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    Öğe
    Aksaray ilinde meydana gelen motosiklet kazalarına bağlı kas iskelet sistemi yaralanmaları
    (2013) Kömürcü, Erkam; Arık, Kasım; Hatay, Umut Gölge; Nusran, Gürdal; Kurt, Tolga
    Son yıllarda motosiklet kullanımının artmasıyla birlikte motosiklete bağlı kazalar ve bu kazalara bağlı gelişen sakatlıklar ve ölüm oranlarında artış gözlenmektedir. Çalışmamızda motosikletin yaygın olarak kullanıldığı Aksaray ilinde motosiklet kazalarına bağlı kas iskelet sistemi yaralanmalarının değerlendirilmesi amaçlandı. Gereç ve Yöntem Aksaray Devlet Hastanesi Acil Servisine başvuran motosiklet kazalarına bağlı yaralanması saptanan 189 hastanın dosyaları retrospektif olarak incelendi. Hastaların yaş, cinsiyet ve travmaları kaydedildi. Kas iskelet sistemi yaralanması saptanan olgular travmanın yerleşim yerine göre gruplandırıldı, gelişen morbitide ve mortalite değerlendirildi. Bulgular Hastaların (n=189) 168i erkek (%89.9), 21i (%11.1) kadındı. Hastaların 147sinde (%77.8) kas iskelet sistemi yaralanması mevcuttu. Hastaların birden çok ekstremite ve izole ekstremite yaralanması sırasıyla 26 (%17.69) ve 70 (%47.62) idi. 51inde (%34.69) sadece yumuşak doku travması saptandı. Kırık ve çıkıkların dağılımı şu şekildeydi: 74 (%54.81) alt ekstremite, 48 (%35.56) üst ekstremite, 9 (%6.67) pelvis, 4 adet (%2.96) vertebraydı. Ekstremite yaralanmalarında sıklık sırasına göre; femur (%27.41) ve tibiayı (%19.26), el ve el bileği (%9.63) yaralanmaları izlemekteydi. Çoklu organ yaralanması olan 7 hasta hayatını kaybetti ve kas iskelet sistemi yaralanması olan 22 hastada ekstremitenin fonksiyonunu kaybetmesinden dolayı kalıcı sakatlık gelişti. Komplikasyon olarak 2 hastada pulmoner emboli, 1 hastada osteomiyelit saptandı. Yaralanmaların en sık temmuz ayında saat 23:00 03:00 ve 04:00-07:00 arasında olduğu görüldü. Kayıtlarda hastaların 48 inin (%32.70) alkollü olduğu saptandı. Sonuç Motosiklet kazasına bağlı gelişen kas iskelet sistemi yaralanmaları yaşam boyu devam eden sakatlıklara ve ölümlere neden olabilmektedir. Bu konuda toplumsal bilinç arttırılmalı, motosiklet kullanımı konusunda eğitim programları daha etkin ve yaygın hale getirilmelidir.
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    Öğe
    Cemented and cementhless hemiartroplasty in collum femoris fractures of elderly patients
    (2013) Nusran, Gürdal
    The comparement of perioperatif complications between the cemented and cementhless parsiel hip prosthesis in collum femoris fractures of elderly patients. Between June, 2000 and March 2009, the patients who had been treated with parsiel hip prosthesis which is garden type 3 and type 4, were assessed retrospectively. The patients were divided into two groups as group A treated with cementless, group B treated with cemented. The groups were evaluated in terms of follow up periods, demografic features, associated diseases, operation time, loss of blood, hospitalization time and per operative mortality. In our research, totaly 92 patients (44 from group A, 48 from group B) were treated with parsiel hip prosthesis. Average age was 77+11 for group A, and 81+13 for group B. A significiant difference wasn't evaluated between two groups in terms of demografic features. Average operation time was evaluated as 52+12 min. for group A and 88+16 min. for group B. The loss of blood during the operation was 280+30 ml. for group A and 480+45 ml. for group B. Hospitilization time was observed as 5+2 for both groups. While perioperative mortality wasn't observed in group A, 6 perioperatif mortalities were observed in group B. In parciel hip prosthesis that is treated in collum femoris fractures, the operation time shortens significiantly and intraoperatif amount of bleeding decreases in the patients treated with cemented compared to the patients treated with cementless. The use of cement increases the perioperative mortality significiantly. We believe that in such phenomenons, cementless parciel hip prosthesis can be a more suitable choise od therapy.
