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    Injuries associated with motorcycle accidents
    (Turkish Assoc Orthopaedics Traumatology, 2008) Alicioglu, Banu; Yalniz, Erol; Eskin, Deniz; Yilmaz, Baris
    Objectives: In recent years, there has been a significant increase in motorcycle accidents in parallel with the increasing number of motorcyclists. Data on motorcycle accidents/injuries are relatively limited in Turkey. This study sought to determine the injury profile of patients involved in motorcycle accidents. Methods: This retrospective study included 212 patients (204 males, 8 females; mean age 36 16 years; range 2 to 79 years) who were hospitalized for injuries caused by motorcycle accidents. Data on age and sex, injury patterns, length of hospitalization were recorded. Injuries were grouped according to localization. Results: The frequencies of injuries in descending order were as follows: musculoskeletal system injuries (n=106, 50% skull injuries (n=103, 48.6%), maxillofacial injuries (n=38, 17.9%), thoracic (n=15, 7.1% vertebral (n=10, 4.7%), and abdominal (n=6, 2.8%) injuries. Multiple fractures in upper and lower extremities were seen in 17 (8%) and 43 (20.3%) patients, respectively. The most frequent extremity injuries were tibia-fibula fractures (17.9%) followed by shoulder injuries (11.3%). Both extremity and skull injuries were seen in 23 patients (10.9%). The mean hospital stay was 12.2 +/- 16.8 days (range 1 to 150 days). Eight patients required intensive care for a mean of seven days. As a complication, one patient (0.5%) with olecranon and tibial plateau fractures developed pulmonary embolism. Motorcycle accidents resulted in mortality in nine patients (4.3%). Conclusion: Since motorcycle accidents are preventable or associated risks for injuries are reducible, risk factors for our country should be determined, necessary laws and restrictive regulations should be put into practice, and educational programs should be implemented.
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    The safety of pedicle screw fixation in the thoracic spine
    (Turkish Assoc Orthopaedics Traumatology, 2009) Yalniz, Erol; Ciftdemir, Mert; Eskin, Deniz; Dulger, Hakan
    Objectives: Thoracic pedicle screw fixation has many advantages over other methods of spinal fixation in treating various conditions. We evaluated the safety and efficacy of pedicle screw fixation in the thoracic spine. Methods: We retrospectively reviewed 144 patients (65 males, 79 females; mean age 38 years; range 9 to 82 years) who underwent posterior thoracic pedicle screw instrumentation. A total of 827 thoracic pedicle screws were inserted to the thoracic spine (T1-12) by the same senior spine surgeon using the free-hand technique. Indications for thoracic spine surgery were deformities (n=47, 32.6%), metastatic or primary tumors (n=15, 10.4%), spinal infections (n=7, 4.9%), degenerative diseases (n=13, 9%), and spinal trauma (n=62,43.1%). Screw containment was assessed by three independent reviewers on postoperative plain radiographs. In addition, thin-slice computed tomography scans were obtained in 21 suspected cases (29 screws). Results: Screw containment was found in 94.3% (780 screws). Incorrect screw placement was found in 47 screws (5.7%), including 31 screws (3.8%) demonstrated by plain radiographs, and 16 screws (1.9%) demonstrated by thin-slice computed tomography scans. More than half of the faulty screws (n=24, 51.1%) were detected in scoliosis patients, especially on the concave side of the curvature (83.3%). The most frequent site of faulty screw placement was the T-8 level (21.3%). No symptoms or complications occurred related to faulty screw placement. Conclusion: The high accuracy of thoracic pedicle screw placement (94.3%) using the free-hand technique suggests that pedicle screw fixation of the thoracic spine is safe, reliable, and useful in the treatment of all types of spinal diseases.
