Browsing by Author "Kaleli, Tufan"

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A new material for prevention of peritendinous fibrotic adhesions after tendon repair: oxidised regenerated cellulose (Interceed), an absorbable adhesion barrier
(Springer, 2008-06) Öztürk, Çağatay; Temiz, Atiye; Kara, Kurşat; Kaleli, Tufan; Bakunov, Ayvaz; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedik Cerrahi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; 0000-0002-2058-6534; 0000-0003-3133-206X; W-4795-2018; S-6686-2019; 6701549831; 24075290800; 24076392800; 6603422875
In this experimental study, we aimed to examine the ability of absorbable oxidised regenerated cellulose (Interceed, TC-7, Johnson & Johnson, USA) to inhibit the formation of peritendinous fibrotic adhesions after tendon repair in rats. Both Achilles tendons of 23 female Wistar-Albino rats weighing between 350 and 450 grams were cut and repaired. On the right side, Interceed absorbable adhesion barriers were wrapped around the repaired tendon (group I). On the left, the same procedures were applied except for the Interceed wrapping and these were grouped as control (group II). Animals were sacrificed at postoperative day 28 and macroscopic and histological examination was performed. All the animals survived and no tendon rupture was observed. No wound dehiscence, wound infection or exposure of repaired tendons occurred. Macroscopically, there were three (13.1%) tendons without adhesion formation and 20 (86.9%) tendons with inferior adhesion formation in group I; on the other hand, there were 16 tendons (69.5%) with medium grade adhesion formation and seven tendons (30.5%) with severe peritendinous adhesion formation in group II (control group) (p < 0.05). Histologically, adhesion formation was absent in 11 tendons (47.8%) and slight in 12 tendons (52.2%) in group I; while in group II, it was slight in two (8.6%), moderate in 15 (65.2%) and severe in six tendons (26.2%) (p < 0.05). Sixteen (69.5%) of 23 tendons in group I and 11 (47.8%) of 23 tendons in group II showed no inflammatory reaction (p < 0.05). Nineteen (82.6%) tendons in group I and only one tendon in group II showed excellent to good tendon healing (p=0.00). According to our results, we feel that Interceed may have an intraoperative role to play in the reduction of adhesions after surgical tendon repair. This study suggests that absorbable oxidised regenerated cellulose merits further evaluation as a potential treatment to inhibit the formation of peritendinous adhesions. Rigorous and extensive controlled trials should be undertaken on patients undergoing tendon repair with or without this barrier.
Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study
(Türk Eklem Hastalıkları Vakfı, 2018) Şahin, Namık; Atıcı, Teoman; Çavun, Sinan; Özakın, Cüneyt; Kaleli, Tufan; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Farmakoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; 0000-0001-5428-3630; A-5095-2018; AAC-9702-2019; AAB-6136-2022; AAG-8392-2021; 7801647288; 6507468595; 57200678942; 6603422875
Objectives: This study aims to compare the antibiotic release and biological effectiveness of bead type and articulating spacers of different cement types with antibiotics added at alternative phases of cement preparation. Materials and methods: Four gram vancomycin was added into two types of antibiotic-free cement (Simplex®, Biomet®) with similar viscosity and also gentamycin-containing cement (Refobacin®). Prepared specimens were used to create cement beads and articulating hip spacers, making a total of six different groups. Two alternative groups were formed by adding the Vancomycin while the cement was in dough phase. Antibiotic release and biological activity were evaluated with immunoassay techniques and agar-disk diffusion methods. Results: All groups showed initial antibiotics surge in the first week, which was 2 to 4 times more evident in the beads group. Antibiotic release and change in release rate were significantly different between Simplexalternative and Simplex, Biomet, Refobacin-beads, and between Biometspacer and Refobacin-beads groups (p<0.05). Elution of antibiotics was not different between mobile spacers prepared with conventional or alternative methods (p>0.05). Biomet cement showed larger diffusion inhibition zone in agar. There was no difference between biological activity of the bead and mobile designs of the Biomet brand (p>0.05). Inhibition zone analyses of agar and disk diffusion tests revealed significant differences between several groups (p<0.05). Conclusion: Cement beads provide superior antibiotic release regardless of cement type or preparation method. Simplex P® cement has lower anti-bacterial efficiency than Biomet®. Different methods for cement and antibiotics mixing and addition of extra vancomycin into the commercially drug loaded cement do not have any effect on the results.
