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    Comparison of the results of percutaneous and open screw fixation in the treatment of scaphoid nonunion fractures
    (Verduci Publisher, 2022) Atilgan, N.; Duman, N.; Colak, T. S.; Korucu, I. H.; Demiryurek, M.; Yilmaz, M.
    OBJECTIVE: Our study aims to compare the clinical results of percutaneous screw fixation and non-vascularized bone graft-ing with open screw fixation in patients who did not achieve union due to failure in diagnosis and treatment after a scaphoid fracture. PATIENTS AND METHODS: Forty-three pa-tients with scaphoid nonunion fractures cor-responding to the first three Slade and Dodds classification were divided into two groups. Non-vascularized bone grafting with open re-duction and internal fixation (ORIF) was applied to 24 patients in the first group, and 19 patients in the second group were treated with a closed reduction and internal fixation (CRIF) (percu-taneous screw fixation). The patients were fol-lowed up for preoperative and postoperative functional scores and time to union.RESULTS: Our study found that the scaphoid was most commonly fractured in the waist of the scaphoid. In our study, we found that distal scaphoid fractures had the highest union rate (100%), followed by the waist fractures (93.2%) and the weakest union (50%) in the proximal pole fractures. We observed that the fastest union had occurred in the fractures of the waist. We also ob-served that the union was completed earlier in patients who operated with ORIF than those with CRIF. We found union in 87.5% of patients who underwent ORIF, in 84.2% of patients who under-went CRIF. CRIF operation duration was short-er than expected from ORIF operation duration.CONCLUSIONS: We found that similar union rates could be achieved in the patient groups who underwent percutaneous and open screw fixation by selecting the appropriate patient in scaphoid nonunion fractures. Union was faster and functional results were more satisfactory in the ORIF group. The operation time was shorter in the CRIF group.
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    Multidisciplinary treatment and functional outcome evaluation of combined injuries of nerves, vessels, and flexor tendons: spaghetti wrist
    (Verduci Publisher, 2022) Atilgan, N.; Duman, N.; Colak, T. S.; Korucu, I. H.; Demiryurek, M.
    OBJECTIVE: In this study, we aimed to evaluate the effectiveness of the modified Kessler technique in managing spaghetti wrist lacerations by multidisciplinary treatment. PATIENTS AND METHODS: Patients who were operated and followed up with the diagnosis of spaghetti wrist tears in our clinic between January 2012 and December 2020 were included in the study. In the postoperative follow-ups, the parameters evaluating the functionality of the patients were examined. RESULTS: Patients were 105 male (86.7%) and 16 women (13.2%), with a mean age of 36.83 & PLUSMN; 16.38 years. At the final follow-up, functional outcomes were assessed. The most common injury mechanism was glass-related injuries (35.5%). The mean starting surgery time of the patients was 4.64 & PLUSMN;2.98 hours. The most frequently involved structures were the palmaris longus with a rate of 51% and the flexor digitorum superficialis with a rate of 45%. There were significant differences regarding intrinsic function and grip strength between male and female patients (p = 0.04, p = 0.21, respectively). There were significant differences regarding sensation and grip strength between smoker and nonsmoker patients (p = 0.03, p = 0.01, respectively). The number of the damaged structures was negatively correlated with postsurgical functional outcomes of four tests, including tendon function, opposition, intrinsic function, and grip strength. The physical therapy period was correlated to hand function tests (r = 0.756, p < 0.05). Nerve damage was negatively correlated with sensation (p = 0.011, r =-0.932). CONCLUSIONS: The modified Kessler technique is reliable with functional outcomes for spaghetti wrist injuries involving tendons, nerves, and arteries. Meticulous and early surgical treatment within the first 8 hours of spaghetti wrist injury and early initiation and long-term physical therapy are vital in patients' functional outcomes.
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    The relationship of preoperative hematologic parameters to invasion of anatomic structures and recurrence in tenosynovial giant-cell tumor of the digits
    (Elsevier, 2022) Colak, T. S.; Ozgezmez, F. T.; Kaya, Huseyin
    Although the pathogenesis of Teno- Synovial Giant Cell Tumor (TSGCT) is not known, inflammation is thought to play a role in the etiology beside some other factors. Many researchers have found a close relationship between hematological parameters such as Mean Platelet Volume (MPV), Platelet/MPV Ratio (Plt/MPV), Monocyte/Neutrophil Ratio (MNR), Neutrophil/Lymphocyte Ratio (NLR), Platelet/ Lymphocyte Ratio (PLR) and certain inflammatory, autoimmune and neoplastic diseases. The aim of the present study was to assess the relationship of hematological parameters (NLR, MNR and Plt/MPV) to tumor recurrence and spread after TSGCT surgery. Data from 102 patients who matched the inclusion criteria comprised preoperative hematological parameters, tumor size, anatomic region, side, presence of bone invasion, proximity to joints or neurovascular structures, and postoperative recurrence and complications. The mean follow-up was 54.2 months (similar to 26.5). Recurrence was observed in 12 (11.8%) of the 102 cases. No significant correlation was found between recurrence and hematologic parameter, age, laterality (right-left) or zone (volar-dorsal). There were no significant differences in NLR, Plt/MPV or MNR between patients with and without bone, capsular, nerve or total involvement. The study thus showed that the various inflammatory parameters (NLR, Plt/MPV and MNR) calculated from blood count were not predictive of tumor invasion into anatomical structures or of digital TSGCT recurrence. (c) 2022 SFCM. Published by Elsevier Masson SAS. All rights reserved.