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    Biomechanical comparison of a new handy tension band with malleolar screw, bicortical screw and conventional tension band for the fixation of transverse medial malleolar fractures
    (Turkish Joint Diseases Foundation, 2019) Kuru, Tolgahan; Akpinar, Fuat; Isik, Cengiz; Ozkilic, Recai; Ipek, Serdar; Mutlu, Ibrahim; Kizilay, Hasan
    Objectives: This study aims to compare the biomechanical features of a new handy tension hand with the malleolar screw, bicortical screw and conventional tension hand for the fixation of transverse medial malleolar fractures. Materials and methods: This study used 20 Kirschner wires, five cerclage wires, six double-hole U pins, six cortical screws, six malleolar screws, three malleolar clamps and one osteotomy set. A total of 24 tibias of two-year-old cows were obtained and stripped from soft tissue. Each tibia was cut with an electric saw at 15 cm proximal to the tibiotalar joint surface and the proximal tibia sections were discarded. A transverse fracture line was created with an asteotome on the medial malleolus. The tibias were separated into four groups with six tibias in each group. The distal tibia medial malleolar transverse fragments were fixed under guidance of fluoroscopy with the malleolar screw, bicortical screw, conventional tension band and the new handy tension band. Results: In the application of both transverse and axial force, the new handy tension band resisted higher forces in respect of catastrophic damage force being more resistant compared to the bicortical screw, malleolar screw and conventional tension band. However, in respect of the 2 mm displacement force of the forces applied in the axial and transverse sections, no difference was determined between the handy tension hand and the other three implants. Conclusion: The new handy tension band seems to be more successful when hiomechanically compared with the other implants.
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    Comparison of Bicortical Headless Cannulated Screw Fixations, Tension Band Fixations, and Kirschner Wire Fixations of a Jones Fracture A Biomechanical Study
    (Amer Podiatric Med Assoc, 2024) Yilmaz, Onur; Mutlu, Ibrahim; Kuru, Tolgahan; Bilge, Ali; Gungor, Berna; Kizilay, Hasan; Olcar, Haci
    Background: The aim of study was to biomechanically compare the fixation of Jones fracture using headless cannulated screw, tension band, and two Kirschner wires.' Methods: A total of 60 fourth-generation, fifth metatarsal synthetic bone models were divided into three groups according to the fixation techniques. A vertical load, oriented from plantar to dorsal and lateral to medial, was applied to the metatarsal specimen that were potted with molding material. The stiffness and fatigue values were compared between the three fixation groups. Results: In the plantar to dorsal load test, the stiffness values were found to be significantly higher in Group 1 compared to the other groups (P = .034, P = .013). No significant difference was found in the analysis in terms of fatigue values in plantar to dorsal load testing (P = .348, P = .416). No significant difference was found between compression screw and tension band groups in lateral to medial loading test, in terms of stiffness and fatigue values (P = .096, P = .762). However, the stiffness values and fatigue values of these two groups were found to be statistically significantly higher than the Kirschner wire group (P = .003, P = .002, P = .016, P = .023). Conclusions: The result of this study showed that the bicortical fixation of headless compression screw provides a more stable fixation than other fixation methods, especially in plantar to dorsal loading. (J Am Podiatr Med Assoc 114(6), 2024; doi:10.7547/22-201)
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    Effects of Stellate Ganglion Block on Healing of Fractures Induced in Rats
    (Hindawi Ltd, 2020) Kizilay, Hasan; Cakici, Husamettin; Kilinc, Erkan; Firat, Tulin; Kuru, Tolgahan; Sahin, A. Alper
    Objective. Sympathetic blocks are used as an adjunct for pain management in the treatment of orthopedic and traumatic conditions. Stellate ganglion (ganglion stellatum) provides sympathetic innervation of the head, neck and cervicothoracic regions, and upper extremities. No study was found in the literature investigating the effects of stellate ganglion block performed in the upper extremity, on blood supply to bone, density, vascularization, and bone metabolism. Therefore, the objective of this study was to investigate the effects of stellate ganglion block on healing of closed forearm fractures that were induced in rats.Material and Methods. A total of 42 Wistar albino rats weighing between 398 and 510 g were used in this study. The rats were randomly divided into 2 groups with one group treated with stellate ganglion and the other included as the control group. In each 2 groups, a closed forearm fracture was created, confirmed with X-ray, and then stabilized by splint application. The forearm bones were examined with X-ray views on the same day and were then decalcified.Results. When histological findings of the fracture region were examined, predominantly cartilage and less woven bone were found in 7 rats, equally distributed cartilage and immature bone in 14 rats, and predominantly imitation bone and less cartilage formation in 21 rats. In the control group, the agreement between the 1st and 2nd orthopedists for the radiological evaluation of bone formation was moderate.Conclusion. The group administered stellate ganglion block showed a more significant fracture healing.