Antioxidant effect of alpha-trocopherol on fracture haematoma in rabbits
(Sage Publications, 1996) Durak, Kemal; Bilgen, Ömer Faruk; Kaleli, Tufan; Tuncel, Pınar; Özbek, Resul; Turan, K.; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.
In this study, the effect of free oxygen radicals on lipid peroxidation and the antioxidant role of alpha-tocopherol (vitamin E) in these reactions were investigated in haematoma fluid and venous blood samples in rabbits with femoral fracture. There were 21 male rabbits, divided into 3 groups. Conjugated dienes values (as optical density) were compared in venous blood of the rabbits in Group I taken preanaesthesia and after the onset of anaesthesia and the difference between these values proved to be insignificant (P > 0.05). A control group (Group 2) was given saline before fracture occurrence and the other group (Group 3) was injected with alpha-tocopherol 20 mg/kg intramuscularly. Venous blood samples and fracture haematoma fluids in both Group 2 and Group 3 were assayed biochemically. It was established that conjugated dienes values in fracture haematoma fluid in rabbits in the control group were higher than the values in the venous blood of the rabbits in the same group (P < 0.05). However, conjugated dienes values in the alpha-tocopherol injected group both in the haematoma fluid and in venous blood were reduced compared with those in the control group (P < 0.5). In view of the fact that ischaemia and reperfusion develop in fractured regions and that general body ischaemia develops following serious fractures of the extremities, we consider that prophylactic administration of antioxidants such as alpha-tocopherol may be beneficial in suppressing the destructive effects of free oxygen radicals in cells.
Associations between initial injury severity in acute hand, wrist or forearm injuries and disability ratings and time to return to work
(Türk Travma ve Acil Cerrahi Derneği, 2019-08-06) Çapkın, Sercan; Cavit, Ali; Yılmaz, Kutay; Erdoğan, Eralp; Kaleli, Tufan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı/El Cerrahisi Anabilim Dalı.; 0000-0002-2693-1570; 0000-0002-4292-3837; AAB-6136-2022; ABG-3559-2020; HTN-5096-2023; FZU-6956-2022; ESB-9213-2022; 56662490000; 55507113700; 57216913348; 57216914145; 6603422875
BACKGROUND: This study aimed to examine the relationships between the initial anatomic severity of hand, wrist and forearm injuries, as evaluated by the Modified Hand Injury Severity Score (MHISS), and each of the following parameters: disability rating and time to return to work. METHODS: In this study, 94 patients who underwent operations due to acute hand, wrist and forearm injuries were included. MHISS was used to assess the severity of the injury. Disability rates of the patients were calculated six months after injury in accordance with the 'Regulation on Disability Criteria, Classification and Health Board Reports to be Given to Disabled People'. The time to return to work was defined as the length of time (in days) between the injury and the patient's return to work. Spearman rank correlation analysis was performed to analyse correlations between the MHISS and each of the following: disability rates and time to return to work. RESULTS: The mean overall MHISS was 125.23 (5-880). The mean overall upper extremity disability ratio (UEDR) was 17.64 +/- 22.6 (range: 0-94), and the mean overall total body disability ratio (TBDR) was 10.57 +/- 13.45 (range: 0-56). Among the study population, 87 (92.6%) patients were able to return to their jobs. The mean overall time to return to work was 138.69 (range: 35-365 days). A statistically significant correlation was found between MHISS and UEDR, TBDR and time to return to work and UEDR, TBDR (p<0.001). CONCLUSION: As a result, as the initial injury severity increased, greater disability remained and the time to return to work increased. Predicting prognosis by determining the injury severity in the initial evaluation of patients may be important in predicting a patient's future permanent disability level, which can contribute to maintaining patient expectations at a reasonable level, thereby aiding in psychosocial support.
