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    A Hybrid Schwannoma of Median Nerve
    (Coll Physicians & Surgeons Pakistan, 2014) Komurcu, Erkam; Kaymaz, Burak; Adam, Gurhan; Gokmen, Ferhat; Murath, Asli
    Schwannomas are the most common benign neoplasms of the peripheral nerves in the upper extremity originating from the schwann cells of nerve sheath. They account for 5% of all tumours in upper extremity. Schwannomas are usually solitary, encapsulated and homogeneous masses and present with slowly growing masses, sometimes associated with pain and paresthesia. Pre-operative evaluation is based on ultrasonography and magnetic resonance imaging, but final diagnosis requires histopathology. It is important to distinguish plexiform schwannoma from plexiform neurofibroma because of the possibility of malignant transformation in plexiform neurofibroma. Plexiform schwannoma may be confused with neurofibromatosis and this can lead to overtreatment. We present a very rare case of solitary mass which had a plexiform type multicentric extension: hybrid schwannoma of the median nerve of a 20-year-old young girl.
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    A Rare Cause of Median Nerve Entrapment Neuropathy: Carpal Lipoma
    (2019) Aylanç, Nilüfer; Kaymaz, Burak; Reşorlu, Mustafa; Toprak, Canan Akgün
    Lipomas are common benign soft tissue tumors andmay appear in different anatomical regions of thebody. They are rarely seen in the hand. These lesions,in varying sizes, can cause some complications andclinical symptoms depending on the mass effect onthe anatomic region. Especially lesions in the hand,can cause carpal tunnel syndrome (CTS), due to theproximity to the median nerve or to compressioneffect. In this article, the lipoma causing median nerveentrapment will be discussed, although it is notlocated just in the carpal tunnel but distally.
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    Adölesan amatör futbolcularda görülen spina iliaka anterior ve superior avulsiyon kırıklarının konservatif tedavisi: İki olgu sunumu
    (2015) Gölge, Umut Hatay; Kaymaz, Burak; Göksel, Ferdi; Kuyucu, Ersin; Kömürcü, Erkam
    Spina İliaka Anterior İnferior (SİAİ) ve Spina İliaka Anterior Superior (SİAS) avülsiyon kırıkları pelvisin nadir görülen yaralanmalarındandır. Genelde sporcularda ve futboloynarken şut çekme sırasında gerçekleştiği düşünülmektedir. Bu yüzden SİAİ ve SİAS avülsiyon kırıklarının gözden kaçmaması için ayrıntılı anamnez ve fizik muayeneile başlanmalıdır. Olgularımızın ikiside amatör düzeydefutbol oynarken şut çekme sonrasında kalça ağrısı vehareket kısıtlılığı ve yürümede zorluk nedeniyle poliklinikte görüldü. Yaşları 15 ve16 olan hastalarımızın fizikmuayene sonrası yapılan radyolojik değerlendirmelerinde bir olguda SİAİ diğer olguda da SİAS avülsiyon kırığısaptandı. Koltuk değnekleri ile tam yük vermeden yürümeve non-steroidal antiinflamatuar ilaçlar ile yaklaşık bir ayistirahat ettirilen olgularımızın konservatif tedavi sonrasımuayenede pasif kalça hareket açıklıkları tam ve ağrısızolarak değerlendirildi. İkinci ayın sonunda aktif spora dönüş gerçekleştirildi. SİAİ ve SİAS avulsiyon kırıkları adölesan futbolcularda daha sık gözlenen ancak nadir olanbu durumun gözden kaçmaması için ayrıntılı anamnez vedikkatli fizik muayene yapılması ve direkt grafinin yeterliolacağı kanaatindeyiz.
