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    Acetabular fractures from Judet and Letournel to the present: Research trends and global outcomes with bibliometric analysis during 1980 to 2022
    (LIPPINCOTT WILLIAMS & WILKINS, 2023) Dündar, Abdulrahim; İpek, Deniz; Kaya, Şehmuz
    Fractures of the acetabulum are one of the most challenging injuries treated by orthopedic surgeons. However, a bibliometric analysis has not been performed in the literature on acetabular fractures, which seriously affect the quality of life of patients. The aim of this study was to summarize the bibliometric and intellectual structure, and determine and map the most recent trends on the topic of acetabular fractures by analyzing the social and structural relationships between the different research components of articles published on the acetabular fractures. 1599 articles on acetabular fractures published between 1980 and 2022 were extracted from the Web of Science (WoS) database and analyzed. Bibliometric visualization maps were used to reveal trending topics, citation analyses, and international collaborations. Spearman correlation analysis was performed for correlation investigations. The trend in the expected number of articles to be published over the next few years was displayed using the exponential smoothing estimator. The top 3 contributing countries to the literature were United States of America (USA) (551, 34.4%), China (170, 10.6%), and Germany (160, 10%). The most active author was Berton R. Moed (n = 29) and the most active institution was the University of California System (n = 41). A high-level statistically significant correlation was found between the number of articles on the topic of acetabular fractures published by nations and the gross domestic product (GDP) and GDP per capita values of those countries (R = 0.719, P < .001; R = 0.701, P < .001, respectively). The trending topics researched in recent years were 3D printing, 3-dimensional printing, outcomes, Open Reduction and Internal Fixation (ORIF), mortality, Kocher-Langenbeck, Pararectus approach, tranexamic acid, transfusion, epidemiology, fracture mapping, modified Stoppa approach, post-traumatic osteoarthritis, pelvis fracture, pelvic trauma, fracture reduction, and pelvic ring injury. The leading countries in research on the subject of acetabular fractures were seen to be western countries with large economies (especially the USA, European countries, and Canada) and China, India and Turkey.
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    Cementless Total Hip Arthroplasty: Short And Mid-Term Results
    (2021) İpek, Deniz; Pestilci, Fatih İbrahim; Ateş, Yalım; Kovalak, Emrah
    Objective The destruction of the joint cartilage either by age or trauma can develop coxarthrosis limiting the motion of the patient, which is treated by the replacement of the whole joint with total hip arthroplasty. In this study, we aimed to report our short and mid-term results and discuss with the current literature on postoperative results of cementless total hip arthroplasty (THA) in patients with coxarthrosis. Material and Method One hundred thirty patients (86 female, 44 male) with a mean age of 54.1±9.6 years who underwent total hip arthroplasty with a cementless prosthesis included in the study. The outcomes and complications of the total hip arthroplasty were reviewed from patient’s counseling charts, laboratory tests and radiographs. retro Results There was a statistically significant difference between pre (41.75±9.62) and postoperative (90.44±7.51) mean modified Harris Hip Score measurements (p<0.001) indicating the successful outcome. Intraoperative femur fracture occurred in 10 patients (7.6%). Anterior thigh pain (26 patients, 20.0%) and extremity length difference (20 patients, 15.4%) were the most common complications observed. Although 13 patients (10.0%) had heterotopic ossification after total hip arthroplasty, none of the patients had limited motion associated with it. Malpositioning (7 patients, 5.4%), dislocation (3 patients, 2.3%), infection (2 patients, 1.5%) and deep venous thrombosis (1 patient, 0.8%) were among the other complications observed. There were no cases with acetabular cup migration or pain limiting hip movement. Conclusion The cementless THA provides improvement of hip function in patients with coxarthrosis. The preoperative risk assessment of the coxarthrosis patients is necessary to ensure patient’s satisfaction, minimize complications and provide long-term durability of the prosthesis
