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    A Bibliometric Analysis of the Most Cited 50 Articles on Ankle Arthroscopy
    (2020) Kuru, Tolgahan; Olçar, Hacı Ali
    Objective: Ankle arthroscopy has become an important treatment tool in the management of chronic and posttraumatic ankle problems. In the literature, there are numerous publications on the subject of ankle arthroscopy,including case series, systematic reviews, and prospective cohort studies. The objective of this bibliometric studywas to determine the most cited 50 articles on ankle arthroscopy and to analyse characteristics of these studies.Method: The articles published between 1985 and 2019 were screened by two orthopedists via the Web of Sciencev. 5.11 academic search engine with ‘Ankle Arthroscopy’ term as of 03/21/2019. Titles, first authors, years of publication of the articles, number of citations, journal of publication, subtype, country of origin and institute of thestudy were recorded.Results: The number of total citations was 5378 for all 50 articles. The mean citation number of all articles wasfound as 107.6±45.6 (min-max: 64-240). The articles belonged to 13 different countries of origin. One article waspublished in 1980s, 13 articles in 1990s, 30 in 2000s, and 6 in 2010s.Conclusion: The articles on ankle arthroscopy were predominantly case series, and according to our bibliometricanalysis we believe that further comparative randomized controlled studies are needed to be conducted on anklearthroscopy.
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    Analysis of Emergency Department Presentations due to Injuries From Motor Vehicle Crashes and Pedestrian Strikes
    (Springernature, 2020) Akman, Canan; Kuru, Tolgahan
    Objective The objective of this study was to analyze the causes and outcomes of presentations to the emergency department (ED) due to injuries from motor vehicle crashes and pedestrian strikes along several parameters. Methods Data from 798 patients who were injured due to motor vehicle crashes or pedestrian strikes that occurred in Canakkale Province were retrospectively analyzed. Patient demographic data such as age and gender, emergency service outcomes, and the consulted clinics were also recorded. Distributions of the crashes by weekdays or weekends, national and religious holidays, official holidays, and Ramadan month were comparatively analyzed. Results A total of 253 people injured in motor vehicle crashes and 395 people injured in pedestrian strikes were directly brought to the ED from the crash or strike scene. While 656 patients were discharged from the ED, 142 patients were referred to other clinics for surgery. A total of 538 crashes occurred on weekdays and 206 on weekends, and 54 crashes occurred during official and religious holidays. Most crashes occurred in summer, and the second most occurred in autumn. The rate of pedestrian strikes that occurred in summer and autumn was statistically significantly higher than the rate of injuries from motor vehicle crashes observed in the same seasons. The majority of the weekend crashes were caused by persons who had not consumed alcohol. Conclusion Traffic crashes occur more commonly among young men and in the summer season, while national, official, and religious holidays do not seem to play a role in the frequency of traffic crashes.
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    ASSESSMENT OF 'PHYSICAL THERAPY FOR ELDERLY PEOPLE' VIDEOS ON YOUTUBE
    (Nobel Ilac, 2020) Ozerdogan, Ozgur; Kuru, Tolgahan
    Objective: In this study, we aimed to investigate reliability and utility of videos accessed with 'Senior Physical Therapy' term on YouTube in terms of medical information. Material and Method: 'Senior Physical Therapy' term was screened on YouTube. The non-english videos, advertisements, videos shorter than 45 seconds, repeated two or more times, and the videos with an irrelevant content were excluded, and the most viewed 50 videos were evaluated by two independent orthopedists according to DISCERN (Quality Criteria for Consumer Health Information) and JAMA (Journal of the American Medical association) scoring systems. The correlation between the observers was assessed with Spearman Correlation Analysis, and the compliance with Krippendorff alpha. According to the normality results, non-parametric Kruskal-Wallis Variance Analysis test was applied. p<0.05 values considered statistically significant (p<0.017 values at Bonferroni-Correction Mann-Whitney U test). Results: The videos was most commonly upload by health channels (66%) and physiotherapists (14%). A strong statistically significant correlation was found between DISCERN (r:0.971, p<0.001) and JAMA (r:0.808, p<0.001) scores of the observers. The compliance between two observers was high in DISCERN scores (Krippendorff alpha.: 0.970) and moderate in JAMA scores (Krippendorff alpha.: 0.792). DISCERN scores of the videos uploaded by physiotherapist were highest. Of the 50 videos, 70% was determined as poor, 28% very poor and 2% fair in terms of the information content. Conclusion: Preparation of the videos with medical contents by specialized person and based on references may increase the quality of information obtained via the social media.
