Browsing by Author "Özalp, T"

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    Perforator artery repair in revascularization of extremity degloving injuries
    Kabakas, F; Özçelik, IB; Mersa, B; Dagdelen, D; Aksakal, IA; Özalp, T
    Introduction: This article aims to expand the microsurgical treatment options for extremity degloving injuries with perforator artery repairs of the specific degloved angiosomes in upper and lower extremity. Methods: Fourteen perforator arteries were repaired in seven patients. Four of them had circumferential degloving and 3 of them have non circumferential degloving injury. All had repair of the perforator arteries of the specific degloved segments. Four patients had additional vein repairs but none of the patients had AV shunts. Results: All perforators provided adequate arterial supply to their specific angiosomes with some necrotic areas in neighboring angiosomes. Conclusions: Perforator artery repair within the degloved tissues provides a direct arterial supply successfully even if one could not find an intact venous plexus. (C) 2019 Elsevier Ltd. All rights reserved.
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    Scaphoid nonunion treated with vascularised bone graft from dorsal radius
    Özalp, T; Öz, Ç; Kale, G; Erkan, S
    Introduction: The main aim of this retrospective study was to present our experience on scaphoid nonunion treated with vascularised bone graft. Methods: Between 2006 and 2012, 58 patients presenting with symptomatic scaphoid nonunion were eligible to participate in this study. Topography of the nonunion included 29 proximal, 25 waist and 4 distal scaphoid nonunions. Vascularised bone graft from distal dorsal radius was used in all cases which were stabilised with the headless cannulated compression screws. Scapholunate angles, Natrass carpal height ratio were evaluated pre and postoperatively. Range of motion of the affected side was compared to that of the contralateral side after the surgery. Results: Radiographic union was achieved in 50, out of 58 cases with an average time of 9.9 weeks (range, 6-18 weeks). Out of all the non-united cases, four of them were in proximal, three in the waist and one was in distal scaphoid. In nine proximal nonunions treated by 4 + 5 ECA graft all but one were united. The mean follow up was 21.7 months (12-62 months). The flexion was 91.6%, the extension was 91.5%, the radial deviation was 81.2%, and the ulnar deviation was 89.5% compared to the other side. The grip strength was 93%. Preoperative DASH score was 61.5 diminishing to 28.7 postoperatively. There was no significant change in Natrass carpal height ratio but a slight improvement occurred in scapholunate angles both pre and postoperatively. Conclusion: Vascularised bone graft is a good solution for scaphoid nonunion to enhance the healing rate especially in the presence of avascular necrosis. Proximal pole nonunions, humpback deformity and smoking are important negative factors for scaphoid nonunion despite the use of a vascularised bone graft. A trapezoidal wedge graft is necessary for the volar type nonunions with humpback deformity. 1,2 ICSRA offer an advantage with its proximity to scaphoid in all nonunion locations. Nonetheless, 4 + 5 ECA graft is also a good solution for proximal nonunions. (C) 2015 Elsevier Ltd. All rights reserved.