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    An uncommon cause of anterior knee pain in a child: Osteoid Osteoma of the patella and a review of the literature
    (2022) Kaymaz, Nazan; Kaymaz, Burak
    Introduction: Osteoid osteoma (OO) is a small, benign bone neoplasm that has a well demarcated nidus surrounded by a reactive zone of sclerosis. It is most common in the long bones and only rarely in the patella. Case Presentation: An eight-year-old girl was admitted to the outpatient clinic with the complaint of anterior knee pain. She had been suffering from pain for approximately one year. The patient had a patellar osteoid osteoma. Surgical curettage of the lesion was performed, and the patient was free of pain the day after the surgery. Conclusions: Although Patellar OO is rare, it should be included in the differential diagnosis of persistent knee pain in children and young adults.
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    An Uncommon Cause of Anterior Knee Pain: Patellar Chondroma
    (Lippincott Williams & Wilkins, 2014) Kaymaz, Burak; Eroglu, Mehmet; Kaymaz, Nazan; Ucar, Mehmet
    A 16-year-old boy presented with a patellar mass and anterior knee pain without any trauma. On physical and radiologic assessment, a mass at the superolateral edge of the patella and a hyperintense lesion on T2 sequences of magnetic resonance imaging was detected. Excisional biopsy revealed a chondroma of patella. Primary bone tumors of the patella are extremely rare and occurence of chondroma in this localization is very uncommon. Although anterior knee pain is a very frequent and usually harmless, it is essential to consider the more severe disorders such as bone tumors.
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    An Unusual Location for Cellular Schwannoma
    (Coll Physicians & Surgeons Pakistan, 2014) Golge, Umut Hatay; Komurcu, Erkam; Kaymaz, Burak; Yilmaz, Deniz
    Schwannomas are solitary benign tumours derived from peripheral nerve sheath that are difficult to diagnose using imaging only. Diagnoses are commonly confirmed with conventional surgical resection. Small proportion of cases are formed by cellular schwannoma usually seen at paravertebral, pelvic, retroperitoneal, or mediastinal location. This patient had a 3 x 2 cm hard mass at the dorsal side of proximal phalanx of the right third toe. Bone destruction was seen on radiography and MR imaging. Curettage after excision and grafting were performed. No complication was seen after surgery. The histopathology result was reported as cellular schwannoma. It was an atypical location for cellular schwannoma not previously described in literature.
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    Anterior cruciate ligament reconstruction using a hamstring graft: a retrospective comparison of tunnel widening upon use of two different femoral fixation methods
    (Springer, 2015) Mermerkaya, Musa Ugur; Atay, Ozgur Ahmet; Kaymaz, Burak; Bekmez, Senol; Karaaslan, Fatih; Doral, Mahmut Nedim
    To compare femoral and tibial tunnel widening (TW) in patients undergoing anterior cruciate ligament (ACL) reconstruction using an interference screw (IS), or an EndoButton-Continuous Loop(A (R)) on the femoral side, and an IS/staple on the tibial side. Between 2006 and 2009, at a single institution, 72 patients who underwent arthroscopic ACL reconstruction with quadrupled hamstring tendon grafting were retrospectively reviewed. Fixation was performed, and with the EndoButton-Continuous Loop(A (R)) device (Group I (TM)) in 48 patients (mean age 29.1 +/- A 7.3 years) with a bioabsorbable IS (Group I (TM) I (TM)) in 24 patients (mean age 28.5 +/- A 8.4 years) on the femoral side. Evaluation included standardized anteroposterior (AP) and lateral radiography. The diameters of tunnels at the last follow-up visit (at a median time of 17 months postoperatively) were compared to those noted on radiographs taken 1 day postoperatively. The two groups were similar in terms of age and gender distribution, the operated side, the size of the tunnel created, and the follow-up period (n.s.). Femoral TW at the proximal and middle levels (on both AP and lateral views) in Group I (TM) I (TM) was significantly greater than in Group I (TM) (p < 0.050 for all comparisons). No significant difference in femoral TW at the distal level was evident between the groups, and tibial TW at all levels was similar in both groups (n.s.). Femoral TW is less after EndoButton-Continuous Loop(A (R)) fixation and not reduced after IS fixation. Surgeons should be aware of TW when selecting a fixation device for hamstring graft. Therapeutic, retrospective comparative study, Level III.