Bilateral brachial artery infiltration by tumoral calcinosis: A case report
(Türkiye Ortopedi Travmatoloji, 2021-05-01) Cavit, Ali; Çapkin, Serkan; Yılmaz, Kutay; Kaleli, Tufan; Yılmaz, Kutay; KALELİ, HÜSEYİN TUFAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/El Cerrahisi Kliniği/Ortopedi ve Travmatoloji Anabilim Dalı; 0000-0002-2693-1570; HTN-5096-2023; AAB-6136-2022
We, herein, presented a rare case of bilateral brachial artery infiltration by tumoral calcinosis located on both elbows. A 58-yearold man presented with a history of painless, palpable solid mass restricting the range of motion of both elbows. These masses were located on the anterior aspect of the elbows and gradually enlarged. After clinical, laboratory and radiological examinations, tumoral calcinosis was suspected, and excisional biopsy was planned for a definite diagnosis. Surgery was first performed on the left elbow. The median nerve was found to be compressed but not infiltrated by the mass. Interestingly, the brachial artery was totally infiltrated throughout the entire mass. Occlusion was observed in the brachial artery located within the mass. The tumor on the left elbow, 8.5 x 5.5 x 2.5 cm in size, was totally excised with approximately 12-cm brachial artery segment. The artery was resected until the healthy tissue was reached. The defect was reconstructed with saphenous vein graft obtained from the ipsilateral lower extremity. The same surgical procedure was performed on the right elbow after 3 months. The tumor size on the right elbow was 7 x 3.5 x 1.7 cm. Approximately 15-cm brachial artery segment was excised, and the defect was reconstructed with saphenous vein graft. Tumoral calcinosis is a rare benign condition that can be located in close relationship with neurovascular structures. In such cases, detailed neurologic and vascular examination, including imaging modalities, for arterial flow is essential to establish a more accurate surgical plan and avoid any unexpected situation during surgery.
Bilateral traumatic dislocation of the hip: Simultaneously one hip anterior and the other posterior
(Springer, 1998) Alyüz, Necmi; Kaleli, Tufan; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; 6603422875
The case of a 28-year-old man with bilateral dislocation of the hip, simultaneously one hip anteriorly and the other posteriorly is reported. In this case a very drunk driver without a seatbelt crashed his car. Uncontrolled trauma resulted in two different types of hip dislocation. At the 2-year follow-up he had a serious mobilisation problem with avascular necrosis of one hip.
Carpal tunnel syndrome in long term hemodialysis patients
(Medimond S R L, 1998) Roth, J. H.; Richards, R. S.; Kaleli, Tufan; Karaeminoğulları, Oğuz; Dilek, Kamil; Gedikoğlu, Öner; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; 0000-0002-7434-8769; AAI-3754-2021
The frequency of carpal tunnel syndrome in 95 patients who has been receiving long term hemodialysis in terms of hemodialysis period was investigated. Carpal tunnel syndrome was established in 9 (%41) out of 22 patients who were receiving hemodialysis for 8-16 years (group 1), in 6 (%14.6) out of 41 cases, which dialysis period was 4-8 years (group 2) and in 1 (%3) out of 32 cases, which dialysis period was 1-4 years (group 3). A total of 16 patients who were receiving hemodialysis for 3-14 years (13 female, 3 male) were operated for carpal tunnel syndrome. Histological examination of the synovial tissues revealed amyloid deposition (B-2 microglobulin) in 12 patients.
Distal fibula resection in osteochondroma
(Sage Publications, 1996) Durak, Kemal; Bilgen, Ömer; Kaleli, Tufan; Aydınlı, Ufuk; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; 6602850051; 16933501900; 6603422875; 6602800134
We evaluated the effects of distal fibula resection on the ankle function in a patient with osteochondroma. Osteochondroma is a benign tumour which localizes in the metaphysis of the long bones, in the knees and in the shoulders, Although it does not usually cause any symptoms in children under 10 years, we had a 4-year-old patient with a painful swollen ankle with Limited motion, Resection of the lateral malleolus did not affect ankle function and he remained pain-free in daily activities during a 2.5 year follow-up period.