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    The analysis of functional and radiographic outcomes of conservative treatment in patients with low lumbar burst fractures
    Erkan, S; Tosyali, K; Özalp, T; Yercan, H; Okcu, G
    Introduction: Burst fractures of the low lumbar spine constitute approximately one percent of all lumbar fractures. There is still no consensus on the optimal treatment of low lumbar burst factures. We aimed to evaluate the functional and radiographic outcomes of conservative treatment in patients with low lumbar burst fracture. Methods: 15 patients (11 males, 4 females; mean age 32 +/- 8) who had low lumbar spine burst fracture treated with a custom-moulded thoracolumbosacral orthosis (TLSO) with a thigh extension were enrolled. The mean follow-up period was 22 +/- 6 months. 14 patients were neurologically intact and one had isolated nerve root injury. There were 24% type A fractures and 76% type B fractures according to the Denis classification system. Functional outcomes were evaluated by using Oswestry Disability Index (ODI), Short-Form 36 (SF-36) and Visual Analogue Scale (VAS). Radiographic outcome was analyzed by measuring anterior vertebral height loss, kyphosis angle, amount of canal retropulsion. Functional and radiographic outcomes were reviewed initially and at 1, 3, 6, 12 months, and at the latest follow-up. Functional and radiographic improvements were analyzed statistically. Results: The mean bracing period was 11.9 +/- 1.7 weeks. The mean initial ODI, SF- 36, and VAS score of the patients was 78.3 +/- 9.6, 23.7 +/- 8.9, and 8.7 +/- 0.7, respectively. The mean ODI, SF- 36, and VAS score of the patients at the final follow-up was 26.4 +/- 6.5, 68.1 +/- 11.2, and 2.8 +/- 1.7, respectively. The improvement in functional outcomes was measured to be significant (p < 0.05 for ODI, SF-36 and VAS). The mean initial anterior vertebral height loss, kyphosis angle, amount of canal retropulsion was found to be 27.2% +/- 9.6%, -6.8 degrees +/- 3.28, 37.4% +/- 10.2%, respectively. The mean anterior vertebral height loss, kyphosis angle, and amount of canal retropulsion at the final follow-up was 23.1% +/- .6.7%, 4.2 degrees +/- 2.48, 19.6% +/- 7.7%, respectively. Among the radiographic outcomes, only the amount of canal retropulsion improved statistically (p = 0.042). Conclusion: Conservative treatment using a custom-moulded thoracolumbosacral orthosis with a thigh extension is a safe and effective method in patients with low lumbar spine burst fractures and can improve functional and radiographic outcomes. (C) 2015 Elsevier Ltd. All rights reserved.
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    Secondary chondrosarcoma arising from a solitary enchondroma at the index finger of the right hand: A case report\
    Demireli, P; Çavdar, DK; Vural, S; Ovali, GY; Özalp, T
    Enchondromas are benign cartilaginous tumors and tend to present in small bones of hands and feet. Malignant transformation, though rare, is seen more often in multiple rather than solitary enchondromatous. A 70year-old woman presented with swelling and pain lasting for years at the index finger of the right hand. Excisional curettage material of the mass revealed to be entirely an enchondroma. Seven months later, the lesion recurred at the same localization and amputation of the finger was performed. This time the tumor was found to be transformed into an intermediate grade (grade II) which demonstrated chondrosarcoma intermingled with classical enchondromatous areas. Enchondromas arising at the hands and feet very rarely transform into chondrosarcomas. Since enchondromas at this site often show histological and clinical features suggestive of malignancy, it is often is difficult to make a histological distinction between benign cartilaginous tumors and chondrosarcomas. Detection of radiological as well as pathological findings are essential for differential diagnosis. This case is remarkable for she has a solitary enchondroma located at the index finger of the right hand that transformed into chondrosarcoma in seven months.
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    The treatment of Kienbock disease with vascularized bone graft from dorsal radius
    Özalp, T; Yercan, HS; Okçu, G
    Numerous surgical treatment options are proposed for the Kienbock disease but there has not been a consensus on the most appropriate method yet. The aim of this study is to present our experience and preliminary results of the use of vascularized bone graft from dorsal radius. Second and third intercompartmental supraretinacular artery pedicled bone graft has been used to treat 11 patients with Kienbock disease between 2001 and 2006. The average follow-up period was 37 months (range 19-77 months). Pre- and post-operative range of motion, pain and grip strength, radiologic parameters such as carpal height ratio, Stahl index and scapholunate angle were evaluated. Eleven patients were composed of two stage II, one stage IIIA and eight stage IIIB patients according to Lichtmann classification. At the end of the observation period, five excellent, four good, one fair and one poor results were observed. There were no or little changes in carpal height ratio and Stahl index. Pain has diminished considerably. We believe that the treatment of Kienbock disease with vascularized bone graft from the dorsum of the radius has encouraging results and need no other additional procedures.