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Öğe Outcomes of primary surgical repair of zone 2 dDigital nerve injury(Acta Medica Belgica, 2018) Acar, Erdinc; Turkmen, Faik; Korucu, Ismail H.; Karaduman, Mert; Karalezli, NazimThe objective of our study was to assess the functional and sensory outcomes of the primary repair of 138 digital nerve injuries in 48 consecutive patients between January 2012 and November 2014, and to determine whether there were any relationships between demographics, clinical characteristics, or functional test results and post-operative sensory recovery outcomes. Mean follow-up was 14 (range, 10 to 20) months. Sensory evaluation was performed using the static two-point discrimination test, and post-operative sensoryrecovery results were classified according to the Seddon Classification: 69 (50%) injuries were S3+, 3 (2%) were S3, 15 (II%) were S2, 18 (13%) were S1, and 33 (24%) were S0. Sensory recovery was associated with time between surgery and testing and with objective functional recovery. More than half of digits sustaining nerve injuries had good intermediate-term recovery of sensation after early primary surgical repair. Surgeon experience and early primary repair may have a favorable impact on results.Öğe Predictors of Lower Extremity Amputation and Reamputation Associated With the Diabetic Foot(Elsevier Science Inc, 2017) Acar, Erdinc; Kacira, Burkay KutluhanIn the present study, we aimed to identify the comorbidities that would be predictive of requiring lower extremity amputation or reamputation for diabetic foot wounds. We performed a retrospective review of 132 consecutive patients who had undergone lower extremity amputations (110 patients) or reamputations (22 patients) for diabetic wounds from January 2013 to March 2016. We used multivariate logistic regression to calculate the odds ratios (ORs) for amputation and reamputation for various comorbidities. The ORs of undergoing amputation were greatest for adult males (OR 5.12, 95% confidence interval [CI] 1.56 to 13.04; p = .05) and those with longer term diabetes (OR 4.22, 95% CI 2.01 to 12.95; p = .05), wound infection (OR 3.94, 95% CI 1.04 to 9.00; p = .05), diabetic neuropathy (OR 3.53, 95% CI 1.07 to 9.11; p = .05), and a positive history of smoking (OR 3.04, 95% CI 1.55 to 9.89; p = .05). Similarly, the ORs of undergoing reamputation were greatest for adult males (OR 4.06, 95% CI 1.02 to 12.08; p = .05) and those with longer term diabetes (OR 3.67, 95% CI 1.94 to 11.42; p = .05), wound infection (OR 3.12; 95% CI 0.9 to 8.32; p = .05), diabetic neuropathy (OR 3.01, 95% CI 0.92 to 8.54; p = .05), and a positive history of smoking (OR 2.89, 95% CI 1.09 to 9.42; p = .05). The early identification of these comorbidities could help determine which patients are most likely to require amputation or reamputation. (C) 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.Öğe Steroid Injection Versus Open Surgery in the Treatment of De Quervain's Tenosynovitis(Emergency Medicine Physicians Assoc Turkey, 2019) Acar, Erdinc; Memik, RecepAim: This study aimed to compare steroid injection and open surgery in the treatment of De Quervain's tenosynovitis. Materials and Methods: Between January 2013 and April 2015, a total of 82 patients (65 females, 17 males; mean age=40.3 years; range, 20 to 71 years) who were admitted were included retrospectively. The patients were assigned into two groups, including group I undergoing open surgery, and group II receiving steroid injections. The rates of recurrence and satisfaction were evaluated. The patients undergoing surgery were also evaluated for the wound site infection, nerve injury, wound opening, and limited range of motions of the joints. The patients receiving steroid injections were evaluated for subcutaneous atrophy, fat necrosis, weakening or rupture of tendons, and depigmentation. Results: The mean follow-up was 12 months (range: 6 to 22). Recurrence occurred in eight patients (20%) in the steroid injection group; however, no recurrence was seen in patients undergoing open surgery. Satisfactory or very satisfactory results were achieved in all patients in the surgery group (p=0.04). There were no complications in both groups. Conclusion: Although steroid injection is a therapeutic option in De Quervain's tenosynovitis, open surgery appears to be a more beneficial method with relatively low recurrence and complication rates.Öğe Surgical Treatment Results in Pediatric Supracondylar Humerus Fractures(Emergency Medicine Physicians Assoc Turkey, 2020) Acar, Erdinc; Memik, RecepAim: This study aims to evaluate the outcomes of cross fixation with Kirschner wire (K-wire) following closed reduction of displaced supracondylar humerus fractures in children. Materials and Methods: Between December 2012 and June 2015, a total of 32 patients with suprachondral humerus fractures were retrospectively analyzed. Data including demographic data, causes and types of fracture, associated injuries, postoperative complications, radiological parameters, and cosmetic and functional outcomes were recorded. Results: Of the patients, 24 (75%) were male and eight (25%) were female with a mean age of 6.5 years (range: 2 to 12 years). The mean follow-up was 19 months (range: 13 to 26 months). None of the patients developed iatrogenic vascular or nerve injuries. No postoperative complications were observed during follow-up. The functional result according to the Flynn criteria was excellent in 93.4% and good in 6.6% patients, while cosmetic results were excellent in 93.4%, good in 5.2%, and fair in 1.4%. Conclusion: Percutaneous fixation with K-wire following closed reduction of displaced supracondylar humerus is a reliable method which can be applied with high success rates in pediatric cases.Öğe Winograd Method Versus Winograd Method With Electrocoagulation in the Treatment of Ingrown Toenails(Elsevier Science Inc, 2017) Acar, ErdincAn important component of the Winograd surgical method for an ingrown toenail is total excision of the associated germinal matrix. However, this might not always be accomplished with the procedure. We hypothesized that the surgical results might be improved by adding electrocoagulation of the germinal matrix to the Winograd method. The objective of the present study was to compare the recurrence, satisfaction, and complication rates of the Winograd method with those of the Winograd method with electrocoagulation. We retrospectively evaluated the records of 102 patients with single Heifetz stage 2 or 3 ingrown toenails who had undergone surgery from January 2013 to October 2014 using 1 of these 2 methods. Of the 102 patients, 50 (49%) underwent the Winograd method and 52 (51%) underwent the Winograd method with electrocoagulation. The mean follow-up period of our patients was 12 (range 6 to 22) months. An ingrown toenail recurred in 3 patients (6%) in the Winograd group and in no patient in the Winograd with electrocoagulation group (p =.04). Among the patients in the Winograd group, 46 (92.0%) were satisfied or very satisfied. Among the patients in the Winograd plus electrocoagulation group, 49 (94.2%) were satisfied or very satisfied (p =.04). No complications developed in either group. In conclusion, the Winograd method for ingrown toenails results in high satisfaction rates, low recurrence rates, and low complication rates. The addition of electrocoagulation of the germinal matrix to the Winograd method could result in even lower recurrence rates, while maintaining high patient satisfaction and without increasing the risk of complications. (C) 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