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    Clinical and Radiological Results of Patients Treated with Talon Distalfix Femoral Intramedullary Nail for Femoral Shaft Fractures
    (Hitit University, 2023) Dündar, Abdulrahim; İpek, Deniz; Zehir, Sinan; Kaya, Şehmuz
    Objective: Talon distalfix intramedullary nails have been developed as a solution to the technical difficulties experienced during the placement of locking screws. We aimed to evaluate the radiological and clinical results of retractable talon distal fix for the treatment of femoral shaft fractures. Material and Method: Between January 2017 and January 2022, 28 patients with femoral shaft AO type 32-A and B fractures were treated with Talon distalfix nails. AO Type 32-A and B fractures were included in the study. Demographic characteristics, follow-up times, ASA of Anesthesiologists classification and fracture type were recorded. The duration of the operation, intraoperative blood loss, fluoroscopy time (in min), and time to bone union were recorded. General and technical complications (nonunion, malunion, malrotation, and shortening) were evaluated. Clinical functional outcomes were evaluated using the Knee Injury and the Osteoarthritis Outcome Score Physical Function Shortform (KOOS-PS), Hip Injury and Osteoarthritis Outcome Score Physical Function Shortform (HOOS-PS) and Thoresen criteria. Results: A total of 28 patients (11 female and 17 male) were included in the study. The mean age was 46.8 years and the mean follow-up was 23.7 months. The mean time to bone union was 22.6 weeks. No nonunion was observed in any of the patients. The mean hospital stay was 3.4 days and the mean Body Mass Index was 24.2. The mean operation time was 40.3±3.4 minutes and the mean scope time was 26.9 seconds. The mean KOOS-PS score and HOOS-PS were 83.4 and 85.6, respectively. Conclusion: Talon distalfix nails can be safely used in AO type A-B fractures of the midshaft femur. Talon distalfix nail application provides advantages including shorter operation times, less radiation exposure, fewer surgical incisions, and less blood loss. In addition, it should be emphasized that the union time is prolonged compared with that of conventional nails
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    Comparison between locked intramedullary nailing and anatomical locking plating in the treatment of displaced clavicular midshaft fractures
    (Ekin Medical Publishing, 2016) Zehir, Sinan; Çalbıyık, Murat; Şahin, Ercan; İpek, Deniz
    Objective: The aim of this study was to compare the results of expandable flexible locked intramedullary nailing and anatomical locking plating in clavicular midshaft fractures. Methods: Thirty-three patients (21 male, 12 female) who had displaced fractures and at least 2-cm shortening fixed with expandable flexible locked intramedullary nailing and 38 patients (24 male, 14 female) who underwent anatomical locking plating were recruited. Duration of surgery, incision size, duration of hospital stay, union time, and early and late complications were compared between the groups. Functional results were compared with Constant scoring system. Results: Mean duration of surgery was 32.4±9.1 minutes (range: 20-42 minutes) in the nailing group and 54.1±11.9 minutes (range: 42-70 minutes) in the plating group. The incision was 4.1±0.9 cm (range: 3-5 cm) in the nailing group and 9.5±1.7 cm (range: 7-12 cm) in the plating group. Mean union time was 14.8 weeks (range: 10-24 weeks) in the nailing group and 21.3 weeks (range: 12-33 weeks) in the plating group. Mean duration of hospital stay was 3.6±1.1 days (range: 2-4 days) in the plating group, whereas it was 2.3±0.8 days (range: 1-3 days) in the nailing group. In the plating group, an average of 2.7-mm (range: 0-7 mm) shortening was determined in the clavicles that underwent surgery as compared to the intact clavicles, whereas shortening was 2.3 mm (range: 0-6 mm) in the nailing group. Conclusion: Expandable flexible locked intramedullary nailing can provide more successful outcomes than plating in displaced clavicular midshaft fractures, due to advantages such as shorter union time, lower complication rate, and better cosmetic outcomes. © 2016 Turkish Association of Orthopaedics and Traumatology.
