Browsing by Author "Özalp T."

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    Free radial forearm flap transfer for the reconstruction of the Achilles tendon and soft tissue defect: A case report; [Aşil tendon ve yumuşak doku defektinin rekonstrü ksiyonunda serbest radial önkol flep transferi: Olgu sunumu]
    (2005) Coşkunol E.; Özdemir O.; Özalp T.
    Reconstruction of the soft tissue defects around the Achilles tendon is a difficult challenge. This condition traditionally has been treated with staged procedures. We report a case treated with a one stage procedure. A neuromusculocutaneous radial forearm free flap was used for the reconstruction of an achilles tendon and for covering the overlying large soft tissue defect caused by a gun shot injury. The defect on the Achilles tendon was 15 cm in length and soft tissue loss was 18 × 10 cm. The flap including flexor carpi radialis muscle tendon was applied over the Achilles tendon. A terminolateral arterial anostomosis was performed on the tibialis posterior artery. There was no complication except a mild superficial infection on the lateral side of the flap treated by antibiotherapy. A satisfactory functional result was obtained. Application of a free neuromusculocutaneous radial forearm composite flap is a good technique to cover achilles tendon and soft tissue defects and to restore the function as a one stage procedure.
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    The treatment of Kienböck disease with vascularized bone graft from dorsal radius
    (2009) Özalp T.; Yercan H.S.; Okçu G.
    Introduction: Numerous surgical treatment options are proposed for the Kienböck 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. Materials and methods: Second and third intercompartmental supraretinacular artery pedicled bone graft has been used to treat 11 patients with Kienböck 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. Results: 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. Discussion: We believe that the treatment of Kienböck disease with vascularized bone graft from the dorsum of the radius has encouraging results and need no other additional procedures. © Springer-Verlag 2008.
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    Medial patellofemoral ligament reconstruction in skeletally immature patients
    (SAGE Publications Ltd, 2014) Yercan H.S.; Kale G.; Erkan S.; Özalp T.; Okcu G.
    Objectives: To evaluate the clinical outcome after medial patellofemoral ligament (MPFL) reconstruction for patellofemoral instability in skeletally immature patients. Methods: Study participants were 8 patients (median age, 10 years; range, 5-14 and one male, others female) who had suffered from persistent patellofemoral instability. Our technique preserves femoral and patellar insertion anatomy of MPFL using a free semitendinosus autograft, together with tenodesis to the adductor magnus tendon thus sparing the open physis of distal femur and the patellar attachment of MPFL. The clinical results were evaluated preoperatively and the final follow-up period using the Kujala patellofemoral score. Patellar shift, tilt and height were measured preoperatively and on the latest follow-up on plain radiographs. Results: At average 42 months follow-up (range, 16 to 56), %80 of patients were satisfied with the treatment. Redislocation or instability symptoms occurred in two patients. No apprehension signs or redislocations were seen in the remanining six patients. A significant improvement (p<0.05) in Kujala score (from 36 to 77) was found. Patellar shift & tilt decreased to anatomic values in six patients but patella alta persisted. Conclusion: The result of this study show that MPFL reconstruction with our technique seems to be an effective treatment for recurrent and habitual patellofemoral dislocation in skeletally immature patients; leading to significant increases in stability and functionality. © The Author(s) 2014.
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    The analysis of functional and radiographic outcomes of conservative treatment in patients with low lumbar burst fractures
    (Elsevier Ltd, 2015) 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° ± 3.2°, 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° ± 2.4°, 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. © 2015 Elsevier Ltd. All rights reserved.
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    Scaphoid nonunion treated with vascularised bone graft from dorsal radius
    (Elsevier Ltd, 2015) 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. © 2015 Elsevier Ltd. All rights reserved.
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    Perforator artery repair in revascularization of extremity degloving injuries
    (Elsevier Ltd, 2019) Kabakaş F.; Özçelik İ.B.; Mersa B.; Dağdelen D.; Aksakal İ.A.; 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. © 2019 Elsevier Ltd