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Öğe Amputation for upper extremity ischemia following shoulder dislocation: case report and a review of literature(2015) Songur, Murat; Şahin, Ercan; Kalem, Mahmut; Zehir, SinanInjury of the axillary artery following glenohumeral dislocation is a very rare situation. The mechanisms for arterial injuries are lacerations, rupture, avulsion of main branches or intimal tears and pseudo aneurysm formations. In this report we present an upper extremity ischemia following shoulder dislocation resulting with loss of extremity. Our aim was to highlight the importance of the third part of axillary artery and consequences of underestimation of vascular pathologies following shoulder injuries.Öğe Chondral lesion of the capitellum humeri accompanying a radial head fracture: A case report(Sağlık Araştırmaları ve Stratejileri Derneği, 2015) Songur, Murat; Şahin, Ercan; Kalem, Mahmut; Zehir, SinanIn this case report we present a case of a full thickness chondral lesion of the anterior-distal surface of the capitellum humeri, accompanying an intraarticular radial head fracture. The importance of this case is the resemblance of the chondral injury to a Lorenz-Kocher lesion of the humerus and atypical displacement of chondral fragments. A 32-year-old man was admitted to the emergency room after a fall on his right upper extremity. X-ray and Computed Tomography (CT) scan of the elbow revealed a minimally displaced radial head fracture (Mason type 2), with a 4 mm step (depression) at the joint surface. During the operation, at the anterior surface of the distal humerus, a full thickness chondral lesion was encountered.After removal of chondral fragments from the fractured radial head surface, it was seen that these fragments were of capitellar origin. Following radial head fixation, early active assistive motion was started. At the 6 month visit, the patient was painfree with full participation in activities of daily livingwith a DASH score of 12.5. This injury is important due to demonstration of such an extensile injury in spite of benign looking radiology. Although radial head fractures were described, these type of occult injuries may be responsible for unexplainable and unfavorable outcomes following low energy radial head fractures treated conservatively.Öğe Conventional trans-tibial versus anatomic medial portal technique for femoral tunnel preparation in anterior cruciate ligament reconstruction; Comparison of clinical outcomes(Medknow Publications, 2016) Zehir, Sinan; Şahin, Ercan; Songur, Murat; Kalem, MahmutAim: Method of femoral tunnel preparation in anterior cruciate ligament (ACL) reconstruction is controversial. In this study, we aimed to determine if there is any difference between the clinical outcomes of two most commonly used drilling techniques; which are conventional trans-tibial (TT) drilling of femoral tunnel and anatomic preparation of femoral tunnel through medial portal (MP), in patients who underwent ACL reconstruction. Material and Methods: One hundred and twenty-nine male patients who underwent ACL reconstruction between 2010 and 2012 were included in the study. Single-bundle reconstruction with a quadrupled autologous hamstring graft was performed in all patients. Femoral tunnel was drilled by the conventional TT technique in 58 patients (Group 1) and through MP in 71 patients (Group 2). Functional evaluation was made about 12 months postoperatively. Functional evaluation included the Lysholm Knee Scale, International Knee Documentation Committee Scoring (IKDC), and Tegner Activity Level Scale were used for assessment. The anteroposterior stability was assessed using KT-1000 arthrometer and the pivot shift test for assessment of rotational stability. Results: Interval between injury and surgery was similar between two groups (median 8.0 vs. 10 weeks, for TT vs. MP, respectively). One hundred twenty-five patients attending the final follow-up examination (96.8%) were evaluated. The results of Lysholm, IKDC, and Tegner scales were found to be similar. According to KT-1000 arthrometer results, MP group revealed slightly better results than TT group. Regarding pivot shift, MP group showed significantly better stability than TT group (P < 0.001). Conclusion: The anatomical single-bundle femoral tunnel preparation in the reconstruction of the ACL seems as effective as the conventional technique in terms of functional stability in the midterm. The technique better preserved the rotational stability in non-professional athletes.Öğe Effect of intramuscular botulinum toxin-A in a rat rotator cuff repair model: An experimental study(Ekin Medical Publishing, 2015) Şahin, Ercan; Kalem, Mahmut; Zehir, Sinan; Songur, Murat; Demirtaş, Mehmet A.Objective: Rotator cuff repair is associated with multiple complications, significant morbidity, and reintervention, which could be mitigated by postoperative chemodeneveration with botulinum toxin-A (BTX-A). This study evaluated the antinociceptive and paralytic effects of BTX-A on an experimental supraspinatus repair rat model and its effect on functional outcomes (running performance). Methods: Thirty rats were grouped into the surgical repair group (group A), repair + intramuscular BTX-A group (group B), or control group (group C). At the end of the 3-month follow-up, running performance of the rats on a motorized treadmill was evaluated in four time periods (0-30 min, 30-60 min, 60-90 min, and 90-110 min), and penalty points (i.e., number of shock stimuli per lane) were recorded. Afterwards, the supraspinatus muscles were removed and evaluated histologically. Results: Regarding running performance, group B received significantly fewer penalty points than did group A (p<0.05). The penalty points received were not significantly different between groups B and C in the first three time periods, but were significantly higher in group B at the 90-110-min interval than in group C. On necropsy, all repaired tendons were intact, with no sign of failure at the repair site. Histological evaluation revealed marked degeneration and necrosis of muscles in both repair groups, which was much less evident in group B. Groups A and B had less fatty infiltration than group C. Conclusion: BTX-A injections resulted in a better function based on running performance, probably due to decreased tissue tension at the repair site and less pain. Further studies on humans are needed to demonstrate this effect clinically. © 2015 Turkish Association of Orthopaedics and Traumatology.Öğe Gluteal compartment syndrome secondary to superior gluteal artery injury following pelvis fracture: a case report and review of literature(Emergency Medicine Association of Turkey, 2016) Songur, Murat; Şahin, Ercan; Zehir, Sinan; Öz, İbrahim İlker; Kalem, MahmutAcute gluteal artery syndrome secondary to superior gluteal artery injury following pelvic fracture is a rare entity with potential for significant morbidity and mortality. In this report we present such a case resulting with a favorable outcome with prompt diagnosis and appropriate treatment. © 2016 The Emergency Medicine Association of Turkey.
