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    Clinical and surgical outcomes of pediatric pelvic fractures: experience from a mass-casualty and routine trauma cohort
    (Bmc, 2025) Sari, Bedirhan; Gokmen, Mehmet Yigit; Pazarci, Ozhan
    Background Pediatric pelvic fractures are rare but potentially life-threatening injuries associated with high-energy trauma and complex anatomical considerations. Surgical management is often required, necessitating multidisciplinary care. This study aimed to evaluate the clinical outcomes of surgically treated pediatric pelvic fractures, with special emphasis on earthquake-related injuries. Methods This retrospective, single-center study included 36 pediatric patients (aged 0-17) who underwent surgical treatment for pelvic fractures between January 2021 and October 2024. Demographics, injury mechanisms, fracture types (Torode and Zieg classification), surgical procedures, and short-term outcomes were analyzed. A subgroup comparison was performed between earthquake-related and non-earthquake trauma cases. Results Earthquake-related trauma was the most frequent mechanism (36.1%), followed by motor vehicle accidents (30.6%) and falls from height (25%). Type IVB fractures were the most common (55.6%). Earthquake-related cases showed longer time to surgery (8.5 vs. 2.3 days, p<0.001) and higher postoperative CRP (116.7 vs. 33.2 mg/L, p<0.001). Despite greater injury severity, the majority of patients achieved functional recovery: 63.9% regained full mobility, while 33.3% walked normally with limited running. The overall complication rate was low (16.6%), and no life-threatening events occurred. Hospitalization costs were higher in earthquake cases, driven by Intensive Care Unit (ICU) stay and surgical delay. Conclusion Surgical stabilization of pediatric pelvic fractures achieved favorable short-term outcomes with low complication rates, even in earthquake-related mass-casualty settings. Earthquake cases presented with more severe patterns, longer time to surgery, and greater inflammatory and resource burdens, underscoring the need for rapid triage, coordinated multidisciplinary care, and early mobilization despite operational constraints. These findings argue for disaster-ready pediatric trauma systems and merit validation in prospective multicenter cohorts with long-term functional and economic endpoints.
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    Evaluating Large Language Model Adherence to AAOS Knee Osteoarthritis Guidelines: A Comparative Study of ChatGPT and NotebookLM
    (Springer Heidelberg, 2025) Yildiz, Cemil; Gokmen, Mehmet Yigit; Utlu, Cetin; Karabay, Elif Sude; Tanik, Ugur; Pazarci, Ozhan
    PurposeThis study evaluated how closely large language models (LLMs), specifically ChatGPT (OpenAI) and NotebookLM (Google), adhere to orthopedic guidelines. The objective was to determine whether AI-generated reasoning aligns with the 2021-2022 American Academy of Orthopaedic Surgeons (AAOS) clinical practice guidelines for knee osteoarthritis (OA).MethodsA mixed-methods design combined quantitative concordance scoring with qualitative content analysis. Thirty-three decision points covering non-arthroplasty and surgical management were derived from AAOS guidelines. Structured Population-Intervention-Comparison-Outcome (PICO) prompts were presented to each model. Two orthopedic surgeons independently rated all outputs using a four-domain rubric assessing accuracy, evidence reasoning, additional information, and knowledge integration (0-4 scale). Concordance was classified as full (4), partial (3), or discordant (<= 2), with disagreements resolved through consensus. Inter-rater reliability was almost perfect (weighted kappa = 0.87).ResultsChatGPT achieved a mean composite score of 3.67 +/- 0.92, and NotebookLM 3.55 +/- 0.87, with no significant difference between models (p = 0.18). Full concordance with AAOS recommendations occurred in 84.8% of ChatGPT responses and 75.8% of NotebookLM responses. Both models performed consistently in high-evidence domains such as NSAID therapy, tranexamic acid use, and weight-loss counseling. Variability increased in limited-evidence or technology-driven areas. Partial concordance reflected the omission of evidence qualifiers, while discordant responses involved overstated or speculative interpretations.ConclusionBoth LLMs demonstrated strong alignment with evidence-based orthopedic reasoning. ChatGPT showed slightly higher fidelity to recommendation strength, whereas NotebookLM provided broader contextual interpretation. Structured, guideline-oriented prompting may enhance AI reasoning consistency and support the potential role of LLMs as complementary tools for evidence translation and orthopedic education.