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    Assessment of ‘physical therapy for elderly people’ videos on youtube
    (Nobelmedicus, 2020) Özerdoğan, Özgür; Kuru, Tolgahan
    Objective: In this study, we aimed to investigate reliability and utility of videos accessed with ‘Senior Physical Therapy’ term on YouTube in terms of medical information. Material and Method: ‘Senior Physical Therapy’ term was screened on YouTube. The non-english videos, advertisements, videos shorter than 45 seconds, repeated two or more times, and the videos with an irrelevant content were excluded, and the most viewed 50 videos were evaluated by two independent orthopedists according to DISCERN (Quality Criteria for Consumer Health Information) and JAMA (Journal of the American Medical association) scoring systems. The correlation between the observers was assessed with Spearman Correlation Analysis, and the compliance with Krippendorff ?. According to the normality results, non-parametric Kruskal-Wallis Variance Analysis test was applied. p<0.05 values considered statistically significant (p<0.017 values at Bonferroni-Correction Mann-Whitney U test). Results: The videos was most commonly upload by health channels (66%) and physiotherapists (14%). A strong statistically significant correlation was found between DISCERN (r:0.971, p<0.001) and JAMA (r:0.808, p<0.001) scores of the observers. The compliance between two observers was high in DISCERN scores (Krippendorff ?.: 0.970) and moderate in JAMA scores (Krippendorff ?.: 0.792). DISCERN scores of the videos uploaded by physiotherapist were highest. Of the 50 videos, 70% was determined as poor, 28% very poor and 2% fair in terms of the information content. Conclusion: Preparation of the videos with medical contents by specialized person and based on references may increase the quality of information obtained via the social media. © 2020, Nobelmedicus. All rights reserved.
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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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    Biomechanical Comparison of Single- and Double-Twist Tension Band, Cancellous Screw, and Single-Screw Tension Band Models in Medial Malleolus Fractures
    (Amer Podiatric Med Assoc, 2025) Nusran, Gurdal; Yilmaz, Onur; Mutlu, Ibrahim; Kuru, Tolgahan; Erken, H. Yener
    Background: Models using a double-twist tension band, two partially threaded cancellous screws, a single-twist tension band, and a single-screw tension band were biomechanically compared for fixation of medial malleolus fractures. Methods: All 72 composite cortical tibial bones used in the study were osteotomy suitable for medial malleolus fracture. They were divided into four groups: double-twist tension band (group 1), two partially threaded cancellous screws (group 2), single-twist tension band (group 3), and single-screw tension band (group 4), with 18 composite tibial bones in each group. Bones in each group were divided into three subgroups and subjected to biomechanical tests by applying force as tension, transverse, and axial loading. Results: In the tension and transverse loading tests, the highest mean stiffness was in groups 1 and 4. Group 4 had statistically significantly higher stiffness values than groups 2 and 3. All of the other groups had statistically significantly higher stiffness values than group 2. A statistically significant difference was found comparing group 4 (with the highest value in the axial loading test) with the other groups. No significant difference was found between groups 1 and 3 in any of the biomechanical tests. Conclusions: Tension band method did not make a difference biomechanically when applied as a double or single twist. Single-screw tension band was found to be the most stable fixation method in tension, transverse, and axial loading tests. We think that the single-screw tension band method is a stable and suitable fixation method and should find more place in current surgical practices.
