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Öğe Avulsion fractures of both anterior and posterior cruciate ligament tibial insertions(Springer-Verlag, 2002) Calpur, OU; Copuroglu, C; Ozcan, MIpsilateral femur fracture, patellar fracture, and tibial avulsion fractures of anterior and posterior cruciate ligament injuries are reported. We know of no other report of an injury such as this in the literature. We sutured the tibial avulsion fractures by transtibial suturing technique and internally fixated the femur by intramedullary interlocking nailing 2 weeks after the trauma. After I year the results were evaluated as very good. Early surgical repair is valuable in these injuries.Öğe Clinical evaluation of ulnar nerve repair at wrist level(Springer-Verlag, 2004) Gurbuz, H; Aktas, S; Calpur, OUIntroduction. In this study, the results of ulnar nerve repair were analyzed. The relation between the functional outcome scores and clinical findings were investigated to find out whether any clinical finding could be predictive of the outcome. Materials and methods. Seventeen patients who underwent ulnar nerve repair formed the study group. Average follow-up lasted 45.5 months (range 39-48 months), and average age of the study group was 31.7 years (range 26-42 years). The same operative technique was applied to all patients by one of the authors (HG). Follow-up checks were done at 3, 6, and 12 months postoperatively. The patients who did not attend the last follow-up were excluded from the study group. The Seddon classification was used as the functional scoring system. Wound healing, Tinel sign, interosseous atrophy, atrophy of the first web space, clawing, and protective sensation were the clinical findings examined at the follow-ups. Wound healing was classified as either normal scar formation or hypertrophic scar-keloid (HsC) formation. Results. Good results in 4 and fair results in 13 were obtained according to the Seddon classification. Statistically, there was no difference between the clinical findings at the 3, 6, and 12 month follow-ups. Conclusion. Presence of HsC and clawing can be regarded as a predictive sign for fair results in nerve repairs.Öğe Full arthroscopic lateral retinacular release with hook knife and quadriceps pressure-pull test: long-term follow-up(Springer, 2005) Calpur, OU; Ozcan, M; Gurbuz, H; Turan, FThe most important causes of anterior knee pain include patellofemoral malalignment which causes patella - condyle contact anomalies at the patellofemoral joint, excessive patellar lateral pressure increase, trauma and overuse. In this article, besides presentation of late clinical results of 169 lateral retinacular release cases which were surgically treated between January 1995 and December 2002 with the help of a hook knife from the anterolateral portal due to lateral compression syndrome and patellar maltracking, we also described quadriceps tendon pressure-pull test which strongly indicates patellofemoral pain during physical examination of a patient with anterior knee pain. In addition to radiological patellofemoral imaging methods, we describe dynamic arthroscopic patellofemoral joint examination which is applied perarthroscopically to all of our surgically treated patients. We divided the patients into two groups: group 1 was the younger group with age 16 - 40 years; group 2 was the older group with age > 41 years. Preoperative mean Lysholm scores for group I was 67.6 and 98.6, postoperatively, whereas it was 62.3 preoperatively and 91.4 postoperatively in group 2. This improvement of Lysholm scores postoperatively was statistically significant for each of the two groups ( p= 0.001). For group 1 preoperative IKDC scores were A in 8 patients, B in 61 patients and C in 11 patients, whereas it was A in 78 patients and B in 2 patients postoperatively. For group 2 preoperative IKDC scores were A in 2 patients, B in 43 patients, C in 36 patients and D in 8 patients, whereas it was A in 78 patients and B in 11 patients. This improvement of IKDC scores postoperatively was also statistically significant for each of the two groups ( p= 0.001). Preoperative and postoperative congruens angles of all patients were also measured. Preoperative mean congruens angle was + 16.4 in group 1 while mean congruent angle was - 7.1 postoperatively. For group 2 preoperative mean congruens angle was + 18.7 preoperatively and - 6.9 postoperatively. This