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    Öğe
    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.
  • Küçük Resim
    Öğe
    Erken tanı konulması gereken bir kırık: femur boyun kırığı
    (Çanakkale Onsekiz Mart Üniversitesi, 2013-03) Kömürcü, Erkam; Kızıldağ, Betül; Özden, Raif; Nusran, Gürdal; Urunç, Vedat
    [No Abstract Available]
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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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    Öğe
    İlerleyici erken başlangıçlı skolyozların tedavisinde vertikal ekspandabl prostetik titanyum rib (veptr) tekniği
    (2012) Atıcı, Yunus; Sarı, Seçkin; Nusran, Gürdal; Albayrak, Akif; Beng, Kubilay; Yavuz, Umut; Tacal, Mehmet Temel
    Erken yaşta başlayan skolyozun ilerlemesi, organ ve solunum sistemlerinin gelişimi ile normal spinal büyümeyi kötü yönde etkileyeceği için erken dönemde tedaviye başlanması gerekmektedir. Yapılan çalışmalarda gösterilmiştir ki erken başlangıçlı skolyozların erken dönemde spinal füzyonu sonrası akciğerin fonksiyonları negatif yönde etkilenmektedir. Aynı zamanda spinal füzyon vertebra gelişimini de engellemektedir. Konjenital skolyoz ve kot füzyonuna, hipoplastik göğüs duvarı deformitesi ve erken başlangıçlı skolyoza eşlik eden torasik yetmezlik sendromu tedavisi için VEPTR ve ekspansiyon torakostomisini Robert Campbell ve Melvin Smith geliştirmiştir. Spinal füzyon yapılmadan deformiteyi düzeltmeye yönelik bir teknik olan VEPTR sistemi, toraksın görevini yapamadığı, akciğerin büyümesini ve solunumunu desteklemesi için multipl etiyolojiye sahip spinal deformiteli çocuklarda kullanılmaktadır. Bu sistem daralmış hemitoraksı genişleterek ve uzatarak göğüs kafesinin ve vertebranın büyümesine izin vermektedir. Bu teknik direk torasik yetmezlik sendromunu tedavi ediyor gözükmektedir. Aynı zamanda indirekt olarak spinal füzyon oluşturmaksızın skolyozu düzeltmektedir. VEPTRın kullanımında tekrarlayan cerrahi işlemler gerektiği için komplikasyon oranları yüksek oranda görülmektedir. VEPTR sisteminin uygulanması için hastaların yeterli cilt dokusu, subkutan yağ dokusu ve kas dokusuna sahip olmaları gerekmektedir. Eğer uygun koşullar yoksa, VEPTR sisteminin uygulanması sonucu olası komplikasyonlarla karşı karşıya kalınabilir.
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    Öğe
    Nadir Görülen Tuber Kalkanei Kırığı Kaynamama Sonrası Çift Düğme İmplant ile Revizyon Cerrahisi Olgu Sunumu
    (2020) Nusran, Gürdal; Taşova, Ali Osman; Çıkrıkçıoğlu, Görkem
    Tuber kalkanei kopma kırıkları, genellikle indirekt travma sonrası oluşan ve nadir görülen kırıklardır. Osteoporoz ve diyabet, kırık gelişiminde risk faktörleridir. Bunlar, olası yara sorunları nedeniyle erken cerrahi girişim ile tedavi edilmesi gereken kırıklardır. Bu yazıda, kopmakırığı nedeni ile cerrahi tedavi uygulanan ve vida ile tespiti yapılan, takiplerinde osteoporoz, hasta uyumsuzluğu (erken yük verme), yara yeriproblemleri nedeniyle sirküler alçı uygulanamaması gibi problemler nedeniyle erken dönemde implant yetmezliği ve kırık fragmanda redüksiyon kaybı gelişmesi üzerine çift düğme implantı ile revizyon cerrahisi yapılan bir olgu sunuldu.