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    Biomechanical Effect of Ankle Ligament Injury in AO Type 44B2.1 Lateral Malleolus Fractures After Lateral Plate Fixation A Finite Element Analysis
    (Amer Podiatric Med Assoc, 2024) Olcar, Haci Ali; Mutu, Halil Burak; Ozer, Alaettin; Kuru, Tolgahan; Aydin, Davut; Korkmaz, Murat
    Background: Distal fibula fractures at the ankle level are common and are usually accompanied by ligament injuries. This study aims to evaluate the effects of ankle ligament ruptures on ankle joints, fracture instability, and plate stress after distal fibula fracture fixed with a plate created by finite element analysis modeling and loading applied to ligament rupture models that may accompany this fracture. Methods: A finite element model consisting of three-dimensional fibula, tibia, foot bones, and ankle ligaments was designed to investigate the effects of ligament injuries accompanying plate-detected AO type 44B2.1 fractures on fracture detection, fixation material, and ankle joints. Then, the results were evaluated by modeling ligament rupture in six different ways. Results: In the modeling where the deltoid and talofibular ligaments are broken together, instability is highest in the ankle (2.31 mm) and fracture line (0.15 mm). The rupture of the anterior and posterior tibiofibular ligaments associated with syndesmosis caused less instability in the fracture and ankle than the single-ligament rupture models of both the deltoid and talofibular ligaments. Conclusions: In the finite element modeling of AO type 44B2.1 fractures detected with plate, the importance and potential effects of often-overlooked ankle ligament injuries are pointed out. Note that when treating ankle injuries, the ankle should be treated as a whole, with both bone and soft tissue. In some cases, the fracture may represent the visible tip of the iceberg. (J Am Podiatr Med Assoc 114(4), 2024; doi:10.7547/22-214)
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    Cerrahi Olarak Tedavi Edilen Distal Radius Kırıklarının Klinik Profili
    (2020) Kuru, Tolgahan; Yılmaz, Onur
    Amaç: Bu çalışmanın amacı hastanemiz acil servisine başvuran ve kliniklerimizde distal radius kırığı nedeniyle cerrahiolarak tedavi edilen ve takipleri yapılan hastaların kırık paternleri ve uygulanan tedaviler ile kırık kaynaması arasındakiilişkiyi araştırmaktır.Yöntemler: Çalışmaya dahil edilen hastaların epikrizleri ve X-ray görüntüleri taranarak DRF’leri AO sınıflandırmasistemine göre sınıflandırılmıştır. Ayrıca hastaların yaşı, cinsiyeti, kırık oluşma paterni, uygulanan tedavi türü, konservatifolarak takip edilen hastalarda cerrahi yapılıp yapılmadığı, hastanede yatış süresi, izlem süresi, kaynama durumu vekomplikasyonları kaydedilmiştir. Hastalara uygulanan tedavilerin sonuçları komplikasyonlar ve kırık kaynamasıaçısından değerlendirilmiştir.Bulgular: Kliniğimizde cerrahi olarak tedavi edilen distal radius kırıklarının 41’inde (%78.8) doğrudan travma sonrasıcerrahi planlanırken, 11’inde ise (%21.2) acil serviste kapalı redüksiyon sonrası sirküler alçı uygulandıktan sonrapoliklinik takiplerinde kırık hattında kayma olması üzerine cerrahi planlama yapılmıştır. Hastaların ortalama yatış süresi3.5 ± 1.8 (min-maks: 1-10) gün olarak bulunmuştur. Ortalama izlem süresi 95.8 ± 51.7 gündür. Konservatif olarak takipedilen ve sonrasında cerrahi tedavi uygulanan hastaların yaş ortalaması doğrudan cerrahi uygulanan hastalardanistatistiksel olarak anlamlı şekilde daha yüksektir (p=0.045). İki grup arasında preoperatif voler tilt, radial inklinasyon,radial uzunluk ve eklem basamaklanması açısından istatistiksel olarak anlamlı fark saptanmamıştır. Sonuç: Hastalarımızda uygulanan çeşitli cerrahi tekniklerinin tümünde tam kaynama sağlanmış olup, bu tekniklerarasında postoperatif komplikasyonlar açısından anlamlı fark saptanmamıştır.