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    Comparison of the Hook Plate versus TightRope System in the Treatment of Acute Type III Acromioclavicular Dislocation
    (HINDAWI LTD, 2022) Dündar, Abdulrahim; İpek, Deniz
    Introduction. The objective of this study is to compare the effectiveness of the clavicular hook plate (HP) technique and the minimally invasive coracoclavicular (CC) fixation with a TightRope (MITR) procedure in treating acute unstable distal clavicle dislocation. Method. MITR (minimally invasive TightRope) group had 21 patients, and the open reduction and internal fixation (HP) group included 23 patients. Researchers compared MITR and HP (hook plate) outcomes for the treatment of acute type III AC joint dislocation in a retrospective analysis. The patients were followed up at 1 3, 6, and 12 months postoperatively. Complications were analyzed such as redislocation, fractures, implant-related complications, or subacromial erosion. For the clinical outcomes, the visual analog scale (VAS) (0: no pain, 10: worst possible pain), Constant-Murley score (CMS) (100: no pain, 0: maximum pain), the average satisfaction score with their current shoulder function (range: 0-10), and the University of California at Los Angeles Shoulder score (UCLA) (> 27 good/excellent < 27 fair/poor) were recorded at the last follow-up. Result. There were 21 sufferers in the MITR group, which comprises 19 males and 2 females and 23 individuals in the HP group (20 men and 3 women), with average ages of 43.9 and 39.2, respectively. Age, sex, laterality, and the interval between injury and surgery did not significantly differ between the two groups (0.357, 0.792, 0.432, and 0.55, respectively). No statistically significant difference was found between the groups in terms of the VAS score and CMS score at one year postoperatively. The mean CCD at the initial trauma and last follow-up was not significantly different between the MITR and HP groups (p = 0.365, p = 0.412 respectively). Conclusion. For treating acute type III AC dislocations, the minimally invasive TightRope (MITR) system and the hook plate technique were great options. However, the minimally invasive TightRope system showed further benefits such as reduced reoperation for implant removal and reduced risk of subacromial distal clavicle osteolysis.
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    Evaluation of short term outcomes of transportal femoral cross pin fixation in anterior cruciate ligament reconstruction
    (SAGE Publications Ltd, 2014) Zehir, Sinan; Şahin, Ercan; Çalbıyık, Murat; Kalem, Mahmut; İpek, Deniz; Songür, Murat
    Objectives: Many fixation techniques are currently in use for femoral side graft fixation at ACL reconstruction surgery. Short term success following ACL reconstruction highly depends on fixation strength of the graft. In this study we report short term results of anterior cruciate ligament reconstruction using double hamstring tendon autograft using double cross pin for femoral tunnel fixation. Methods: Between years 2009 and 2013, 51 male adult anterior cruciate ligament injury cases treated surgically, in a single center, with at least one year follow up were investigated. Professional athletes, multi-ligamentous instability cases, cases requiring meniscus repair or further treatment for chondral injuries and cases with concomitant medial and lateral meniscus lesions were not included in the study. Femoral tunnel was prepared anatomically through accessory medial portal, opened medially and distally. Reconstruction was performed using double loop hamstring tendon autograft. Femoral side was fixed using double cross pin, whereas tibial side was secured using single biodegradable interference screw and titanium staple. No external immobilization method such as brace was administered. Patients were encouraged to bear weight as tolerated. Standard physiotherapy was instructed to all patients postoperatively. All cases were evaluated clinically at the end of at least one year follow-up. Clinical and functional evaluation consisted of pivot shift and Lysholm, International Knee Documentation Committee (IKDC) scores and Tegner activity evaluation systems. Results: Mean age was 28.4 (18-39) years. Mean time between the injury and reconstruction was 13 (3-21) weeks. Average duration of surgery was 48 (35-70) minutes. No case of graft failure or posterior cortical fracture was encountered. In two cases, infection was treated successfully with local debridement and antibiotics with retention of the graft. At the end of follow-up period, none of the cases demonstrated positive pivot shift test. Pre-operative and follow-up Lysholm scores were 58.3±6.7 and 87.1±5.3 (p<0.001) respectively. Pre-operative IKDC scores were evaluated as C at 37 cases and D at 14, whereas, follow-up IKDC scores were evaluated as A at 42 cases, B at 8 and C at 1 case. Pre-operative and follow-up Tegner scores were 3.7±0.6 and 6.7±0.4 (p<0.001) respectively. Conclusion: Although fixation strength of transcondylar graft fixation techniques has been questioned over loop systems with cortical fixation, it was reported that transcondylar fixation causes less tunnel widening at long term. Our study revealed successful short term results, with femoral tunnel preparation using accessory medial portal and double cross pin femoral fixation, allowing early weight bearing and rehabilitation without graft and fixation failure. © The Author(s) 2014.