Distribution of Intramuscular Giant Lipomas in the Functional Compartments of the Forearm: A Report of 12 Cases
(Georg Thieme, 2020-08-01) Çapkın, Sercan; Cavit, Ali; Yılmaz, Kutay; Kaleli, Tufan; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmakoloji Anabilim Dalı; ABG-3559-2020; AAB-6136-2022; 56662490000; 55507113700; 57216913348; 6603422875
Purpose The aim of this study was to investigate the distribution of intramuscular giant lipomas in the functional compartments of the forearm and to compare their clinical, radiological and histopathological features with those reported in the current literature. Methods The study included 12 patients who were surgically treated for intramuscular lipomas > 5 cm in size located in the forearm that had been confirmed histopathologically between April 2006 and March 2017. Data about the patients with respect to age, sex, affected side, localisation of the lipomas in the forearm functional compartments, size, histopathological features and recurrence were collected. According to the clinical complaints, direct radiography and magnetic resonance imaging were applied. Results The average diameter was 6.5 cm (range: 5.5-9 cm). All lipomas had a well-defined border. All the patients presented with soft-tissue masses that were painless in seven patients. Five patients had nerve compression symptoms. When the lipomas were classified according to the functional compartments of the forearm, six of them were located in the superficial volar compartment, two in the deep volar compartment, two in the deep dorsal compartment and two in the lateral compartment. All lipomas were surgically removed by marginal excision. None had complications or recurrence at a mean of 6.5 years follow-up (range: 1-12 years) after surgery. Conclusions Intramuscular lipoma is a relatively uncommon tumour, especially in the forearm. Because of the proximity to the neurovascular structures in the forearm, excision of lipomas should be performed with care and include wide incisions. Additionally, knowing the anatomical features of the compartment where the lipoma is localised in the forearm is important in planning surgery to enable easier dissection of the lipoma and lessen the risk of damage to adjacent neurovascular structures.
Double reverse-flow island flaps for two adjacent finger tissue defect
(Springer, 2004-04) Kaleli, Tufan; Ersözlü, Salim; Öztürk, Çaǧatay; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Tramvatoloji Anabilim Dalı.; 0000-0003-3133-206X; S-6686-2019; AAB-6136-2022; 6603422875; 8869531800; 8230555600
Introduction. Soft-tissue reconstruction of fingertip injuries remains a challenge for hand surgery. Tissue loss of multiple digits is a serious problem for hand surgeons. Surgical possibilities include regional, distant and local flaps. In this study, five patients presented with tissue loss of two adjacent fingers and were treated by double reverse-flow island flaps. Materials and methods. The surgical technique is an application of the reverse-flow homodigital island flap for two adjacent finger tissue defects. Instead of one flap, double island flaps are applied to two adjacent finger tissue defects. The flaps are raised from the lateral or medial palmar surface of the proximal phalanx level. Anastomoses between the radial and ulnar digital arteries at the distal interphalangeal joint level are preserved. Results. Three of the patients had tissue defects at the fingertip. In these cases, digital nerve anastomosis with the counter lateral digital nerve made the flaps sensitive. In two patients, the tissue defect was on the dorsum of the middle phalanx level. In these cases, the flaps were non-sensitive. Nneither infection nor flap failure was seen in the patients. Sensitive function was satisfactory in fingertip applications. Conclusion. The reverse-flow homodigital island flap is a commonly used surgical technique for tissue defects in the fingers. The double reverse-flow island flaps involve the application of this technique for two adjacent fingers. The important point in the surgical technique is that the vascular supply of the two flaps should originate from the same common palmar digital artery. This technique offers a possibility to repair the defects of two adjacent fingers.
Dupuytren kontraktürü: parsiyel fasiektomi uygulanan 32 hastanın retrospektif analizi
(Bursa Uludağ Üniversitesi, 2019-04-08) Çapkın, Sercan; Kaleli, Tufan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı/El Cerrahisi Bilim Dalı.