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    Assessment of Calcaneal Morphology and Radiological Parameters in Haglund's Syndrome
    (Galenos Publ House, 2022) Buyukdogan, Kadir; Aslan, Lercan; Kaymaz, Burak; Yilmaz, Onur; Ayik, Gokhan; Mermerkaya, Musa Ugur
    Objective: To compare the radiological parameters of the normal population with the patients with Haglund's syndrome (HS) and to seek a correlation between pain scores and radiological parameters in patients with HS.Methods: Thirty-one patients surgically treated for HS (Haglund group) and 36 healthy subjects free of hindfoot pathology seen in consultation for any other foot pathologies (control group) were included in the study. Demographic data of the patients were acquired, and radiological measurements such as; Fowler Philip Angle (FPA), lateral talus-first metatarsal angle (LTFMA), and Calcaneal pitch angle (CPA) were recorded. The visual analog scale (VAS) and the American Orthopaedic Foot & Ankle Society (AOFAS) scores of the patients in the Haglund group were assessed.Results: Mean CPA, FPA, and LTFMA in the Haglund group were 23.88 +/- 4.6, 58.16 +/- 5.7, and 4.92 +/- 1.88, respectively, and the same recordings in the control group were 21.16 +/- 4.81, 59.1 +/- 4.3, and 4.25 +/- 2.57, respectively. CPA differences between Haglund and control groups were statistically significant (p=0.021). The average values of the VAS and AOFAS scores of the patients in the Haglund group were 8.45 +/- 1.06 and 47.4 +/- 7.58, respectively. There was no correlation between the scores and the radiological measurements of patients in the Haglund group.Conclusion: Radiological assessments are widely debated. Many studies support our results that measurements defined for the morphology of calcaneus are not associated with the Haglund's disease severity. Increase in the CPA is found to be related to HS. This may be explained by the extension of the calcaneus to irritate the Achilles tendon and cause heel pain.
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    Atypical Localization of Enchondroma in the Calcaneus
    (Amer Podiatric Med Assoc, 2015) Komurcu, Erkam; Kaymaz, Burak; Golge, Umut Hatay; Goksel, Ferdi; Resorlu, Mustafa; Kilinc, Nihal
    A 53-year-old man presented to the orthopedic outpatient clinic with pain and swelling in the right heel without any trauma. On physical examination and radiologic assessment, a lesion with calcification and peripheral sclerosis was detected in the medullary cavity of the calcaneus, and computed tomographic images revealed cortical thinning adjacent to the lesion. Magnetic resonance images showed a 23 x 19-mm lesion. Tru-Cut biopsy, performed to clarify the diagnosis, revealed an enchondroma. As a definitive treatment, curettage of the lesion and grafting of the cavity was performed. Although enchondromas are common pathologic abnormalities of the skeleton and are usually asymptomatic, atypical localization, such as the calcaneus, and atypical clinical manifestations, such as heel pain, should also be kept in mind.
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    Avulsion Fracture of Tendon of Extensor Carpi Radialis Longus
    (2015) Gölge, Umut Hatay; Kömürcü, Erkam; Kaymaz, Burak; Göksel, Ferdi
    [Abstract Not Available]
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    Bilateral quadriceps tendon rupture in a end-stage renal disease patient: case report
    (Çanakkale Onsekiz Mart Üniversitesi, 2014) Kaymaz, Burak; Gölge, Umut Hatay; Göksel, Ferdi; Kömürcü, Erkam; Mermerkaya, Musa Uğur; Eroğlu, Mehmet
    Simultaneous bilateral quadriceps tendon rupture is a very rare injury. Occurrence after minor trauma is predominantly associated with certain medical problems including chronic diseases and long-term use of certain drugs.We report the case of a 56-year-old patient with end stage renal disease who sustained a simultaneous bilateral quadriceps tendon rupture following minor trauma and succesful surgical treatment.
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    Comment on the article 'The biomechanics of guided growth: does screw size, plate size, or screw configuration matter?' by Schoenleber et al.
    (Lippincott Williams & Wilkins, 2014) Kaymaz, Burak; Komurcu, Erkam; Goksel, Ferdi; Golge, Umut H.