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    Intramedullary repair device against volar plating in the reconstruction of extra-articular and simple articular distal radius fractures; a randomized pilot study
    (Springer Verlag, 2014) Zehir, Sinan; Çalbıyık, Murat; Zehir, Regayip; İpek, Deniz
    Purpose: This prospective randomized pilot study reports our institutional experience and early results using Sonoma Wrx (Sonoma Orthopedic Products, Santa Rosa, CA) in the treatment of extra-articular and simple intra-articular distal radius fractures. Material and methods: A total of 64 patients, were enrolled in the study. They were considered eligible if they had; unstable extra-articular distal radius fractures and simple intra-articular distal radius fractures suitable for closed reduction (AO types; A2.2, A2.3, A3.1 C2.1, C2.2). Patients in group I received intramedullary fixation using the Sonoma Wrx® device and patients in group II received standard volar locking plate fixation. Radiographic criteria of acceptable healing were used for evaluation. Results: Two groups were similar in terms of baseline characteristics. Mean time of operation was significantly shorter in Group 1 vs. in group 2 (36.81 ± 7.11 vs. 48.97 ± 5.9 minutes, p = 0.001). Time to healing of the fracture was not different between two groups (5.45 ± 1.09 vs. 5.70 ± 1.04 weeks for Group 1 vs. 2, respectively p = 0.36). Overall complications occurred in 9 patients in group 1 and in 15 patients in group 2 (p = 0.17). Follow-up was completed in all patients with a median time of 12 months and 13 months in group 1 and 2, respectively. On radiographic evaluation radial inclination, radial height and volar tilt were not significantly different between group 1 and 2, respectively. There were no significant differences between two groups in regard to wrist rotational degrees measured in last follow-up visit. Conclusion: Sonoma Wrx Device is reliable and effective in terms of achieving satisfactory outcomes in treatment of distal radius fractures. It may be reasonable to use this device to prevent complications that are related to extensive soft tissue dissection. © 2014 Springer-Verlag.
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    Intratendinous Injection of Autologous Conditioned Serum for Treatment of Lateral Epicondylitis of the Elbow: A Pilot Study
    (ACAD MEDICAL SCIENCES I R IRAN, 2022) İpek, Deniz; Çalbıyık, Murat; Zehir, Sinan
    Background: Autologous conditioned serum (ACS) has been effectively used in treatment of osteoarthritis. However, less is known about its efficacy in tendon disorders. In this pilot study, we aimed to evaluate the short- and long-term effects of intratendinous injection of ACS in lateral epicondylitis (LE) of the elbow. Methods: This prospective cohort included 42 patients with LE of the elbow who received 4 intratendinous injections of Orthokine (R) (Orthogen Lab Services GmbH, Dusseldorf, Germany) under local anesthesia over 2 weeks in an outpatient setting. The clinical and functional outcomes of injections were evaluated at 3 months and 1 year after the procedure. Pain was assessed using a visual analog scale (VAS) and functional assessment was made using the Mayo Elbow Performance Score (MEPS) and Oxford Elbow Score (OES). Results: The pre-injection VAS score (7.07 +/- 1.19) improved significantly after the procedure at both 3 months (3.55 +/- 0.56, P < 0.001) and 1 year (1.73 +/- 0.82, P < 0.001). Similarly, the mean MEPSs were significantly different between baseline and 3 months (56.42 +/- 7.51 vs. 79.76 +/- 3.81, P < 0.001) and between baseline and 1 year (56.42 +/- 7.51 vs. 94.28 +/- 4.06, P < 0.001). The baseline OESs (84.17 +/- 6.07) also improved with intratendinous injection of ACS at 3 months (41.96 +/- 9.23, P < 0.001) and 1 year (7.43 +/- 4.31, P < 0.001). Only six patients (14.2%) had mild ecchymosis and swelling around the injection site which resolved spontaneously. Conclusion: ACS is a promising option for treatment of LE of the elbow, given its early onset of pain-relieving action and long-lasting functional effects. These findings await confirmation by large-scale and prospective trials.
