Person: EKEN, GÖKAY
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EKEN
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GÖKAY
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Publication Fracture line and comminution zone characteristics, and rotator cuff footprint involvement in OTA/AO 11C3-type proximal humeral fractures: complex proximal humerus fracture map(Springer, 2023-06-28) Mısır, Abdulhamit; Oğuzkaya, Sinan; Kızkapan, Turan Bilge; Eken, Gökay; Canbaz, Sebati Baser; EKEN, GÖKAY; Tıp Fakültesi; Ortopedi ve Travmatoloji Ana Bilim Dalı; 0000-0001-9447-4749 ; ABE-9918-2021PurposeTo identify fracture characteristics and zones of comminution as well as the relationship with anatomic landmarks and rotator cuff footprint involvement in OTA/AO 11C3-type proximal humerus fractures.MethodsComputed tomography images of 201 OTA/AO 11C3 fractures were included. Fracture lines were superimposed to a 3D proximal humerus template, created from a healthy right humerus, after fracture fragment reduction on 3D reconstruction images. Rotator cuff tendon footprints were marked on the template. Lateral, anterior, posterior, medial, and superior views were captured for the interpretation of fracture line and comminution zone distribution as well as to define the relationship with anatomic landmarks and rotator cuff tendon footprints.ResultsA total of 106 females and 95 males (mean age = 57.5 & PLUSMN; 17.7 [range 18-101] years) with 103 C3.1-, 45 C3.2-, and 53 C3.3-type fractures were included. On the lateral, medial, and superior humeral surfaces, fracture lines and comminution zones were distributed differently in 3 groups. Tuberculum minus and medial calcar region were significantly less severely affected in C3.1 and C3.2 fractures than C3.3 fractures. The supraspinatus footprint was the most severely affected rotator cuff footprint area.ConclusionsSpecifically defining the certain differences for repeatable fracture patterns and comminution zones in OTA/AO 11C3-type fractures and the relationship between the rotator cuff footprint and the joint capsule may contribute to the decision-making process of surgeons.Publication Comparison of computed tomography, traction, and inverted grayscale radiographs for understanding pilon fracture morphology(Sage Publications Inc, 2021-10-12) Eken, Gökay; Mısır, Abdulhamit; EKEN, GÖKAY; Tıp Fakültesi; Ortopedi ve Travmatoloji Ana Bilim Dalı; 0000-0001-9447-4749; ABE-9918-2021Background: There have been no studies evaluating the usefulness of grayscale radiographs in extremity fractures. We aimed to compare the ability and reliability of traction radiographs vs traction grayscale inversion radiographs to detect fracture fragment and comminution zones in comminuted tibia pilon fractures. Methods: Plain radiographs and grayscale inversion images of 60 patients with Orthopaedic Trauma Association/AO Foundation type C3 fracture were evaluated by 20 observers (15 orthopedic surgeons and 5 radiologists) after traction had been applied. The anterolateral, posterolateral, and medial malleolar fragments, as well as the lateral, central, and medial column comminution zones, were identified by all physicians. Computed tomography scan images were used as the "gold standard" against which plain radiographs and grayscale inversion image interpretation were measured. Intra- and interobserver reliability and correct identification of fracture fragments and comminution zones were evaluated. Results: The interobserver reliability for 3 of the fracture fragments and comminution zones on the traction plain radiographs was moderate, whereas it was substantial on traction grayscale inversion radiographs. The lateral comminution zones (P = .001) and presence or absence of posterolateral fragments (P < .001) were significantly better identified in grayscale inversion radiographs compared to standard radiographs. Conclusion: After traction was applied, we found grayscale inversion radiographs are superior to plain radiographs in the identification of posterolateral fragment and lateral zone of comminution in comminuted intraarticular pilon fractures.Publication Less malunion and shorter bone union time with titanium elastic nail treatment for isolated femoral shaft fractures in three- to six-year-old children(Springernature, 2022-02-18) Eken, Gökay; EKEN, GÖKAY; Ermutlu, Cenk; ERMUTLU, CENK; Sarısözen, Bartu; SARISÖZEN, MEHMET BARTU; Atıcı, Teoman; ATICI, TEOMAN; Çakar, Adnan; DURAK, KEMAL; ÇAKAR, ADNAN; Tıp Fakültesi; Ortopedi ve Travmatoloji Ana Bilim Dalı; 0000-0003-4071-8052; 0000-0002-3396-3407; AEQ-5464-2022; ABE-9918-2021Purpose Titanium elastic nail (TEN) is a good option for femoral shaft fractures in school-age children, whereas a spica cast is favored