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    Öğe
    The effect of intraoperative sounds of saw and hammer on psychological condition in patients with total knee arthroplasty: Prospective randomized study
    (Hindawi Publishing Corporation, 2015) Kömürcü, Erkam; Kiraz, Hasan Ali; Kaymaz, Burak; Gölge, Umut Hatay; Nusran, Gürdal; Göksel, Ferdi; Şahin, Hasan
    Purpose. Surgical procedures are likely to be stressful for patients and their families. Total knee arthroplasty (TKA) is a major surgical procedure used in the treatment of osteoarthritis. During this procedure the sounds of the saw and hammer may irritate the patient and adversely affect mood. The present study examines the effect of these intraoperative sounds during TKA on postoperative mood and anxiety, by comparing two different anesthetic procedures. Methods. A total of 40 patients who underwent TKA for grade IV gonarthrosis participated in the study. Patients were randomly divided into two groups: 20 patients in the general anesthesia group and 20 patients in the spinal anesthesia group. Mood and anxiety changes were evaluated using the Profile of Mood States (POMS) and State-Trait Anxiety Inventory (STAI) instruments, respectively. Results. The postoperative POMS value in the spinal anesthesia group was definitively higher than the general anesthesia group, though the difference in preoperative and postoperative POMS and STAI scores between the two groups was not significant. Conclusion. It would seem that sounds of hammer and saw have no evident negative effect on patient's mood. Regional anesthesia is advisable for TKA patients and appropriate sedation can be administered during the operation if needed. © 2015 Erkam Kömürcü et al.
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    THE EVALUATION OF THE INFECTIONS AFTER ALGOLOGIC POSTERIOR PARAVERTEBRAL INJECTIONS
    (2018) Nusran, Gürdal; Karagüven, Doğaç; Bayraktar, Kürşat; Tüysüz, Murat; Atıcı, Yunus; Benli, İ. Teoman
    Background Data: Recently, the development of algology and the increase of algological initiatives have accompanied complications. Especially in patients with immune system disorders, epidural abscesses, facet joint septic arthritis, or abscess formation in paravertebral muscles have significantly increased after corticosteroid injections, especially applied to the disc, around nerve roots and facet joints.Aim: The aim of this study is to evaluate the cases of infections after 1028 algological treatments in 3 hospitals.Patients and Method: In this study, 24 patients who were referred to Orthopedics and Traumatology clinics with low back pain and fever, were evaluated retrospectively. 16 of the patients were male and 8 were females. The mean age was determined as 62.6 ± 10.4 (46-92). These patients were questioned for diabetes mellitus, history of tuberculosis, immunodeficiency syndromes and their epidemiological characteristics. The isolated microorganisms and complications associated with clinical findings have been evaluated and classified. In addition, it has been investigated whether the infections are eradicated or not in these treatments. Root blockage was found in 12 (50%) of the infected patients, facet joint injection in 6 (25%) and paravertebral intramuscular injection in 6 (25%). 4 (16.7%) of these patients developed epidural abscesses, 4 (16.7%) had facet joint septic arthritis, and 16 (66.6%) of them developed paravertebral intramuscular abscess formation. All of the patients were surgically drained and facet joint fusion was performed in the cases of septic arthritis.Results: There were 1028 cases of algological intervention in the last two years in these three hospitals. It was determined that 24 or more of these cases developed superficial or deep infection. The infection rate was generally found to be as high as 2.34%. Additionally, It was found that 8 (33.3%) of the patients had received insulin- dependent diabetes mellitus treatment, 12 (50%) received oral antidiabetic drugs due to Type-2 diabetes, and 1 patient had a treated tuberculosis. No cases were found to have immunodeficiency (such as AIDS). Prophylactic antibiotics were not used in any of the patients. At the end of the treatment regimen, CRP and ESR values decreased statistically and came to normal values (p <0.05). The variance analysis shows that the most important predisposing factors were; cigarette, DM and the processing conditions of the injections (p <0.05).Conclusion: It has been detected that the use of prophylactic antibiotics is particularly important in patients with impaired immune system and diabetes mellitus. It has been suggested that the most important measure in the prevention of infections in algological interventions is to perform these procedures in sterile conditions, especially in operating room conditions with positive pressured ventilation.