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    Is Lever Test Superior to Lachman, Pivot Shift, Drawer Tests in Diagnosing Anterior Cruciate Ligament Injuries?
    (CUREUS INC, 2022) İpek, Deniz; Zehir, Sinan; Dündar, Abdulrahim
    Abstract Introduction: The physical examination in anterior cruciate ligament (ACL) injuries is extremely important, and the Lever test is commonly utilized on ACL evaluation. However, the number and scope of studies on the Lever test is limited. In this prospective cross-sectional study, we aimed to evaluate the effectiveness of the diagnostic values of Lachman, Pivot Shift, Lever, and Anterior Drawer tests in terms of quadriceps atrophy and case phase in ACL injuries. Methods: In this prospective study, diagnostic values of Lachman, Pivot Shift, Lever, and Anterior Drawer tests were examined on 189 patients with positive MRI results as the gold standard. Results: Lever test positivity was significantly more frequent in the group with quadriceps atrophy preoperative and after sedation (p<0.05). Anterior Drawer test positivity was significantly more frequent in the group with positive quadriceps atrophy preoperatively, after sedation and after spinal anesthesia (p<0.05). Lever and Anterior Drawer tests were positively correlated with quadriceps atrophy preop and after sedation (p<0.05). Lever test before surgery, after sedation and after spinal anesthesia in the chronic patient group was more positive than in the acute and subacute groups (p<0.05). Lever test was positively correlated with phase preoperatively, after sedation and after spinal anesthesia (p<0.01). Conclusion: The presence or absence of quadriceps atrophy in patients with acute, sub-acute, or chronic ACL injury has a significant effect on the predictive value of the Lever test. We think that univariate analyzes may give incorrect results when demonstrating predictive value, and it would be more correct to perform multivariate analyzes.
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    Long-term outcomes of percutaneous release technique or open for trigger finger in diabetic patients
    (MediHealth Academy Yayıncılık, 2023) Dündar, Abdulrahim; İpek, Deniz; Kaya, Şehmuz
    Aims: Trigger finger is seen more often in diabetic patients and can lead to more serious postoperative complications compared to non-diabetic patients. The aim of this study was to compare the outcomes of open and percutaneous release techniques in diabetic patients. Methods: This retrospective study included 62 patients who met the study criteria. Of these patients, 32 underwent open release surgery and 30 underwent percutaneous release with an 18-gauge needle. The patients were evaluated retrospectively in respect of the data on first presentation preoperatively and at postoperative follow-up examinations at 3 weeks, 6 months and 1 year. A retrospective examination was made of the demographic data, Visual Analog Scale (VAS) scores preoperatively, at 6 and 12 months postoperatively, recurrence rates at the end of 6 months and 1 year, the Quinnell grading scale at the end of 1 year, wound site infection, tendon damage and neurovascular complications. VAS scores and the Quinnell grading scale were used for clinical evaluation. Results: The data of a total of 62 patients were statistically analyzed in the study, with 32 (51.6%) in the Open group and 30 (48.4%) in the Percutaneous group. The mean age of the patients was 58.97±7.51 (min-max: 45-72) years. The distributions of trigger finger and Quinnell grading system scores were statistically similar between the groups (P=0.974, P=0.279, respectively). The recurrent triggering rate at the 6th and 12th month was significantly higher in the Percutaneous group (P=0.049, P=0.049, respectively). The average return to work duration in the Percutaneous group (1.70±0.75) was significantly shorter than that in the Open group (3.88±1.21) (P<0.001). Pre-op, Post-op 6th and 12th month VAS scores did not significantly differ between the groups (P=0.466, P=0.356, P=0.175, respectively). Conclusion: Although satisfactory results were obtained with both percutaneous and open release techniques in the patients with diabetes in this study, the percutaneous release technique was seen to be a method which can be easily performed in an outpatient setting and had fewer complications.