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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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    Computational Mechanical Analysis of AO 44A1, 44B1, and 44C1 Fractures with Finite Element Modeling: Evaluation of Screw, Plate, and Kirschner Wire Fixation
    (Amer Podiatric Med Assoc, 2024) Olcar, Haci Ali; Ozer, Alaettin; Mutu, Halil Burak; Yurdakul, Goker; Kuru, Tolgahan; Aydin, Davut; Korkmaz, Murat
    Background: The aim of this study was to create AO 44A1, 44B1, and 44C1 fractures using finite element analysis to determine the stability of Kirschner wire, intramedullary screw, and plate-screw fixation methods in fracture. Methods: Using finite element analysis, the postreduction behavior of AO 44A1, 44B1, and 44C1 fractures with Kirschner wire, intramedullary screw, and plate-screw fixation methods was analyzed and compared in terms of displacement and stress. Results: The lowest amount of displacement was provided with the intramedullary screw method in AO 44A1 and 44B1 fractures and with the 4-mm Kirschner wire method in AO 44C1 fractures. The total displacement of the intramedullary screw system used for fixation in AO 44A1, 44B1, and 44C1 fractures was lower. Conclusions: According to finite element analysis results, the lowest amount of displacement was obtained with intramedullary screw fixation in AO 44A1 and 44B1 fractures, and 4mm Kirschner wire fixation was achieved in AO 44C1 fractures. (J Am Podiatr Med Assoc 114(1), 2024 doi:10.7547/22-155)
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    Effectiveness and Short Term Functional Results of Surgical Treatment with Locking Plate in Proximal Humerus Fractures
    (2020) Kuru, Tolgahan; Yılmaz, Onur
    Objective: In this study, we aimed to investigate postoperative short term outcomes, union status, early and late complications and the relationship between them in patients treated with plate osteosynthesis due to proximal humerus fractures in our hospital.Method: A total of 34 patients aged between 18-92 years were included in the study. Patients’ demographic data as age, gender, and also fracture pattern, time from hospitalization to the surgery, time from surgery to discharge and comorbidities were recorded and evaluated.Results: The mean duration of hospitalization was found as 3.4±1.7 days. There was no significant difference between the patients with and without comorbidity in terms of the mean duration of hospitalization. There was no significant difference between the patients with and without complications in terms of the mean time from hospitalization to the surgery. According to Neer classification, postoperative late complications occurred in 40%, 29.4%, and 8.3% of Neer Type 4,3, and 2 fractures, respectively.Conclusion: Internal fixation with locking plate seems a reliable option in the treatment of proximal humerus fractures, especially in osteoporotic bones and Neer Type 2 fractures.
