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 Covıd-19 Pandemi Sürecinde Sağlık Çalışanlarında Maske Kullanımının Etkilerinindeğerlendirilmesi(2020) Ertürk, Emre; Biçen, Ahmet ÇağdaşBu çalışmanın amacı COVID-19 pandemisi sürecinde farklı maske tiplerinin ve bunların kullanım güçlüklerinin incelenmesidir. Çalışma etik kurul onayı sonrası düzenlendi. İzmir Ekonomi ÜniversitesiMedical Park Hastanesi’nde çalışan, sekreter, hemşire ve doktorlardan oluşan, yaş ortalaması 29,5 olan 78kadın, 34 erkek toplam 112 gönüllü çalışmaya dâhil edildi. Gönüllüler cerrahi tıbbi maske ve FFP2 maskekullananlar olarak iki gruba ayrıldı. 1. gruba cerrahi tıbbi maske kullanan 81 gönüllü, 2. gruba FFP2 maskekullanan 31 gönüllü dahil edildi. Gönüllülerin, maske kullanımı esnasında 60. dakika ve 180. dakikada nefesdarlığı, görme sıkıntısı, kulak ağrısı, baş ağrısı, yüzde rahatsızlık hissi, anksiyete şikâyetlerinin gelişipgelişmediği sorgulandı. Ayrıca 60. ve 180. dakikalarda pulse oksimetre cihazı ile gönüllülerin oksijensatürasyonları ve kalp atım sayılarındaki değişiklik ölçüldü ve başlangıç değerleriyle kıyaslandı. Şikâyetlerin;alerji, sigara kullanımı ve gözlük kullanımı ile değişkenlik gösterip göstermediği değerlendirildi. Verilerinanalizinde SPSS 17 paket program kullanıldı. Mevcut verilerin dağılımı Kruskal Wallis ve Shapiro Wilk testleriile incelendi. Verilerin normal dağılım paterninde olduğu saptandı ve ortalama±standart sapma olarak, gruplararasında başlangıç, 60 ve 180. dakika satürasyon ve nabız değerleri açısından fark olup olmadığı Student-t testiile karşılaştırıldı. p<0.05 istatistiksel olarak anlamlı kabul edildi. Nefes darlığı, anksiyete, yüzde rahatsızlıkhissi, baş ağrısı, kulakta ağrı ve görme sıkıntısı açısından grupların kendi içinde ve gruplar arasında fark olupolmadığı Ki-Kare testi ile değerlendirildi. Her iki grupta da başlangıç ile 60. Dakika(p<0.001) ve 180 dakika(p<0.001), oksijen satürasyonları açısından istatistiksel anlamlı fark bulunmuştur. Yine başlangıç nabızdeğerleri ile 60.dakika (p<0.001) ve 180. dakika nabız değerleri açısından (p<0.001) istatistiksel anlamlı farkbulunmuştur. 180. dakika satürasyon değeri arasındaki fark ile maske türü, alerji varlığı, gözlük kullanımı,sigara kullanımı, yaş ve cinsiyet arasında istatistiksel anlamlı ilişki saptanmamıştır. FFP2 tipi maskenin cerrahimaske kullanımıyla kıyaslandığında, daha fazla şikâyete yol açtığı saptanmıştır. Sonuç olarak FFP2 tipimaskenin kullanımda tolerasyonunun daha zor olduğu görülmüştür. Her iki maske tipinde de 180 dakikakullanım sonunda oksijen satürasyonu ve kalp atım hızında düşüş görülmesine rağmen, bu değerler fizyolojiksınırlarda kalmıştır. COVID-19 pandemisi sürecinde, sağlık çalışanları ve toplumdaki kişilerin kendilerininkorunması için önemli bir bariyer olan maske kullanımının sağlık üzerine olumsuz etkisi saptanmamıştır.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.Article Long-Stem Prosthesis for Intertrochanteric and Femoral Neck Fractures in the Elderly: Retrospective Comparison of Short-Term Clinical Outcomes(Galenos Yayincilik, 2021-04-09) Biçen, Ahmet Çağdaş; Akdemir, Mehmet; Turken, Mehmet Aykut; Cekok, KubraObjective: Hip fracture treatment in elderly patients remains challenging. This study aimed to evaluate short-term clinical results of long-stem cementless arthroplasty in elderly patients with femoral neck and intertrochanteric fractures. Materials and Methods: We collected data of patients we treated with long-stem cementless arthroplasty between January 2011 and December 2019 due to hip fractures. This study included 48 patients (>= 65 years of age) with femoral neck and intertrochanteric fractures. The patients underwent either bipolar or total hip arthroplasty. A 2-year follow-up was conducted in all the patients. Outcomes were evaluated with the Harris hip score (HHS), Koval categories, complications and hip and mid-thigh pain. We compared clinical results of patients with femoral neck fractures and those with intertrochanteric fractures. Results: The mean follow-up period was 57 (34-92) months. Sixteen patients had femoral neck fractures and 32 had intertrochanteric fractures. No difference in demographic characteristics and comorbidities was noted between groups. The mean preoperative Barthel index of activities of daily living score was 79. At the last follow-up, the mean HHS of the control group was 77 and the mean Koval categories score was 3. Revision surgeries were conducted in two patients due to dislocation. Infection was observed in one patient and was treated by debridement and anti-biotherapy. Implant loosening and periprosthetic fractures were not noted. Conclusion: With fair outcomes, long-stem cementless arthroplasty is a potential treatment for hip fractures in elderly patients. A longer follow-up to evaluate the efficacy of these prostheses is warranted.Review Article Effects of Coronavirus Disease-2019 Pandemic and New Normal on the Orthopedic Outpatient Clinic Practice(Galenos Yayincilik, 2021-12-28) Biçen, Ahmet Çağdaş; Turken, Mehmet Aykut; Bicen, CagdasObjective: This study aimed to evaluate the effects of the coronavirus disease-2019 pandemic on the orthopedic outpatient clinic, including an investigation of the number, changes in complaints, and demographics of patients. Materials and Methods: Data of patients who visited the orthopedic outpatient clinic at our hospital within four periods were evaluated. Period 1 was between March and May 2019, period 2 was between June and August 2019, period 3 was between March and May 2020, and period 4 was between June and August 2020. Data of patients were recorded for each period including age, gender, number, and International Classification of Diseases 10th Revision codes for comparative analysis. Results: This study included 7,120 patients who were admitted to the orthopedic outpatient clinic within the four periods. The lowest number of patients (1,119) who visited the outpatient clinic was observed in the three months following the pandemic declaration (period 3), in March 2020, whereas the highest number (2,149) was observed in the three months following the lifting of restrictions, in June 2020 (period 4). No significant difference was observed in the age between the four periods (p=0.945). However, a difference was found between the periods for patients aged >= 65 years. Reasons for admission were also different between the periods. In period 3, admissions due to traumatic reasons were statistically higher compared with the other three periods (p<0.001, p=0.003, p<0.001). Conclusion: It was observed that the number of patients visiting the orthopedic outpatient clinic increased after the restrictions were lifted. Outpatient clinic management must be organized in a way that prevents contamination and preserves efficient outpatient support.