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    Minimally invasive implantation of a novel flexible intramedullary nail in patients with displaced midshaft clavicle fractures
    (Springer Berlin, 2016) Çalbıyık, Murat; Zehir, Sinan; İpek, Deniz
    Purpose: We report our initial experiences with use of a new technique we developed for implantation of Sonoma Crx intramedullary rod in patients with displaced clavicle fractures. Methods: A total of 35 patients (mean age 41.82 ± 13.65, male:female ratio = 21:14) having Robinson Types 1b, 2b and 3b displaced midshaft fractures with >2 cm clavicle shortening were included into the study. A single small incision (~1 cm) was made over the anteromedial aspect of the involved clavicle and an appropriate sized intramedullary nail was inserted in reverse (mirror) configuration of that has been suggested by the manufacturer. Functional assessment was made using Constant shoulder and disability of the arm shoulder and hand scoring. Results: Mean time of operation was 51.20 ± 10.56 min and mean time of fluoroscopy was 2.33 ± 1.12 min. One patient had implant failure 2 months after the operation and was revised to a new implant. Superficial or deep wound infection, hematoma, neurovascular complication, substance irritation or implant failure did not occur. Follow-up ranged from 12 to 45 months (mean 28.5 ± 9.95 months). At the latest follow-up, mean Constant shoulder score was 93.14 ± 4.06 (ranging from 84.00 to 100.00) and mean disability of the arm shoulder and hand score was 3.68 ± 1.73 (ranging from 0.0 to 6.80). Conclusion: The technique we described herein provided successful procedural outcomes, eliminated the need for deep dissection of the fracture site and reduced the operation time. Further study on larger populations is warranted to confirm these findings. © 2015, Springer-Verlag Berlin Heidelberg.
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    Opening wedge high tibial osteotomy using tricalcium phosphate wedge: Preliminary results
    (SAGE Publications Ltd, 2014) Zehir, Sinan; Çalbıyık, Murat; Şahin, Ercan; Kalem, Mahmut; Songür, Murat; İpek, Deniz
    Objectives: High tibial osteotomy is a standard procedure indicated for early medial sided osteoarthritis in varus knees. In this study, we present the early results of high tibial open wedge osteotomy cases using beta-tricalcium phosphate as a graft substitute and Otis-c plate. Methods: Between years 2010 and 2013, 47 cases of (34F, 13 M) medial compartmental gonarthrosis with genu varum deformity treated with high tibial osteotomy, were evaluated with at least one year follow-up, preoperatively both clinically and radiologically. Clinical evaluation involved functional assessment and pain evaluation using Lysholm and visual analog scale (VAS) scores, including knee range-of-motion. Radiological evaluation included medial joint space measurements on weight bearing knee radiographs with measurements of varus angle and posterior tibial slope. Surgical procedure included standard arthroscopy followed by medial sided opening wedge osteotomy with correction of the varus deformity using ?- tricalcium phosphate graft substitute and fixation of the osteotomy site using Otis-C plate and locking screws. All patients were evaluated at the end of minimum one-year follow-up period. Results: Mean age of the patients was 56,7 (50- 65) years and mean follow-up period was 24,5 (12- 44) months. Mean duration of surgery was 47,4±10.2 minutes. No case of nonunion, delayed union, neurovascular injury or iatrogenic fracture was encountered. Two cases developed deep vein thrombosis and one case developed superficial wound infection managed successfully by local debridement with retention of implants and antibiotics. Mean duration of union was 13,4±2.7 weeks. Mean preoperative and follow-up range-of-motion were measured as 131±8.9 and 129±9.1 respectively with no statistical difference. Preoperative and follow-up VAS scores showed significant difference as 7.6±1.76 and 2.3±1.08 respectively (p=0.001). Also Lysholm scores improved significantly at the end of the follow-up period (43.23±4.01 vs. 76.3±3.7 p<0,001). Radiological evaluation revealed mean correction angle of 10.84±2.70 degrees at follow-up. Mean posterior tibial slope was measured relatively unchanged (8.6±1.70° degrees preoperatively versus 8.2±2.30° follow-up). Medial joint space width measurements showed a significant increase (pre-op 3.7±1.6 mm. versus 4.6±1.32 mm. at the follow-up (p<0.001)). Conclusion: Medial opening wedge osteotomy for treatment of early medial compartment gonarthrosis in varus knees is still a valuable option. Our short term preliminary results using beta-tricalcium phosphate wedge graft substitute and Otis-c plate-screw osteosynthesis revealed satisfactory short term clinical and radiological results with acceptable complication rates. © The Author(s) 2014.
