthroplasty (n = 74; 48 female, 26 male; mean age = 83.5 +/- 6.9 years), antegrade intertrochanteric nail (n = 61; 35 female, 26 male; mean age = 78.5 +/- 6.8 years), and total hip arthroplasty (n = 55; 34 female, 21 male; mean age = 72.5 +/- 4.3 years). Data including gender, age, duration from injury to surgery, American Society of Anesthesiologists (ASA) score, comorbidities, use of antiplatelet agents, Barthel Index of Activities of Daily Living, type of anesthesia, operation time, preoperative hemoglobin values, blood transfusions given, duration of hospital stay, complications, and type of fracture were recorded. Results: Overall, the mean follow-up was 36.5 (range = 0 - 107) months. The overall mortality rate was 53.2%. The median survival duration was 44.2 +/- 5 months (range = 34.3 - 54). Survival rates were found significantly different among the groups (P = 0.001). In the first three years postoperatively, the mortality rate was higher in the standard-stem bipolar hemiarthroplasty group, but in the long-term follow-up, the long-stem bipolar hemiarthroplasty group exhibited the higher mortality rates. It was observed that some parameters had statistically significant effects on the mortality rates. Male gender, higher age, lower hemoglobin values, increased number of blood transfusions, ASA scores >= 3, the existence of >= 3 comorbidities were found as main predictors of increased mortality rates. Conclusion: The results of this study have shown that age, gender, preoperative hemoglobin levels, ASA scores, and comorbidities are significant factors affecting mortality in elderly patients operated on for hip fractures. Long-stem cementless bipolar hemiarthroplasty appears to show similar rates of mortality with standard-stem cementless bipolar hemiarthroplasty.