    [Anstract Not Available]
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    Comment on the article Dual 8-Plate Technique Is Not as Effective as Ablation For Epiphysiodesis About the Knee by Stewart et al
    (Lippincott Williams & Wilkins, 2014) Kaymaz, Burak; Komurcu, Erkam
    [Anstract Not Available]
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    Comparison of fixed-bearing and mobile-bearing total knee arthroplasties: Short-term clinical results
    (2015) Kaymaz, Burak; Sevinçhan, Cihan; Gölge, Umut Hatay; Nusran, Gürdal; Göksel, Ferdi; Kömürcü, Erkam; Eroğlu, Mehmet
    Objectives: Mobile-bearing knee replacements were introduced as an alternative to fixed-bearing prosthesis to decrease the wear. Despite theoretical advantages of mobile bearings prosthesis, it is still controversial whether there is any clinically significant difference between the patients treated with fixed and mobile bearing prosthesis. The aim of this study is to compare the short-term clinical outcomes of fixed versus mobile-bearing prosthesises. Methods: Patients who were diagnosed as grade 4 gonartrosis and operated for total knee arthroplasty between years 2010- 2014 were evaluated and 33 patients (40 knees) were included in the study. From hospital medical and radiological databases, age and gender of the patients, duration of operation, number of blood tranfusions postoperatively and preoperative range of motions (ROM) of the operated knees were recorded and all the patients were assessed with Knee Society Knee Score. Results: Twenty-two knees (12 female, 10 male) were present in fixed bearing group (Group I) and 18 knees (13 female, 5 male) were present in mobile bearing group (Group II). There was no statistically significant difference between the groups in terms of pre-operative range of motions (ROM), post-operative range of motions (ROM), number of blood transfusions. Knee Society Knee Score was 167.7±23.4 in Group I and 178.1±22.4 in Group II. Mobile bearing prosthesis group was found to have better knee score and this difference was near to statistically significance (p=0.055). Conclusions: Clinical outcomes of mobile bearing prosthesis seems to be better in short-term follow-up but long-term results should also be investigated before recommending the mobile bearing prosthesises.
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    Comparison of Osteoporosis in Two Different Regions of Turkey
    (Galenos Yayincilik, 2014) Golge, Umut Hatay; Komurcu, Erkam; Kaymaz, Burak; Goksel, Ferdi; Guzel, Yunus; Adam, Gurhan; Erbay, Piril
    Objective: The aim of the study was to investigate the effect of different climate and geographic conditions on bone mineral density. Materials and Methods: The patients who had been examined with Dual X-ray Absorptiometry (DXA) for the suspicion of osteoporosis in two different regions of Turkey were included in the study. Medical records of these 2457 patients were evaluated retrospectively. Age, gender, body mass index (BMI) and osteoporosis etiology of these patients were recorded. Results: Dual X-ray Absorptiometry measurements of the femoral neck and lomber vertebras of these patients were investigated. 927 of the patients were found to be osteoporotic and 907 of the patients to be osteopenic. There was no difference between the groups in terms of age, gender and BMI. Lumbar vertebras (L1-4) and femoral neck T scores of the patients with similar age and gender in these 2 different regions were compared and the difference between the groups was found to be statistically significant (p<0.001). Conclusion: The effect of geography and climate conditions on the bone quality is well known. In this respect regional strategies in the prevention and treatment of the osteoporosis may be judicious.
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    Consultation of traditional bone setters instead of doctors: Is it a sociocultural and educational or social insurance problem?