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    Effects of early mobilization and weight bearing on postoperative walking ability and pain in geriatric patients operated due to hip fracture: a retrospective analysis
    (Tubitak Scientific & Technological Research Council Turkey, 2020) Kuru, Tolgahan; Olcar, Haci Ali
    Background/aim: Hip fractures in older adults are associated with high morbidity, mortality, and subsequent hospital costs and decreased quality of life. The objective of this study was to evaluate geriatric patients who underwent partial prosthesis surgery following hip fracture and effects of early mobilization and weight bearing on postoperative walking ability and pain. Materials and methods: A total of 52 geriatric patients with intertrochanteric and femoral neck fractures were included in the study. Patients' service files, system records, pre- and postoperative X-rays were retrospectively reviewed. Results: There were 52 patients in the study group with 36 (69.2%) being female. The mean age of the patients was found as 82.9 +/- 6.5 years. The mean length of stay in hospital was found as 6.2 +/- 2.6 days. The mean length of stay in hospital was found as 5.3 +/- 1.7 days in male and 6.6 +/- 2.8 days in female patients, and the difference was statistically significant (P = 0.035). The mean length of stay in hospital was found as 5.4 +/- 1.8 days in early mobilization group and 6.9 +/- 2.9 days in late mobilization group, and the difference was statistically significant (P = 0.026). There was a significant difference between Harris and pain scores in terms of the time of first weight bearing at the postoperative 1st month follow-up. Harris score was found as 84.0 +/- 5.8 (median: 84.0, min-max: 73-94), and the main pain score as 36.8 +/- 6.8 in the group with the first weight bearing within the first 24 h, while Harris score was found as 71.10 +/- 2.8, and the main pain score as 24.4 +/- 6.4 in the group with the first weight bearing after the postoperative 24th hour. Conclusion: The results of our study indicated that early mobilization and full weight bearing in geriatric patients after hip fracture surgery shortened length of stay in hospital, reduced postoperative pain, and increased walking ability.
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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.
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    Evaluation of the Quality and Reliability of YouTube Videos on Rotator Cuff Tears
    (Springernature, 2020) Kuru, Tolgahan; Erken, H. Yener
    Introduction The objective of this study was to investigate quality and scientific accuracy of videos related to rotator cuff tear on YouTube. Methods Term of rotator cuff tear was entered to the searching bar of YouTube and the first 50 YouTube videos about rotator cuff tear with the highest view counts were recorded and evaluated by two orthopedists. Title of the videos that met the inclusion criteria were recorded. The videos were evaluated with DISCERN and JAMA scoring system, and Video Power Index. Results The mean DISCERN score was calculated as 35.7 +/- 8.9, and the mean JAMA score was found as 2.9 +/- 0.4. The mean DISCERN score was statistically significantly higher in the physician group compared to the non-physician group. There was a very strong and statistically significant correlation and an excellent compliance between both observers. Conclusion In general, quality of videos published on YouTube about rotator cuff tear was low.
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    Evaluation of the relationship between ingrown toenail and hallux interphalangeal angle
    (Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Kuru, Tolgahan; Olçar, Hacı Ali
    Commonly encountered ingrown toenail has been associated especially with shoe properties and nail care. The objective of this study was to investigate the relationship between hallux interphalangeal angle (HIA) and ingrown toenail. A total of 28 patients diagnosed with ingrown toenail without foot deformity except hallux interphalangeal angle were included in the study. Twenty-eight persons without any complaint of ingrown toenail or any foot deformity, and who presented due to any complaint other than lower extremity were enrolled as the control group. Hallux interphalangeal angle was calculated both in patients and control subjects with dorsoplantar projection of the foot, and compared between the groups. The groups were similar in age and gender, but showed differences in terms of HIA. The mean HIA value was significantly higher in the patient group compared to the control group. HIA was higher in male patients with ingrown toenail, while this correlation could not be shown in female patients. Increased HIA may be among the risk factors for ingrown toenail. Deformities of the forefoot should be evaluated in patients with ingrown toenail. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
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    Evaluation of YouTube Information Quality About Pes Planus
    (Amer Podiatric Med Assoc, 2024) Olcar, Haci Ali; Güngör, Berna; Kuru, Tolgahan; Aydin, Davut; Nusran, Gürdal