improvement was statistically significant for each of the two groups ( p= 0.001). The overall number of patellar lateral compression syndrome cases were 51 ( 24 in group 1, 27 in group 2), patellar lateralization cases were 64 ( 28 in group 1, 36 in group 2) and patellar subluxation cases were 54 ( 28 in group 1, 26 in group 2). At the evaluation of arthroscopic lateral patellar facet and lateral femoral condylar chondral pathologies, we statistically showed that patellar chondral pathologies were more severe than the femoral chondral pathologies ( p= 0.001). In our opinion, the severity of patellar lateral facet chondral lesions, although it has a thicker layer of cartilage, is due to distribution of load to a larger contact area of lateral femoral condyle [ 1, 2]. Statistically increasing severity of femoral ( Kendall's tau-b: 0.248, p= 0.001) and patellar chondral lesions ( Kendall's tau-b: 0.444, p= 0.0001) with age is compatible with our arthroscopic and clinical observations. The most important complication seen in our cases was fibrosis at the site of lateral release, seen in three patients. They were healed without any sequela with local corticosteroid injection into the fibrosis tissue. We did not see any hemarthrosis or haematoma as a complication.Öğe Intraarticular analgesia after arthroscopic knee surgery: comparison of neostigmine, clonidine, tenoxicam, morphine and bupivacaine(Springer, 2005) Alagol, A; Calpur, OU; Usar, PS; Turan, N; Pamukcu, ZWe conducted a randomized, placebo-controlled, double blinded study to compare the analgesic effects of intraarticular neostigmine, morphine, tenoxicam, clonidine and bupivacaine in 150 patients undergoing arthroscopic knee surgery. General anaesthesia protocol was same in all patients. At the end of the surgical procedure, patients were randomized into six intraarticular groups equally. Group N received 500 mu g neostigmine, Group M received 2 mg morphine, Group T received 20 mg tenoxicam, Group C received 1 mu g kg(-1) clonidine, Group B received 100 mg bupivacaine and Group S received saline 20 ml. Visual analog scale scores 0, 30 and 60 min and 2, 4, 6, 12, 24, 48 and 72 h, time to first analgesic need, analgesic consumption at 48 h and 72 h and side effects were noted. Demographic and operational parameters were similar in six groups. All study groups provided analgesia when compared with saline group (P<0.05). Duration of analgesia in Group N and C was longer than other groups (P<0.001). Analgesic consumptions of Group N, C and T were lower than other groups (P<0.01). Pain scores during 2 h postoperatively were lower in all study groups than the control group (P<0.001). In Group B, median pain scores were higher than Groups N and C at 0 min and 30 min postoperatively (P<0.001). Side effects were not significantly different among the six groups. We conclude that the most effective drugs that are administered intraarticularly are neostigmine and clonidine among the five drugs we studied. Tenoxicam provided longer analgesia when compared with morphine and bupivacaine, postoperatively.Öğe Patellar metastasis from a lung epidermoid carcinoma(Yonsei Univ College Medicine, 1998) Aktas, S; Demiral, H; Bilgi, S; Caglar, T; Calpur, OUPatellar metastases are very rare. There have been approximately 20 cases reported in the literature. We have also noted two Other reports of patellar metastasis from lung carcinoma as the first manifestation of lung cancer in our literature review. We present a case of patellar metastasis; as the first manifestation of lung epidermoid carcinoma in a patient who was a smoker for 33 years.Öğe United unresorbed medial and lateral plicae as anterior mesenchymal synovial septal remnant(Springer-Verlag, 2002) Calpur, OU; Copuroglu, C; Ozcan, MMesenchymal tissue that forms compartments in the knee joint begins to be resorbed in the 8th week of embryologic life. Unless these mesenchymal tissues are totally resorbed, they remain as septal remnants, and are termed mediopatellar, infrapatellar, suprapatellar, and lateral plicae. We report a case of united anterior plica; the inferior part of the anterior mesenchymal septum at the back of the patellar tendon was unseparated and unresorbed, and one-half of the superior part of the septum beginning from the inferior pole of the patella formed the V-shaped medial and lateral plicae such that their opening looked upwards.