for younger patients. We aimed to compare these treatment modalities in a group of children aged three to six years. Methods 34 patients aged 3-6 years with an isolated closed femoral shaft fracture treated with TEN or one-leg spica cast immobilization were retrospectively assessed. Age, gender, weight, mechanism of injury, hospital stay time, bone union time, radiographic shortening, malunion, and complications were compared between the treatment groups. Results 16 (47.1%) patients who were treated with TEN (Group T) and 18 (52.9%) patients with spica casting (Group S) were included with a mean of 51 (24-94) months follow-up. The mean age was 4.98 years and statistically similar between both groups (mean, 5.2 vs. 4.8 years; p = 0.234). The patients in Group T were heavier (mean, 19.3 vs. 17.2 kg; p < 0.001) and were more likely to have a higher-energy mechanism of injury (p = 0.006). The mean late femoral shortening of Group S patient's was 6.5 +/- 3.5 mm and significantly higher than Group T, which was 2.0 +/- 2.9 (p = 0.050). However, effective late femoral shortening rates were not statistically different between groups (p = 0.347). Malunion was seen in six (33.3%) patients in Group S, whereas none of the patients in Group T had malunion at the last follow-up examination and were statistically different (p = 0.011). Conclusion Our study identified radiographic evidence favoring TEN over spica cast immobilization in treating preschool-age children with an isolated femoral shaft fracture in terms of malunion.Publication Fracture lines and comminution zones of traumatic sacral fractures(Travma Acil Cerrahisi, 2023-02-01) Oğuzkaya, Sinan; Güvercin, Yasin Semih; Kızkapan, Turan Bilge; Eken, Gökay; Arat, Feridun; Mısır, Abdulhamit; EKEN, GÖKAY; Tıp Fakültesi; Ortopedi ve Travmatoloji Ana Bilim Dalı; ABE-9918-2021BACKGROUND: Sacral fractures are uncommon and understanding three-dimensional morphology is needed to obtain proper treatment. The purpose of this study was to identify the repeatable fracture patterns and comminution zones for traumatic sacral fractures and create fracture maps.METHODS: Computerized tomography images of 72 patients with traumatic sacral fracture were included in the study. For each fracture, fracture lines were identified and digitally reduced. All fractures were superimposed over a template and fracture maps; com-minution zones and heatmaps were created for each zone. RESULTS: There were 40 males and 32 females with a mean age of 46.5 +/- 19.9. Fifty-three (73.6%) patients sustained major trauma, and 19 (26.4%) had minor trauma. There were 37 (51.4%) Zone 1, 22 (30.6%) Zone 2, and 13 (18.1%) Zone 3 fractures. Each Denis zone showed certain fracture patterns. In Zone 1 fractures, most of the fracture lines were vertical and oblique (up to 45 degrees) orientation on both sides. In Zone 2 fractures, fracture lines were concentrated on the S1 and S2 levels. Anterolateral and posterolateral parts of the sacrum were less affected in right-side fractures. In Zone 3 fractures, fractures were concentrated in S1, S2, and S3 levels around the sacral canal. The median sacral crest and midline remained mostly unaffected.CONCLUSION: Sacral fractures showed specific repeatable patterns for each zone. These findings may be helpful for pre-operative planning, placement of fixation material, design of new implants, and modification of current fracture-classification systems.Publication The effect of watching shoulder rom changes on functional outcome and quality of life following arthroscopic rotator cuff repair(Sage Publications Ltd, 2022-01-01) Özçamdallı, Mustafa; Mısır, Abdulhamit; Oğuzkaya, Sinan; Uzun, Erdal; Eken, Gökay; EKEN, GÖKAY; Tıp Fakültesi; Ortopedi ve Travmatoloji Ana Bilim Dalı; ABE-9918-2021Purpose This study aimed to evaluate the effectiveness of watching video records of their shoulder motion changes on functional outcomes and quality of life after arthroscopic rotator cuff repair (ARCR). Methods The patients were divided into two groups. In Group 1, video records of pre- and postoperative shoulder motions were recorded and showed. In Group 2, no video was showed to the patients. In Group 1, the first postoperative evaluation was done before video watching, and the second evaluation was done just after watching video records. In Group 2, the first and second postoperative measurements were performed with 10-20 days interval. The Constant Murley score (CS), the American Shoulder and Elbow Surgeons score (ASES), the Short-Form 36 (SF-36) score, and active shoulder range of motion (ROM) values were used as an outcome tool. Results A total of 196 patients (Group 1; 76 patients and Group 2; 120 patients) with a mean age of 62.06 +/- 7.17 years were