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Koyuncu S.,Bayburt State Hospital | Altay T.,Kayseri Training and Research Hospital | Kayal C.,Kayseri Training and Research Hospital | Ozan F.,Kayseri Training and Research Hospital | Yamak K.,Kayseri Training and Research Hospital
Clinical Interventions in Aging | Year: 2015

Background: This study aims at assessing the clinical results, radiographic findings, and associated complications after osteosynthesis of trochanteric hip fractures with proximal femoral nail (PFN). Methods: A total of 152 patients with hip fractures who underwent osteosynthesis with PFN were included. The hip fracture types in the patients included in the study were classified according to the American Orthopedic/Orthopedic Trauma Association (AO/OTA). AO/OTA A1, A2, and A3 type fractures were found in 24 (15.8%), 107 (70.4%), and 21 (13.8%) patients, respectively. The Baumgaertner scale was used to assess the degree of postoperative reduction. The Salvati–Wilson hip function (SWS) scoring system was used to evaluate functional results. After a follow-up period, clinical and radiographic results were evaluated and complications were assessed. The relationship between the complications and SWS score, age, sex, fracture type, reduction quality, and time from the fracture to surgery was evaluated. Results: Eighty-five (55.9%) female patients and 67 (44.1%) male patients were enrolled in the study. Seventy-nine (51.9%) patients had left hip fractures, and 73 (48.1%) had right hip fractures. The mean age was 76 (range 21–93) years, and the mean follow-up duration was 23.6 (range 7–49) months. Postoperatively, one patient (0.6%) had a poor reduction, 16 patients (10.5%) had an acceptable reduction, and 135 patients (88.9%) had a good reduction according to the above criteria. The SWS scores were excellent, good, moderate, and poor in 91 (59.8%), 45 (29.6%), 15 (9.8%), and one (0.6%) patients, respectively. Late postoperative complications were seen in 27 patients (17.7%). A total of 14 patients (9.2%) underwent a revision procedure for mechanical complications. Conclusion: The study results suggest that the quality of fracture reduction is an important factor that affects the revision rate and SWS score in patients with mechanical complications after osteosynthesis with PFN for trochanteric fractures. © 2015 Koyuncu et al.


Cevik Y.,Kecioren Training and Research Hospital | Dogan N.O.,Kocaeli University | Das M.,Bayburt State Hospital | Karakayali O.,Kocaeli Derince Training and Research Hospital | And 2 more authors.
American Journal of Emergency Medicine | Year: 2013

Introduction The aim of this study was to investigate the factors affecting in-hospital mortality among geriatric trauma patients who presented to the emergency department (ED) following a motor vehicle collision. Methods A retrospective cohort study was carried out in a high-volume tertiary care facility in the central Anatolian Region. Clinical data were extracted from hospital databases for all eligible geriatric patients (either driver, passenger or pedestrian) with entries dated between January 1, 2007, and December 31, 2009. Multivariate logistic regression analysis was used to assess the in-hospital mortality effects of variables including demographic characteristics, trauma mechanisms, injured body parts and various trauma scores. Results There were 395 geriatric motor vehicle trauma presentations to the ED during the 3-year period. Of these patients, 371 (93.9%) survived, and 24 (6.1%) died in the ED, operating room or intensive care unit. The multivariate logistic regression model included the following variables: heart failure, cranial trauma, abdominal trauma, thoracic trauma, pelvic trauma, Glasgow Coma Score and Injury Severity Score (ISS). These variables were chosen because univariate analysis indicated that they were potential predictors of mortality. The multivariate logistic regression showed that the presence of heart failure (OR: 20.2), cranial trauma (OR: 3.6), abdominal trauma (OR: 26.9), pelvic trauma (OR: 9.9) and ISS (OR: 1.2) were predictors of in-hospital mortality in the study population. Conclusion In our study, heart failure, cranial trauma, abdominal trauma, pelvic trauma, and ISS were found to be the most important predictors of in-hospital mortality among geriatric motor vehicle trauma patients. © 2013 Elsevier Inc.


Ozan F.,Kayseri Training and Research Hospital | Oncel E.S.,Kayseri Training and Research Hospital | Koyuncu S.,Bayburt State Hospital | Gurbuz K.,Kayseri Training and Research Hospital | And 3 more authors.
International Journal of Clinical and Experimental Medicine | Year: 2016