Dupuytren kontraktürü nedeniyle parsiyel fasiektomi uyguladığımız 32 hastanın demografik ve klinik özellikleri, fonksiyonel sonuçları, komplikasyon ve nüks oranları güncel literatür eşliğinde tartışıldı. Çalışmamızda; erkek/kadın oranı: 7/1, hastalığın başlangıcındaki ortalama yaş 55.4±7.1, cerrahi esnasındaki ortalama yaş 60.4±8.1 olarak tespit edildi. 7 hastada (%21.875) aile öyküsü, 22 hastada (%68.75) sigara kullanımı, 6 hastada (%18,75) düzenli alkol kullanımı, 10 hastada (%31,25) tip 2 diyabet, 2 hastada (%6.25) karaciğer hastalığı, 1 hastada (%3.125) epilepsiye bağlı uzun süre barbitürat kullanımı gibi etiyolojik faktörler mevcuttu. En sık etkilenen parmak 26 hasta (%81.25) ile yüzük parmağı olup, 18 hastada (%56.25) küçük parmak, 8 hastada (%25) orta parmak, 1 hastada (%3.125) işaret parmağı tutulumu vardı. Ameliyat öncesi, ortalama total pasif ekstansiyon kaybı (TPEK) 89.68º±30.29, ameliyat sonrası ortalama TPEK 6.09º±6.44 olarak bulundu. Ameliyat sonrası ortalama total ekstansiyon kazancı %93.2 olarak bulundu. Ortalama takip süresi 70±44 ay olup, bu süre içerisinde 1 hastada (%3.125) nüks görüldü. 2 hastada pansumanlara sekonder iyileşen cilt nekrozu, 1 hastada geçici hipoestezi olmak üzere toplam 3 hastada (%9.375) komplikasyon meydana geldi. MKF ve PİP eklem kontraktüründe yeterli düzelme sağlaması, komplikasyon ve nüks oranlarının düşük olması nedeniyle parsiyel fasiektomi dupuytren kontraktürünün cerrahi tedavisinde etkili ve güvenilir bir yöntemdir.
Efficacy of single-dose radiotherapy in preventing posttraumatic tendon adhesion
(Springernature, 2020-06-02) Ermutlu, Cenk; ERMUTLU, CENK; Kaleli, Tufan; KALELİ, HÜSEYİN TUFAN; Yalçınkaya, Ulviye; YALÇINKAYA, ÜLVİYE; Çetintaş, Sibel; ÇETİNTAŞ, SİBEL; Atıcı, Teoman; ATICI, TEOMAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolijisi Anabilim Dalı.; 0000-0001-8259-3695; 0000-0003-1109-8958; 0000-0002-3396-3407; AAH-8924-2021; AAB-6136-2022; A-5095-2018; AAB-2795-2021
Background and AimPosttraumatic peritendinous adhesion is the greatest obstacle to achieve normal tendon function following lacerations of extrinsic flexor tendons of the hand. In this study, we aimed to evaluate whether single-dose radiotherapy (RT) has the potential to modulate intrasynovial tendon adhesions.Materials and MethodsA total of 80 tendons from the third to fourth flexor profundus of both hind paws of 20 adult New Zealand rabbits were used in this study. Rabbits in the RT group received 3 Gy of X-irradiation in a single fraction. Histopathological evaluation of longitudinal sections of tendons was made using the Tang grading system for peritendinous adhesions. Intratendinous quality of the healing tissue in the laceration zone was assessed using a modified Movin scale.ResultsAdhesion and inflammatory response were greater in the RT group (p(<)0.001). Tendon healing in the radiation group was found to he more uniform and organized compared with the control group. However, this difference was not statistically significant. The nuclei of the tenocytes in the radiation group showed a closer resemblance to normal tendon tissue when compared with the control group (p=0.007).ConclusionsDespite RT's certain advantages such as extracorporeal use, anti-inflammatory effect, and homogenous tissue penetration, 3-Gy X-irradiation resulted in increased peritendinous posttraumatic adhesion, possibly due to dose imbalance. Increased roundness in the tenocyte nuclei was present in the RT group. Studies with different dosing regimens and a higher number of subjects are necessary to establish an ideal dose suppressing the synovial response without compromising tendon healing.
El parmak tümörleri
(Uludağ Üniversitesi, 2006) Bakunov, Ayvaz; Kaleli, Tufan; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.
