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    BIOMECHANICAL FIXATION STRENGTH COMPARISON OF ILIOINGUNIAL AND MEDIAL STOPPA APPROACHES ON ANTERIOR COLUMN FRACTURES
    (World Scientific Publ Co Pte Ltd, 2016) Kacira, Burkay Kutluhan; Ozkaya, Mustafa; Kiran, Uygar; Turkmen, Faik; Arazi, Mehmet; Demir, Teyfik
    Background: Both the ilioinguinal and Stoppa approaches have been used as standard methods for treating anterior column fractures of the pelvis. Objective: We aimed to compare the rigidity of pelvises that were treated using these two approaches. Methods: Fifteen synthetic pelvises were used as test models. Of these, 5 pelvises did not undergo any treatment (control group), and 10 pelvises underwent treatment of one column using the ilioinguinal approach and the other using the medial Stoppa approach (treated group). The compression test was performed on all pelvises, and rigidity of the pelvises was compared between the control and treated groups. Results: A statistical difference was found in the angle between the center of the femoral head and the line from the pubic symphysis to load application between the control and treated groups, using the ilioinguinal approach. The parametric displacement was greater in the treated group using the ilioinguinal approach than in the control group. There were no significant differences between the control and treated groups using the Stoppa approach, and the ilioinguinal approaches. Conclusion: Clinically, the Stoppa approach has several advantages over the ilioinguinal approach. However, based on the compression test, there was no difference in biomechanical rigidity between the fixations performed using these two approaches.
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    Comparison of monoplanar versus biplanar medial opening-wedge high tibial osteotomy techniques for preventing lateral cortex fracture
    (Springer, 2017) Turkmen, Faik; Kacira, Burkay K.; Ozkaya, Mustafa; Erkocak, Omer F.; Acar, Mehmet A.; Ozer, Mustafa; Toker, Serdar
    The purpose of this study was to investigate the mechanical strength of both monoplanar and biplanar medial opening-wedge high tibial osteotomy (MOWHTO) procedures and assess the risk of lateral cortex disruption for both techniques. Twelve synthetic tibia models with cortical shells were used as test models. Saw cuts for monoplanar MOWHTO and biplanar MOWHTO were generated on the test models in equal numbers (n = 6 for both groups). Wedge opening load and wedge gap distance were evaluated via compressive tests. The mean gap distance just before the lateral cortex fracture in the monoplanar group was 14.7 +/- 2.9 mm, which was significantly narrower than that in the biplanar group of 19.1 +/- 2.0 mm (p = 0.015). The mean load just before the occurrence of lateral cortex fracture of 32.4 +/- 3.2 N in the monoplanar osteotomy group was significantly lower than that in the biplanar osteotomy group of 111.8 +/- 9.3 N (p = 0.009). Performing a MOWHTO via the biplanar rather than the monoplanar technique allows larger-sized wedges to be opened with less risk of lateral cortical fracture. Thus, larger gaps can be opened and higher angle corrections can be achieved using the biplanar osteotomy procedure. From a clinical viewpoint, the biplanar osteotomy technique reduced the risk of lateral cortical hinge fracture during MOWHTO.