    Background: The aim of this study was to measure the quality of information about flatfoot and pes planus presented online on the social media site YouTube and to determine the trends of viewers to medical information on YouTube. Methods: Flatfoot and pes planus was typed into the YouTube search module. From the search results, videos with 50,000 views or more, longer than 45 seconds, and containing information about flatfoot and pes planus disease were selected. DISCERN and JAMA scoring, daily average views, number of likes, and number of comments were collected from 53 videos that met the criteria. The profession of the sharer was evaluated in terms of the information quality of the sharing and the orientation of the audience. Results: The mean number of views per day of the examined videos was 2,047. The mean video presentation time was 8 minutes 50 seconds. The mean JAMA score was 2 of 4 and the mean DISCERN score was 38.16 of 75. According to the DISCERN score according to the professions, the video quality was moderate for doctors (41.44 +/- 12.99), moderate for physiotherapists (41.91 +/- 9.04), poor for coaches (32.78 +/- 7.87), poor for patients (34.50 +/- 5.32), and weak for others (34.89 +/- 14.00). According to the Spearman correlation between DISCERN score and mean daily viewing, significant relationships were found for the doctors ( P = .0102) and others groups ( P = .0033); however, no significant relationships were observed for the physiotherapists group ( P = .1073), the flatfoot patients group ( P = .5363), and the coaches group ( P = .9111). There were significant relationships between like and comment counts in all groups (doctors, P = .0088; coaches, P = .0069; physiotherapists, P = .0007; others, P = .0018; and patients, P = .0066). Conclusions: Looking at previous studies, it was observed that the quality of online health information was historically inadequate. Likewise, in our study on YouTube, we found that the quality of flatfoot and pes planus information was poor to moderate. (J Am Podiatr Med Assoc 114(2), 2024; doi:10.7547/22-168)
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    Lateral Decubitus vs Supine Positioning in Surgical Treatment of Hip Fractures with Proximal Femoral Nailing in Geriatric Patients: Whis is more suitable ?
    (2020) Kuru, Tolgahan
    Objective: Intertrochanteric femoral fractures account for more than half of all hip fractures. Proximal femoralnailing is one of the most common methods used in the treatment of these fractures. However, there is no definitiveconsensus on the best positioning when performing proximal femoral nailing in hip fractures, especially in geriatricpatients. The objective of this study was to compare supine and lateral decubitus positioning approach in surgicaltreatment of intertrochanteric femoral fractures with proximal femoral nailing method in geriatric patients.Method: Patients aged over 65 years treated due to intertrochanteric fractures with proximal femoral nailingmethod were included in the study. Patients’ position during the procedure, number of shots received from portableX-ray device, postoperative amount of blood loss, operative time, duration of postoperative follow-up, presence ofpostoperative bleeding, perioperative complications and postoperative long-term complications were also recorded and compared between the patients operated in supine and lateral positions.Results: There was a statistically significant between both groups in terms of the average operative times, andaverage operative time was significantly shorter in the lateral positioning group (p=0.01). No significant differencewas found between the two groups in terms of the amount of postoperative bleeding (p=0.088). There was a statistically significant difference between both groups and the mean number of X-rays received during the procedureswere significantly lower in the lateral positioning group (p=0.010).Conclusion: Lateral positioning in surgical treatment of intertrochanteric fractures with proximal femoral nailingmethod seems to have several advantages over supine position including reduced operative times, blood loss andimaging exposure.
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    No Decrease in Infection Rate with the Use of Local Vancomycin Powder After Partial Hip Replacement in Elderly Patients with Comorbidities
    (Springernature, 2020) Erken, H. Yener; Nusran, Gurdal; Karaguven, Dogac; Yilmaz, Onur; Kuru, Tolgahan
    Introduction The goal of this study was to evaluate the effects of local intra-wound vancomycin powder (VP) administration to decrease surgical site infections (SSIs), particularly in elderly patients with comorbidities, after having undergone partial hip replacement in the treatment of intertrochanteric (ITF) or femoral neck fractures (FNF). Methods We retrospectively reviewed patients who underwent partial hip replacement in the treatment of ITF or FNF in one year. We divided the patients into two groups. The non vancomycin-treated group received standard systemic prophylaxis only (1 gr cefazolin IV), while the vancomycin-treated group received 1 gr of VP in the surgical wound just before surgical closure in addition to the systemic prophylaxis. We included patients of 64 years or older who also had one or more comorbidities. We compared the post-operative SSI rates between the non vancomycin-treated group and the vancomycin-treated group. Results A total of 93 patients were included in the study. We detected post-operative wound infection in six patients (6.4%). The rate of SSI was found to be 5.7% in the vancomycin-treated group and 6.9% in the non vancomycin-treated group respectively, which showed no statistically significant difference (p:0.498). The incidence of SSI was statistically higher in the patients who had a follow-up in the post-operative intensive care unit than the patients who had not any follow-up in the intensive care unit. Conclusion Local application of VP in the surgical wound was found to be ineffective in reducing the incidence of SSI after partial hip replacement in elderly patients with comorbidities.