Uludağ Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı Ocak 1995 – Aralık 2005 tarihleri arasında parmak tümörü ve tümör benzeri lezyon nedeniyle ameliyat edilen 150 hasta çalışmaya dahil edildi. Tümoral lezyonların lokalizasyonu parmaktaki anatomik bölgelere göre yapıldı. Kemik dokusundan kaynaklanan tümörler yerleştiği falanksa göre proksimal (zon I), orta ( zon II) ve distal (zon III) yerleşimli olarak sınıflandırıldı. Başparmakta bu proksimal ( zon I ) ve distal (zon III ) olarak sınıflandırıldı. Yumuşak doku tümörlerinin yerleşiminde yine anatomik kriterler göz önünde bulundurularak parmaklar çeşitli zonlara ayrıldı. Metakarpo-falangeal eklem zon I’e dahil edildi, proksimal interfalangeal eklem zon II’ye, distal interfalangial eklem ise zon III’e dahil edilmiştir. Başparmak farklı olarak sadece zon I’i ve zon III’ü içermektedir. Parmak cilt ve cilt altı anatomisinin dorsal ve volarda farklılık göstermesi göz önünde bulundurularak yumuşak doku tümörleri ayrıca dorsal ve volar olarak da sınıflandırılmıştır. Sonuçta; çalışmada en sık görülen tümör benzeri lezyon sinovit ve ganglion oldu. En sık 3. parmak ve zon Ia ‘da saptandı. En sık benign yumuşak doku tümörü tendon kılıfı dev hücreli tümör oldu. Yoğunlukla 2. parmak zon I a ve zon II a’da saptandı. Kemik ve kıkırdak dokusu tümörlerinden en sık enkondrom ve osteokondrom görüldü. En sık erkeklerde, sağ elde ve zon I’de görüldü. Olguların çoğu kadındı. Tümörler en sık sağ elde ve işaret parmağında saptandı.
El ve el bileği yerleşimli tendon kılıfının dev hücreli tümörü: 42 hastanın retrospektif analizi
(Bursa Uludağ Üniversitesi, 2019-03-06) Çapkın, Sercan; Kaleli, Tufan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı/El Cerrahisi Bilim Dalı.
Tendon kılıfının dev hücreli tümörü (TKDHT), ganglion kistinden sonra elde en sık görülen benign yumuşak doku tümörüdür. Çalışmamızda el ve el bileği yerleşimli TKDHT nedeniyle ameliyat edilen 42 hastanın demografik, klinik, radyolojik ve histopatolojik özellikleri ile cerrahi sonrası nüks oranları güncel literatür eşliğinde tartışıldı. Çalışmamızda; kadın/erkek oranı: 2.5/1, ortalama yaş 40.23±14.86, rın %64.28’inde tümör volar bölgeye lokalize, elde en sık lokalizasyon başparmak (%33.3), parmaklarda ise en sık lokalizasyon proksimal falanks (%35,71) olup, bulgular literatür verileriyle uyumluydu. Serimizde şikayetin başlangıcından cerrahiye kadar geçen ortalama zaman 5.4 ay olarak bulundu. Nüks gelişen 2 hastada (%4.76) tümör volar bölgeden başlayıp dorsal bölgeye doğru uzanmaktaydı ve muhtemel nüks nedeni geride satellit lezyon kalmasıydı. Sonuç olarak TKDHT benign karakterine rağmen lokal agresif bir tümördür. Nüks oranlarını azaltmak için büyütücü gözlük altında, geniş bir cerrahi sahada, titiz bir cerrahi uygulanmalı, özellikle hem volar hem de dorsal bölgeye lokalize olan tümörlerde geride satellit lezyon bırakmamak için ayrı insizyonlar kullanılması akılda bulundurulmalıdır.
Evaluation of patellar tendon with shear wave elastography after anterior cruciate ligament reconstruction using hamstring tendons
(Türk Eklem Hastalıkları Vakfı, 2020) Akdağ, Gökhan; Uzunlulu, Nail; Alp, Nazmi Bülent; Macunluoğlu, Aslı Ceren; Kaleli, Tufan; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; DXD-5241-2022; GBP-6589-2022; AAB-6136-2022; 57195293117; 57203781308; 6603422875
Objectives: This study aims to evaluate the characteristics of patellar tendons (PTs) of patients who underwent anterior cruciate ligament reconstruction (ACLR) with hamstring tendon autograft using shear wave elastography (SWE). Patients and methods: This prospective study was conducted between August 2017 and February 2018. We performed brightness mode (B-mode) ultrasound and SWE on 21 patients (20 males, 1 female; mean age 32 years; range, 19 to 42 years) who underwent ACLR with a single-bundle transtibial technique using quadruple hamstring autografts and 14 healthy controls (13 males, 1 female; mean age 35 years; range, 25 to 47 years). Length and thickness of the PT were evaluated with B-mode ultrasound, while elasticity values were evaluated with SWE in the patient and control groups. Results: The mean SWE value of the patient group on the operated side was 25.30 (min-max=16.60-46.20) and on the non-operated side 23.20 (min-max=12.40-44). There were no statistically significant differences regarding PT elasticity, thickness, or length between the groups (p>0.05). Conclusion: There were no differences regarding elasticity, length, or thickness between the operated and healthy knees detected with SWE. Upcoming research should focus on tendon biopsy and biochemical analyses for the identification of possible intrastructural changes of the tendon due to collagen synthesis after ACLR with hamstring autograft.
