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    Does electromagnetic-manual guided distal locking influence rotational alignment in antegrade femoral nailing?
    (Springer, 2015) Ciftdemir, Mert; Tuncel, Sedat A.; Ozcan, Mert; Copuroglu, Cem; Erem, Murat
    Purpose The aim of this study was to determine whether distal locking using an electromagnetic-manual guided distal locking decreases the malrotation rate in femur fractures treated with intramedullary nailing. Methods A total of 113 adult patients having unilateral femoral shaft fractures treated using IM nails were evaluated regarding demographic features, injury mechanism, fracture type, interval between trauma and nailing, operation time and number of image intensifier shots during the operation at least one year after nailing. Patients were divided into two groups according to distal locking technique. All patients had also undergone clinical examination for lower extremity alignment and range of motion and filled out the SF-36 questionnaire and undergone ultrasound measurement of femoral anteversion angles to reveal any rotational femoral malalignment. Results Group 1 consisted of 47 patients (41.6 %) with electromagnetic-manual targeting guided distal locking and group 2 consisted of 66 patients (58.4 %) with free-hand distal locking. Both groups were statistically similar regarding demographic features, injury mechanism, fracture type, interval between trauma and nailing, clinical examination and SF-36 results. Operation time and number of image intensifier shots were significantly less in group 1. No statistically significant difference was found between the femoral anteversion angles of injured and uninjured sides of the patients in both groups. Conclusions Although there is no significant effect on malrotation, previously known advantages lead us to state that electromagnetic-manual guided distal interlocking is an advantageous treatment option in femoral shaft fractures.
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    Efficacy of Three-Dimensional Contrast-Enhanced Magnetic Resonance Angiography (3D CE-MRA) in the Diagnosis of Thoracic Outlet Syndrome
    (Galenos Publ House, 2011) Unlu, Ercument; Kabayel, Derya Demirbag; Ozdemir, Ferda; Cagli, Bekir; Tuncel, Sedat A.
    Objective: The purpose of this study is to evaluate the effect of various upper extremity positions (adduction-abduction) on vascular structures in contrast-enhanced three-dimensional MR angiographic studies performed in patients with thoracic outlet syndrome. Materials and Methods: Twenty-two consecutive patients with clinical symptoms of neurovascular thoracic outlet syndrome were examined by 1.0 T MR unit. Examinations were studied by three-dimensional contrast-enhanced MR angiography with the arms positioned in abduction and adduction in the same patients. Results: In twenty-one of 44 subclavian arteries, impingement or stenosis with different degrees were found. Majority of lesions were localized in the costoclavicular region. Venous phase sequences of contrast-enhanced MR angiography showed compression of the subclavian vein in the 17 areas. Conclusion: Thoracic outlet syndrome remains controversial in both diagnosis and treatment, particulary in patients with no muscle atrophy, hand ischemia findings or venous stasis symptoms. Three-dimensional contrast-enhanced MR angiography is noninvasive and requires neither ionizing radiation nor administration of iodinated contrast material- and may be used to diagnose early compression findings and stenosis of the subclavian vessels.