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    Prospective randomized study comparing results of fixation for clavicular shaft fractures with intramedullary nail or locking compression plate
    (Springer Verlag, 2017) Çalbıyık, Murat; İpek, Deniz; Taşkoparan, Mehmet
    Purpose: To reveal whether minimal invasive implantation of a novel intramedullary device produces comparable outcomes with LCP fixation in patients with displaced midshaft clavicle fractures. Methods: A prospective randomized two-arm study was performed on patients presenting with Robinson type 2B1 and 2B2 displaced midshaft clavicle fractures with >2 cm shortening. In group 1 (n = 35, mean age; 42.02 ± 13.87) patients received minimal invasive intramedullary fixation with Sonoma Crx device (Sonoma, USA) whereas in group 2 (n = 40, mean age; 39.07 ± 7.04) patients received 3.5 mm locking compression plate (Synthes, USA). Functional assessment was made using range of motion measurement (ROM), constant shoulder score and DASH disability of the arm, shoulder and hand (DASH) scoring. Results: Mean time of operation was similar between the two groups (p = 0.46) whereas mean time of fluoroscopy was significantly longer in group 1 compared to group 2 (p < 0.001). At the 12 month follow-up, there was a slight but significant difference in ROM degrees between the two groups (p = 0.005). Mean quick DASH score was significantly lower in group 1 than that in group 2 (p < 0.001) whereas there was no significant difference in constant shoulder scores between the two groups (p = 0.06). Time to bony union was also shorter in group 1 compared to group 2 (p < 0.001). Conclusion: Minimal invasive intramedullary implantation technique provided satisfactory clinical outcomes and shortened the time until bony union compared to LCP fixation. Further study on larger populations is required to establish whether the technique offers lower complication rates than LCP fixation. © 2016, SICOT aisbl.
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    Treatment of Basicervical Femoral Fracture With Retractable Talon Hip Compression Screw
    (CUREUS INC, 2022) Dündar, Abdulrahim; İpek, Deniz; Zehir, Sinan
    Background Basicervical femoral fractures (BFFs) are rare and biomechanically unstable. The goal of this study was to evaluate the effectiveness of the Talon™ DistalFix™ (Orthopedic Designs North America, Inc., Tampa, FL, USA) nail for the treatment of BFFs with a novel design. Methodology In this retrospective study, 25 patients with BFFs were analyzed between January 2016 and March 2020 at our institute. All patients were treated with the Talon™ DistalFix™ nail. Patients over the age of 60 years with basicervical fractures caused by low-energy trauma were included in this study. For inclusion into the study, the minimum follow-up time had to be longer than six months. The postoperative radiographic bone union, operative time, tip-apex distance (TAD), sliding distance of the lag screw, quality of fracture reduction, and major complications such as cut-out, non-union of the fracture, femoral head collapse, and cut-through were recorded. The Harris Hip Score was used to evaluate hip function at the end of the follow-up period. Results The mean follow-up period was 22 months (range, 16-28 months), and the mean age was 77.8 years (range, 61-91 years). The average sliding distance of the lag screw was 5.7 mm (range, 0.2-13.1 mm). The mean TAD of immediate postoperative view was 20.8 mm (range, 18.7-23.7 mm), and the TAD was 10 mm. Conclusions According to the clinical and radiological findings of this study, treatment with the Talon™ DistalFix™ nail showed satisfactory results. Hence, it can be a suitable option in the treatment of BFFs.