    (Sage Publications Inc, 2015) Golge, Umut Hatay; Kaymaz, Burak; Komurcu, Erkam; Eroglu, Mehmet; Goksel, Ferdi; Nusran, Gurdal
    Background Patients consulting bone setters is common in the eastern and south-eastern regions of Turkey. The reasons for consulting bone setters instead of qualified doctors remains unclear. We investigated the characteristics of such patients who consult traditional bone setters after trauma prior to admission to hospital. Methods In the study, 3,422 of 14,080 patients were investigated admitted to hospital between January 2012 and February 2013 with trauma or sequelae of such who were previously treated by bone setters. The characteristics of these patients and the main reasons for consultation of bone setters instead of doctors were recorded. Results Most of the patients consulting bone setters were found to be young adults or children. Generally speaking, the poorly educated prefer bone setters despite having social insurance. The most common reason (29.3%) was a general preference and secondarily (27.1%) the fear of being disabled after medical treatment. However, the most common cause of patients' consultation at hospital subsequently was due to complications of treatment (46.8%); indeed the complication rate after bone setters' intervention was found to be 54.8%. Conclusion Although improvements have occurred in the access to and utilisation of healthcare services, consultation by patients of bone setters seems to be a sociocultural and educational issue rather than a problem of lack of medical insurance.
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    Effects of Aloe Vera on Spinal Cord Ischemia-Reperfusion Injury of Rats
    (Taylor & Francis Inc, 2016) Yuksel, Yasemin; Guven, Mustafa; Kaymaz, Burak; Sehitoglu, Muserref Hilal; Aras, Adem Bozkurt; Akman, Tarik; Tosun, Murat
    Aim: The purpose of this study was to evaluate the possible protective/therapeutic effects of aloe vera (AV) on ischemia-reperfusion injury (I/R) of spinal cord in rats. Materials and Methods: A total of 28 Wistar Albino rats were divided into four random groups of equal number (n = 7). Group I (control) had no medication or surgery; Group II underwent spinal cord ischemia and was given no medication; Group III was administered AV by gastric gavage for 30days as pre-treatment; Group IV was administered single dose intraperitoneal methylprednisolone (MP) after the ischemia. Nuclear respiratory factor-1 (NRF1), malondialdehyde (MDA) and superoxide dismutase (SOD) levels were evaluated. Tissue samples were examined histopathologically and neuronal nitric oxide synthase (nNOS) and nuclear factor-kappa B (NF-B) protein expressions were assessed by immunohistochemical staining. Results: NRF1 and SOD levels of ischemia group were found to be lower compared to the other groups. MDA levels significantly increased after I/R. Treatment with AV and MP resulted in reduced MDA levels and also alleviated hemorrhage, edema, inflammatory cell migration and neurons were partially protected from ischemic injury. When AV treatment was compared with MP, there was no statistical difference between them in terms of reduction of neuronal damage. I/R injury increased NF-B and nNOS expressions. AV and MP treatments decreased NF-B and nNOS expressions.Conclusions: It was observed that aloe vera attenuated neuronal damage histopathologically and biochemically as pretreatment. Further studies may provide more evidence to determine the additional role of aloe vera in spinal cord ischemia reperfusion injury.
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    Effects of Boric Acid on Fracture Healing: An Experimental Study
    (Humana Press Inc, 2015) Golge, Umut Hatay; Kaymaz, Burak; Arpaci, Rabia; Komurcu, Erkam; Goksel, Ferdi; Guven, Mustafa; Guzel, Yunus
    Boric acid (BA) has positive effects on bone tissue. In this study, the effects of BA on fracture healing were evaluated in an animal model. Standard closed femoral shaft fractures were created in 40 male Sprague-Dawley rats under general anesthesia. The rats were allocated into five groups (n= 8 each): group 1, control with no BA; groups 2 and 3, oral BA at doses of 4 and 8 mg/kg/day, respectively; group 4, local BA (8 mg/kg); and group 5, both oral and local BA (8 mg/kg/day orally and 8 mg/kg locally). After closed fracture creation, the fracture line was opened with a mini-incision, and BA was locally administered to the fracture area in groups 4 and 5. In groups 2, 3, and 5, BA was administered by gastric gavage daily until sacrifice. The rats were evaluated by clinical, radiological, and histological examinations. The control group (group 1) significantly differed from the local BA-exposed groups (groups 4 and 5) in the clinical evaluation. Front-rear and lateral radiographs revealed significant differences between the local BA-exposed groups and the control and other groups (p< 0.05). Clinical and radiological evaluations demonstrated adequate agreement between observers. The average histological scores significantly differed across groups (p= 0.007) and were significantly higher in groups 4 and 5 which were the local BA (8 mg/kg) and both oral and local BA (8 mg/kg/day orally and 8 mg/kg locally), respectively, compared to the controls. This study suggests that BA may be useful in fracture healing. Further research is required to demonstrate the most effective local dosage and possible use of BA-coated implants.