External fixation for surgical treatment of a mallet finger
(Churchill Livingstone, 2003-06) Kaleli, Tufan; Öztürk, Çaǧatay; Ersözlü, Salim; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; 0000-0003-3133-206X; S-6686-2019; AAB-6136-2022; 6603422875; 8230555600; 8869531800
A new surgical technique is described for the treatment of mallet finger deformity which involves the application of a mini external fixator across the distal interphalangeal joint and resection of a portion of the extensor mechanism. We reviewed 19 patients who were treated with this technique, at a mean follow-up period of 36 (range, 24-48) months. The mean. extensor lag was 2degrees (range, -7degrees to 13degrees) and the mean flexion range was 70degrees (range, 20degrees-90degrees).
İnstabil distal radius kırıklı erişkin hastaların volar yerleşimli kilitli plakla tedavisi
(Uludağ Üniversitesi, 2013) Tosun, Murat; Kaleli, Tufan; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.
İnstabil distal radius kırıklarının tedavisinde son yıllarda yaygın kabul gören yöntem açık redüksiyon ve internal tespitidir. Dorsal plaklama sonrası implanta bağlı komplikasyonların yüksek oranda gelişmesi volar kilitli plakların daha fazla tercih edilmesine neden olmuştur. Bu çalışmada, volar yerleşimli kilitli plakla tedavi edilen instabil distal radius kırıklı olguların anatomik ve fonksiyonel sonuçlarının kesitsel olarak değerlendirilmesi amaçlandı. İnstabil distal radius kırığı nedeniyle volar yaklaşımla kilitli plak kullanılarak tedavi edilen 72 olgunun 76 kırığı değerlendirildi. Kırıklar AO sınıflandırma sistemine göre tiplendirildi. Ameliyat öncesi, ameliyat sonrası ve son izlemlerde radyolojik olarak volar tilt, radial kısalma ve radial eğimleri ölçüldü. Bunlara ek olarak radyolojik değerlendirmede Stewart skorlama kriterleri, fonksiyonel değerlendirmede ise Gartland-Werley skorlama sistemi ile Quick DASH anketi kullanıldı. Her iki taraf el bilek eklemi hareket açıklıkları ve kavrama kuvvetleri ölçüldü. Olguların 26'sı (%36) kadın, 46'sı (%64) erkek olup ortalama yaş 49,8 yıl (23-85) idi. Kırıkların 20'si (%26) tip A, 82'i (%11) tip B ve 48'i (%63) tip C idi. Altı (%8,3) olguda kemik grefti kullanıldı. Ortalama izlem süresi 21 ay (6-64) olarak tespit edildi. Radyolojik değerlendirme kriterlerine göre kırıkların %72,4'ü (n:55) mükemmel, %23,7'si (n:18) iyi, %2,6?sı (n:2) orta %1,3'ü (n:1) kötü ve fonksiyonel değerlendirmede kullanılan Gartland Werley skoruna göre ise %51,3'ü (n:39) mükemmel, %35,5?i (n:27) iyi, %9,2'si (n:7) orta, %3,9?u (n:3) kötü olarak değerlendirildi. Ortalama Quick DASH skoru 11,25 (0-77,9) idi. Olguların 17'sinde (%23,6) komplikasyon görüldü ve bu komplikasyonların 6'sına (%8,3) ek cerrahi uygulandı. Kilitli volar plak uygulaması instabil distal radius kırıklarının tedavisinde başarılı bir yöntemdir. Bununla birlikte çevre dokuda meydana gelen komplikasyonlar nedeniyle düşük oranda da olsa ek cerrahi girişimlere gereksinim duyulabilir.