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    No Sedation, No Traction, and No Need for Assistance: Analysis of New Prakash's Method of Shoulder Reduction
    (Hindawi Ltd, 2020) Kuru, Tolgahan; Olcar, Haci Ali; Bilge, Ali; Nusran, Gurdal; Ozkilic, Recai; Akman, Canan; Prakash, Lakshmanan
    Background and Objective. Shoulder dislocations, which often occur anterior, account for about half of all dislocations. There are numerous reduction methods reported for the conservative treatment of acute anterior dislocations. However, there is still an ongoing search for an optimal method given the procedure time, possible complications, success rates, and need for sedation/analgesia in existing methods. This study seeks to explore the effectiveness and safety of Prakash's method in the treatment of acute shoulder dislocations, which is a novel method in the treatment of anterior shoulder dislocations. Materials and Methods. A total of 19 patients who were admitted to the emergency department with the diagnosis of anterior shoulder dislocation participated in this study. The diagnosis of shoulder dislocation was established in the emergency department with physical examination and anteroposterior shoulder radiography. The method was applied only once to the patients in the sitting position by the same physician without using any help, traction, anesthesia, analgesia, and myorelaxant. Results. The mean age of the patients was 37.3 +/- 13.1 years. Among them, 36.8% n=4 of the patients. The success rate of the method was 94.7% n=18. No complication was noted in the patients. The mean procedure time was 243 +/- 38 seconds. Conclusion. Prakash's method is a safe method for anterior shoulder dislocations that can be quickly performed with no need for sedation, assistance, and traction and has a high success rate.
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    Original Research The biomechanical analysis of first metatarsocuneiform arthrodesis using the finite element method: A comparison of plate osteosynthesis in different positions
    (Bayrakol Medical Publisher, 2024) Olcar, Haci Ali; Ozer, Alaettin; Mutu, Halil Burak; Kuru, Tolgahan; Yurdakul, Goker; Aydin, Davut; Korkmaz, Murat
    Aim: The aim of this study was to compare plate positions in Lapidus arthrodesis in terms of displacement and plate stress. Material and Methods: In this study, the Lapidus arthrodesis was performed in a computerised environment using a finite element foot model with differentially positioned plates. The arthrodesis (Lapidus arthrodesis) was applied to the first metatarsocuneiform joint with 2 proximal 2 distal 3.5 mm screws using a 4 -hole plate in three different directions: medial, dorsal and plantar. Results: Displacement in the arthrodesis area and stress on the fixation material, the plate, were evaluated. After loading, the plantar plate arthrodesis model produced more total displacement (1, 97121 mm) and stress (2242 MPa) than other arthrodesis models. On the other hand, the dorsal plate arthrodesis model has less total displacement (1, 20479 mm) and stress (1253 MPa) than other arthrodesis models. In the volar, dorsal and medial finite element models, it was concluded that the least displacement and plate stress were in the dorsal plate application. Discussion: In the finite element study, complications can be seen more frequently in Lapidus arthrodesis performed with plantar and medial plates compared to Lapidus arthrodesis performed with dorsal plates. Therefore, Lapidus arthrodesis performed with a dorsal plate may be more stable.