Objective: With increasing age, minor traumas may result in multipart and unstable fractures of the proximal femur. The treatment aims to return patients to their prefracture functional levels. In elderly patients with proximal femoral fractures, hip replacement with hemiarthroplasty (HA) is common performed. This study aims to evaluate the efficiency of treatment, mortality-morbidity relationship, and postoperative complications in elderly patients with proximal femoral fractures who underwent HA with a Hardinge or Moore approach. Materials and methods: We retrospectively evaluated 233 patients who underwent cement-less bipolar HA for proximal femoral fracture with either a Hardinge approach (Group 1; n = 86; 29 males, 57 females; mean age 78.3 years; range 67-91 years) or a Moore approach (Group 2; n = 147; 68 males, 79 females; mean age 78.7 years; range 65-102 years). Patients in both groups were compared with respect to gender, type of fracture, age, American Society of Anesthesiologist (ASA) score, time from fracture to operation, comorbid factors, postoperative mortality, and postoperative complications. Postoperative functional results evaluated using the University of California, Los Angeles (UCLA) hip scoring assessment. Results: Mean UCLA scores were 12.02 and 11.77 in Groups 1 and 2, respectively (P > 0.05), and mean time from fracture to operation was 2.8 days and 1.7 days, respectively (P < 0.05). Eight (9.3%) and 18 (12.2%) patients died in Groups 1 and 2, respectively (P > 0.05). For both groups, mortality rate of patients with ASA scores of 3-4 was non-significantly higher than that of patients with ASA scores of 1-2 (P > 0.05). In Group 1, but not Group 2, mortality increased significantly with increasing number of comorbidities. Three (3.4%) and 11 (7.4%) patients developed an infection in Groups 1 and 2, respectively (P > 0.05), and postoperative dislocation occurred in four (4.6%) and 17 (11.5%) patients, respectively (P > 0.05). Conclusion: Detecting factors that affect outcomes and taking protective measures are essential in elderly patient groups with low postoperative success levels. The surgical approach is also a factor affecting the outcomes of HA for proximal femoral fracture. © 2016, E-Century Publishing Corporation. All rights reserved.


Dursun M.,Bahcelievler State Hospital | Ozbek E.,Okmeydani Research and Education Hospital | Otunctemur A.,Okmeydani Research and Education Hospital | Cakir S.S.,Bayburt State Hospital
Prague medical report | Year: 2015

Sexual dysfunction in general and erectile dysfunction (ED) in particular significantly affect men's quality of life. Some patients who have ED, also develop osteoporosis. So, in this study we investigated the relationship between erectile dysfunction and osteoporosis in men. 95 men with erectile dysfunction and 82 men with normal sexual function were included in the study. The men's sexual functions were evaluated by International Index of Erectile Function-5 items (IIEF-5). All men received a Dual Energy X-ray Absorptiometry (DEXA; Hologic) scan to measure bone mineral density (BMD) for osteoporosis. Chi-square test was used for statistical analysis. Mean age was 53.5 (38-69) in ED group and 50.1 (31-69) in control group. In ED group the men have lower T score levels than those of the control group. In conclusion, the men who have erectile dysfunction were at more risk for osteoporosis. The results of the present study demonstrate that the men with erectile dysfunction have low bone mineral density and they are at higher risk for osteoporosis. Because of easy and noninvasive evaluation of osteoporosis, patients with ED should be checked for bone mineral density and osteoporotic male subjects should be evaluated for ED.


Karakilic B.,Bayburt State Hospital | Taskiran E.,Ege University | Doganavsargil B.,Ege University | Uzun B.,Dokuz Eylul University | And 2 more authors.
Journal of Orthopaedic Surgery and Research | Year: 2015

Background: The mid-substance central defect injury has been used to investigate the primary healing capacity of the anterior cruciate ligament (ACL) in a goat model. The sagittal plane stability on this model has not been confirmed, and possible effects of fat pad excision on healing have not been evaluated. We hypothesize that excising the fat pad tissue results in poorer ligament healing as assessed histologically and decreased tensile strength of the healing ligament. We further hypothesize that the creation of a central defect does not affect sagittal plane knee stability. Methods: A mid-substance central defect was created with a 4-mm arthroscopic punch in the ACLs of right knees of all the subjects through a medial mini-arthrotomy. Goats were assigned to groups based on whether the fat pad was preserved (group 1, n = 5) or excised completely (group 2, n = 5). The left knees served as controls in each goat. Histopathology of the defect area along with measurement of type I collagen in one goat from each group were performed at 10th week postoperatively. The remaining knees were evaluated biomechanically at the 12th week, by measuring anterior tibial translation (ATT) of the knee joints at 90° of flexion and testing tensile properties (ultimate tensile load (UTL), ultimate elongation (UE), stiffness (S), failure mode (FM)) of the femur-ACL-tibia complex. Results and discussion: Histopathology analysis revealed that the central defect area was fully filled macroscopically and microscopically. However, myxoid degeneration and fibrosis were observed in group 2 and increased collagen type I content was noted in group 2. There were no significant differences within and between groups in terms of ATT values (p = 0.715 and p = 0.149, respectively). There were no significance between or within groups in terms of ultimate tensile load and ultimate elongation; however, group 2 demonstrated greater stiffness than group 1 that was correlated with the fibrotic changes detected microscopically (p = 0.043). Conclusions: The central defect type injury model was confirmed to be biomechanically stable in a goat model. Resection of the fat pad was noted to negatively affect defect healing and increase ligament stiffness in the central defect injury model. © 2015 Karakilic et al.

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