Karpal tünel sendromu tedavisinde knifelight yöntemiyle açık cerrahi yöntemin karşılaştırılması
(Uludağ Üniversitesi, 2006) Yılmaz, Halil Sedat; Kaleli, Tufan; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.
Karpal tünel sendromu (KTS) tuzak nöropatilerinin en sık olanıdır.Açık karpal tünel gevşetme KTS tedavisinde tercih edilen ameliyat yöntemidir. Her ne kadar mükemmel sonuçlar rapor edildiyse de bazı yazarlar açık cerrahi sonrası skar hassasiyeti, tenar veya hipotenar bölgede ağrı ve işe geç dönüş rapor etmişlerdir.Bazı yazarlar açık cerrahi insizyonun yol açabileği problemleri azaltmak için daha kısa bir uzunlamasına palmar insizyon ve fleksör retina kulumu kesebilecek özel cihazların kullanılmasını önermişlerdir. Knifelight (Stryker) bir kere kullanılabilen, kesici bıçağı 2 plastik transparan uç arasında olan karpal tünel gevşetme cihazıdır. Kendi ışık kaynağı ve pili vardır. Knifelight fleksör retina kulumu üzerindeki cilt ve cilt altını sağlam bırakır.Bu çalışmadaki amaç; Karpal Tünel Sendromu nedeniyle açık nöroliz veya Knifelight ile nöroliz uygulanan hastaların sonuçlarını değerlendirerek her iki cerrahi yöntemi birbiriyle karşılaştırmaktır.1999-2005 yılları arasında KTS nedeniyle açık cerrahi uygulanan 54 hasta ve Knifelight cihazıyla ameliyat edilen 54 hasta toplam 108 hasta olacak şekilde çalışmaya seçildi. Hastaların ameliyat öncesi ve ameliyat sonrası klinik durumu Boston Skalasıyla değerlendirildi. Hastaların her iki eline duyu testleri uygulandı, el kavrama, sıkıştırma (pinch) kuvvetleri ölçülüp kaydedildi. Hastaların yara üzerindeki ağrısı ve işe dönüş süreleri kaydedildi. Kniflelight grubunun işe dönüş süresi açık nöroliz uygulanan gruba göre daha kısaydı. Knifelight cihazı ciltte ve cilt altında daha az hasara yolaçtığıiçin bu gruptaki hastaların daha az yara ağrısı ve daha estetik yara izi mevcuttu. Sonuç olarak Knifelight tekniği endoskopik yönteme göre öğrenilmesi veuygulaması daha basit olan; açık ve endoskopik tekniğin avantajlarını birleştiren bir tekniktir. diopatik KTS tedavisinde birinci tercih olmalıdır.
Metacarpal brown tumor in secondary hyperparathyroidism due to vitamin-D deficiency - A case report
(Lippincott Williams & Wilkins, 2005-06) Ertürk, Erdinç; Keskin, Murat; Kaleli, Tufan; Ersoy, Canan; İmamoğlu, Şazi; Filiz, Gülaydan; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0003-4526-4352; AAJ-6536-2021; 7005488796; 23050640000; 6701485882; 6603422875; 6602297533; 6602693514
Microsurgery training with smartphone
(Thieme Medical Publication, 2018-12) Çapkın, Sercan; Cavit, Ali; Kaleli, Tufan; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/El Cerrahisi Anabilim Dalı.; AAB-6136-2022; ABG-3559-2020; 56662490000; 55507113700; 6603422875
Microsurgery is widely used in experimental research models and clinical surgery. However, microsurgical applications require precise technical skills and continuous training. Here, we proposed a low cost, practical microsurgery model, which can be easily applied using smartphones at home or at office. Test platform was created using latex gloves, and a phone holder was then positioned at one side of a table. A smartphone with 10x magnification was secured on the phone holder. Microsurgical device habit, stitching and knotting exercises by making cuts at different angles on the glove model were performed, which was recorded live under the 10x magnification of the phone camera. We believe that the practical microsurgery model presented in this study can form an important part of basic microsurgery education and also act as an alternative training model owing to its ease of application, easy accessibility and low cost.