included. There was a significant improvement in postoperative scores of SF-36 subscales (except emotional well-being and energy/fatigue), ASES, CM scores, and joint ROM values when compared to preoperative values for both groups (p < .001). The first postoperative outcomes were similar between groups (p > .05). In the second postoperative evaluation, emotional role functioning, energy/fatigue, emotional well-being, health change subscales of SF-36, and ASES scores were significantly higher in Group 1 compared with Group 2 (p < .05). Conclusion When patients watch the pre- and postoperative video records of their shoulder ROM after ARCR, patients' satisfaction and well-being perception increase in the short-term despite unchanged shoulder ROM.Publication Comparison of patients undergoing revision total hip arthroplasty and patients undergoing re-revision(Verduci Publisher, 2023-01-01) Yenigül, A. E.; Dikici, A. E.; Eken, G.; Bilgen, M. S.; YENİGÜL, ALİ ERKAN; DİKİCİ, ALPER EMRE; EKEN, GÖKAY; BİLGEN, MÜHAMMET SADIK; Tıp Fakültesi; Ortobedi ve Travmatoloji Ana Bilim Dalı; ABE-9918-2021; IXN-8544-2023; AFH-1678-2022; ACP-2755-2022- OBJECTIVE: The aim of this study is to compare the demographic, clini-cal, and surgical characteristics of patients who underwent revision hip replacement sur-gery and those who underwent re-revision sur-gery. The secondary outcome is the investiga-tion of the factors that play a role in estimating the time between primary arthroplasty surgery and revision surgery.PATIENTS AND METHODS: The patients who underwent revision hip arthroplasty in our clinic between 2010-2020, patients with at least 2 years of follow-up, and who underwent re-revision surgery if needed were included. Demographic and clinical data were investigated. RESULTS: Of the 153 patients who met the study criteria, 120 (78.5%) underwent revision (Group 1) and 33 (21.5%) underwent re -revi-sion (Group 2). The mean age of Group 1 was 53.5 (32-85), and of Group 2 was 67 (38-81) (p=0.003). In both groups, patients who un-derwent hip replacement due to fracture had more revisions and re-revisions (p=0.794). While 53.3 of the patients in Group 1 did not need additional implants, 72.7% of the pa-tients in Group 2 needed additional implants (p=0.010). Fracture-dislocation, fistula, and the need for debridement after the revision were statistically significantly higher in pa-tients who underwent re-revision. Harris hip scores (HHS) were statistically lower in pa-tients who went for re-revision. CONCLUSIONS: The need for reoperation in patients who have undergone revision total hip arthroplasty (THA) surgery is due to the fact that the patient's age is advanced and the indi- cation for surgery is a fracture. While the rate of fistula, fracture, dislocation, and debride- ment increases after re-revision surgeries, the HHS values that indicate clinical success also decrease. We believe that studies with larger participation and longer follow-up periods are needed to explain this issue better.Publication The effect of postoperative sling immobilization and early mobilization on clinical and functional outcomes after arthroscopic rotator cuff repair: A propensity score-matched analysis(Ios Press, 2022-01-01) Mısır, Abdulhamit; Oğuzkaya, Sinan; Kızkapan, Turan Bilge; Sayer, Gokhan; Eken, Gökay; EKEN, GÖKAY; Tıp Fakültesi; Ortopedi ve Travmatoloji Ana Bilim Dalı; ABE-9918-2021BACKROUND: Optimal postoperative management is controversial after arthroscopic rotator cuff repair (ARCR).OBJECTIVE: The aim of the study was to evaluate outcomes of patients with and without postoperative sling immobilization after undergoing arthroscopic RCR rotator cuff repair.METHOD: 369 arthroscopic full thickness superior rotator cuff tears (RCT) with a minimum follow-up of 6 months were included in this study. Propensity score matching was performed for age, sex, BMI, and tear size. Pain (VAS score), shoulder range of motion (ROM), functional outcome (ASES, Constant-Murley [CM] and Oxford shoulder score [OSS]), and health related quality of life (SF-36) scores were compared between patients with and without sling immobilization.RESULTS: According to the propensity match score, 92 patients (50 sling immobilization and 42 no sling immobilization) were matched to be almost identical in age (62.5 +/- 8.0 vs. 61.8 +/- 5.9), sex (female 78% vs. 76.2%), BMI (28.1 +/- 2.8 vs. 27.8 +/- 2.6), and tear size (2.7 +/- 1.1 vs. 2.9 +/- 0.8). The postoperative physical functioning domain of SF-36 scores was found to be significantly higher in the no sling group (p = 0.034).CONCLUSION: Early mobilization after arthroscopic small and medium sized full thickness superior rotator cuff repair is associated with improved ROM and quality of life scores.