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    Treatment of intrarticular distal radius fractures with external fixation
    (Yerkure Tanitim & Yayincilik Hizmetleri A S, 2010) Copuroglu, Cem; Eskin, Deniz; Balik, Mehmet Sabri; Ozcan, Mert
    Objective: To evaluate the treatment results of radius distal intra-articular fractures with external fixation. Material and Methods: Between November 1997-October 2006, 46 radius distal intra-articular fractures of 43 patients were evaluated retrospectively. All the fractures were treated with closed reduction and external fixation. The patients were evaluated functionally and radiologically on April 2007. Results: According to AO (Arbeitsgemeinschaft fur Osteosynthesefragen) classification, 3 (6.52%) of 46 were type B, 43 (43.98%) were type C. Three of the fractures were open. Mean external fixation application time was 7.3 weeks (4-16). Mean follow-up time was 55.4 months (6-114). Functionally 12 (26.9%) excellent, 16 (34.78%) good, 16 (34.78%) fair, 2 (4.65%) bad results were obtained. Anatomically 5 (10.87%) excellent, 30 (65.22%) good, 9 (19.56%) fair, 2 (4.35%) bad results were obtained. Totally 24 (52.7%) complications were faced up. Fifteen (32.6%) reflex sympathetic dystrophia, 9 (19.56%) pain in the distal radioulnar joint, 4 (8.7%) joint stiffness, 3 (6.5%) pin tract infection were observed. In some cases more than one complication could be observed. In some cases sensory disturbances and pin tract sensitivity were observed but after the removal of the fixator they all recovered. Conclusion: Treatment of radius distal intra-articular fractures with external fixation is a successfull treatment modality. Studies with longer follow-up and comparative studies are needed.
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    Treatment of proximal humerus fractures with external fixation
    (Aves Yayincilik, Ibrahim Kara, 2008) Copuroglu, Cem; Gurbuz, Hakan; Eskin, Deniz
    Objectives: We evaluated the functional results of patients who were treated with closed reduction and external fixation for proximal humeral fractures. Patients and Methods: The study included16 patients (11 males, 5 females; mean age 50.3 years; range 9 to 81 years) with proximal humerus fractures. All the patients were treated with closed reduction and external fixation (9 ilizarov external fixator, 7 monolateral external fixator). After bone union was achieved, the fixators were removed and functional results were evaluated with the Constant score. The mean follow-up was 37 months (range 4 to 69 months). Results: The average union time was 14 weeks (range 8 to 22 weeks). Union did not occur in one patient. Avascular necrosis of the humeral head developed in one patient. Superficial pin tract infections were observed in three patients, all of whom were successfully treated with wound care and antibiotic therapy. The mean Constant score was 81. Conclusion: Treatment of displaced fractures of the proximal humerus with closed reduction and external fixation provides satisfactory fracture reduction and stability and functional results.
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    Which Classification System is More Useful for Intertrochanteric Fractures? AO/ASIF or Jensen?
    (Aves Yayincilik, Ibrahim Kara, 2008) Memisoglu, Serdar; Eskin, Deniz; Yamak, Erkan; Guerbuez, Aydin; Saridogan, Kenan; Duelger, Hakan
    Objectives: The aim of this study was to determine intra- and interobserver reliability of AO/ASIF and Jensen classification systems, and to compare reliability when applied by unexperienced and experienced orthopaedic surgeons. Patients and Methods: The anteroposterior and lateral radiographs of 60 intertrochanteric hip fractures were reviewed and classified by two groups (G1, G2) of orthopaedic surgeons using the AO and Jensen classification systems on two separate occasions three months apart. Each group consisted of five orthopaedic surgeons. Group 1 had less than five years, and group 2 had more than 10 years of experience. Kappa statistical analysis was used for determination of intra- and interobserver variation. Results: For the AO classification system without subgroups, the mean kappa value was 0.67 (range 0.47-0.90) for intraobserver variation and 0.42 (range 0.10-0.73) for interobserver variation. For the Jensen classification, the mean kappa value was 0.57 (range 0.35-0.80) for intraobserver variation and 0.30 (range 0.10-0.60) for interobserver variation. For the AO classification system with subgroups, the mean kappa value was 0.49 (range 0.21-0.81) for intraobserver variation and 0.23 (range 0.09-0.51) for interobserver variation. Conclusion: Although these classification systems have disadvantages, this study suggests that AO system without subgroups is more useful than Jensen and AO system with subgroups to classify intertrochanteric fractures of the proximal femur.