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    Use of different methods of intramedullary nailing for fixation of distal radius fractures: a retrospective analysis of clinical and radiological outcomes
    (Int Scientific Literature, 2018) Çalbıyık, Murat; İpek, Deniz
    Background: We aimed to evaluate the clinical and radiologic outcomes of using Sonoma WRx versus Micronail intramedullary nailing for the fixation of distal radius fractures. Material/Methods: A total of 68 patients with primarily extra-articular and simple intra-articular fractures of the distal radius who underwent intramedullary distal radius fixation using Sonoma WRx (n=39) or Micronail (n=29) intramedullary nails were enrolled in the study. The clinical outcome measures included the range of motion (ROM), visual analog scale (VAS), functional outcomes (patient-reported Disabilities of the Arm, Shoulder and Hand [DASH] score and clinician-based Gartland-Werley score), radiographic scores (Stewart score), and parameters related to the quality of radiographic reduction and complications (radial inclination, volar tilt, radial height, and radio-ulnar variance). Results: Significantly higher DASH (15.0±3.3 vs. 8.3±1.5, p
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    Use of volar locking plate versus intramedullary nailing for fixation of distal radius fractures: a retrospective analysis of clinical and radiographic outcomes
    (Int Scientific Literature, 2018-01-30) Çalbıyık, Murat; İpek, Deniz
    Background: The objective of this study was to evaluate clinical and radiographic outcomes of volar plate versus intramedullary nailing for fixation of distal radius fractures. Material/Methods: This retrospective study included 64 patients with extra-articular and simple intra-articular fractures of the distal radius who underwent intramedullary fixation using volar locking plate (n=35, mean age 47.3±16.4 years, 82.9% female) or intramedullary nailing (n=29, mean age 51.3±10.1 years, 58.6% female). Outcome measures were range of motion (ROM); visual analog scale (VAS); Disabilities of the Arm, Shoulder, and Hand (DASH) score; Gartland-Werley score; Stewart score; and radiographic findings. Results: Time to fracture union was 5.5±1.2 and 5.2±0.6 weeks after volar plate fixation and intramedullary nailing, respectively (p>0.05). Compared to volar plate fixation, intramedullary nailing provided better restoration of volar tilt (6.9±6.3° vs. 9.4±1.6°, p=0.004) and wrist flexion (74.3±15.1° vs. 67.9±13.1°, p=0.003). However, volar plate fixation was significantly better in restoration of supination (85.0±8.3° vs. 81.9±5.1°, p=0.001) and radio-ulnar variance (0.7±0.8 mm vs. 1.1±0.9 mm, p=0.05), DASH score (9.2± 9.0 vs. 15.0 ±3.3, p=0.035), and Gartland-Werley score (1.8±0.9 vs. 4.9±5.4, p=0.004). Volar plate and intramedullary nailing groups were comparable with respect to Stewart score (1.5±0.7 and 1.6±1.3, p>0.05) and complication rates (34.3% vs. 37.9%, p>0.05). Conclusions: Both volar plate fixation and intramedullary nail fixation provide good clinical and radiographic outcomes for primarily extra-articular or simple intra-articular distal radius fractures. As intramedullary nailing provides better restoration of volar tilt and wrist flexion, volar plate fixation provides better restoration of radio-ulnar variance and wrist supination.

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