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    Effects of boric acid on the healing of Achilles tendons of rats
    (Springer, 2016) Kaymaz, Burak; Golge, Umut Hatay; Ozyalvach, Gulzade; Komurcu, Erkam; Goksel, Ferdi; Mermerkaya, Musa Ugur; Doral, Mahmut Nedim
    Tendinous lesions are among the most frequent pathologies encountered in sportsmen. The objectives of new treatments are to improve the healing process and reduce the recovery time. Boron plays an important role in the wound repair process by increasing components of extracellular matrix and angiogenesis. This animal study aimed to investigate the effect of boric acid on healing of the Achilles tendon. The right Achilles tendons of 40 rats were completely sectioned, and the rats were randomly divided into five groups. Each group consisted of eight rats. Groups 1 and 2 were oral boric acid groups with the doses of 4 and 8 mg/kg/day boric acid, respectively. Group 3 was the local boric acid group (8 mg/kg boric acid intratendinous injection). Group 4 was administered both oral and local boric acid (8 mg/kg/day orally and 8 mg/kg boric acid intratendinous injection), and group 5 was the control group with no boric acid application. At the end of the fourth week, all the rats were killed and histopathological examination of the Achilles tendon repair site was made. Histopathological examination of the tissue sections revealed more properly oriented collagen fibres, more normal cellular distribution of tenocytes and more properly organized vascular bundles in group 1 and group 2, which were the groups administered oral boric acid. Pathological sum scores of groups 1 and 2 were less than those of the other groups, and the differences between the oral boric acid groups (group 1 and group 2) and the other three groups (groups 3, 4 and 5) were statistically significant (p = 0.001). As boric acid is safe and toxicity even after very high doses is unusual, oral boric acid may be used as an agent to improve the healing process of tendon injuries. However, biomechanical tests should also be performed to show the effect of boric acid on strength and endurance of the tendon before it can be used in clinical practice.
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    Effects of Local Administration of Boric Acid on Posterolateral Spinal Fusion with Autogenous Bone Grafting in a Rodent Model
    (Humana Press Inc, 2015) Komurcu, Erkam; Ozyalvacli, Gulzade; Kaymaz, Burak; Golge, Umut Hatay; Goksel, Ferdi; Cevizci, Sibel; Adam, Gurhan
    Spinal fusion is among the most frequently applied spinal surgical procedures. The goal of the present study was to evaluate whether the local administration of boric acid (BA) improves spinal fusion in an experimental spinal fusion model in rats. Currently, there is no published data that evaluates the possible positive effects if the local administration of BA on posterolateral spinal fusion. Thirty-two rats were randomly divided into four independent groups: no material was added at the fusion area for group 1; an autogenous morselized corticocancellous bone graft was used for group 2; an autogenous morselized corticocancellous bone graft with boric acid (8.7 mg/kg) for group 3; and only boric acid was placed into the fusion area for group 4. The L4-L6 spinal segments were collected at week 6, and the assessments included radiography, manual palpation, and histomorphometry. A statistically significant difference was determined between the groups with regard to the mean histopathological scores (p=0.002), and a paired comparison was made with the Mann-Whitney U test to detect the group/groups from which the difference originated. It was determined that only the graft+BA practice increased the histopathological score significantly with regard to the control group (p=0.002). Whereas, there was no statistically significant difference between the groups in terms of the manual assessment of fusion and radiographic analysis (respectively p=0.328 and p=0.196). This preliminary study suggests that BA may clearly be useful as a therapeutic agent in spinal fusion. However, further research is required to show the most effective dosage of BA on spinal fusion, and should indicate whether BA effects spinal fusion in the human body.