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    Neutrophil to Lymphocyte Ratio May Be a Diagnostic Marker for Prosthetic Joint Infection
    (Derman Medical Publ, 2016) Golge, Umut Hatay; Kaymaz, Burak; Pazarci, Ozhan; Kilinc, Seyran; Oztemur, Zekeriya; Bulut, Okay
    Aim: Total knee arthroplasty (TKA) is an effective and successful procedure but the outcome may occasionally be compromised by complications such as periprosthetic joint infection (PJI). Blood neutrophil to lymphocyte ratio (NLR) is a simple marker of subclinical inflammation that can be easily obtained from the differential White Blood Cell count. This study aims to to analyze the predictive ability of NLR for the diagnosis of PJI. Material and Method: Patients who were diagnosed as grade 4 gonartrosis and operated for total knee arthroplasty between years 2007-2014 were evaluated. Thirty patients with PJI were included in the study as Group I and hematological tests including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cell count (WBC) and neutrophil to lymphocyte ratio (NLR) of the patients were evaluated retrospectively. Preoperative and postoperative 6th month NLR values of the patients were compared. Also 103 age matched patients operated for total knee arthroplasty with no sign of infection were included in the study as controls (Group II). Patients in Group I and Group II were also compared in terms of NLR. Results: Thirty patients (17 female, 13 male) were present in Group I (patients with PJI and treated with two staged revision surgery) and 103 patients (94 female, 9 male) were present in Group II (patients operated for total knee arthroplasty and had no sign of infection during the follow up period). NLR has been found to decrease from 3.2+/-0.7 to 2.2+/-0.5 when compared between the preoperative and postoperative 6th month period (p=< 0,001). NLR has been found to be 2.1+/-0.7 in Group II and 3.2+/-0.7 in Group I at preoperative period. (p=< 0,001). The value of 2.45 was found to be cut-off point for infection. Discussion: NLR can be used as marker for PJI together with the other markers as ESR and CRP to increase the accuracy of the diagnosis.
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    Pediatric earthquake-related amputations: associations with fasciotomy, crush syndrome, and entrapment duration
    (Springer Heidelberg, 2025) Pazarci, Ozhan; Battal, Vahit Erdal; Gokmen, Mehmet Yigit; Sonmez, Emre; Cicek, Oguzhan; Uslu, Hakan
    BackgroundPediatric earthquake victims face unique challenges due to their distinct physiology, vulnerability to crush and compartment syndromes, and long-term functional and psychosocial needs. While adult earthquake-related amputations have been described, comprehensive pediatric-focused analyses remain scarce.MethodsWe conducted a retrospective study of 54 pediatric patients who underwent earthquake-related amputations following the February 6, 2023, T & uuml;rkiye double earthquakes. Demographics, amputation characteristics, fasciotomy, crush syndrome, entrapment under debris, intensive care unit (ICU) admission, and early outcomes were systematically evaluated.ResultsLower extremity amputations predominated (79.6%), with bilateral limb loss in 18.5% of patients. Fasciotomy was performed in 40.7% and was associated with shorter entrapment duration (p = 0.023), longer hospitalization (p = 0.027), and absence of debris entrapment (p = 0.019). Crush syndrome (25.9%) was linked to longer hospital stay (p = 0.017) and higher ICU admission (p = 0.043). Debris entrapment (13.0%) significantly increased the risk of thoracic trauma (p = 0.046) and ICU requirement (p = 0.033). Notably, no fasciotomy was performed in entrapped children. Older age, crush syndrome, and debris entrapment were significantly associated with ICU admission.ConclusionsThis study provides an early description of pediatric earthquake-related amputations. Fasciotomy appeared most beneficial when performed shortly after rescue, whereas prolonged entrapment was linked to systemic compromise and critical care needs. Crush syndrome was associated with greater resource utilization. These early descriptive findings underscore the importance of pediatric-specific considerations in disaster preparedness and highlight priorities for future multicenter and comparative research.
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    Relationship Between Second to Fourth Digit Ratios and Obesity, Muscle Mass2.
    (Derman Medical Publ, 2015) Golge, Umut Hatay; Sivasli, Zeynep; Pazarci, Ozhan; Goksel, Ferdi; Kaymaz, Burak; Kuloglu, Huseyin Emre
    Aim: Transmitted through genetic inheritance and later unchanging, the ratio of 2nd and 4th fingers (2D: 4D) is related to the hormone testosterone. We aimed to investigate the correlation of this ratio to muscle mass and obesity. Material and Method: Adult patients attending the diet clinic were categorized by body type analysis, age and gender. Body mass index (BMI) was calculated from height and weight, and body analysis was completed with a Tanita (TANITA BC-418 MA III) device. Additionally patients had the index and ring fingers of both hands separately measured with the aid of digital calipers and recorded. The ratio of the values was determined and compared with the values obtained by the Tanita device. Result: Of 216 patients at the diet clinic, 168 were female and 48 were male. The measurements of individuals with 2D: 4D of both hands above 1 were compared with those of individuals with 2D: 4D of both hands below 1. Differences were observed in terms of total fat (TF), fat free mass (FFM) and fat mass (FM). While there was a positive correlation of the 2D: 4D of both hands with BMI, FM and TF; there was a negative correlation observed with FFM. Discussion: We believe the 2D: 4D may be directly related to obesity and inversely related to body muscle mass.
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    The treatment of intertrochanteric fractures comparison of PFN and hemiar-throplasty 3-year mortality study
    (Acta Medica Belgica, 2016) Golge, Umut Hatay; Pazarci, Ozhan; Kilinc, Seyran; Nusran, Gurdal; Kaymaz, Burak; Goksel, Ferdi; Komurcu, Erkam
    Intertrochanteric fractures in elderly patients can increase mortality due to complications and negative functional results. The aim of this study is to retrospectively compare the follow-up and mortality rates among patients given a proximal femoral nail (PFN), the current routine treatment for these types of fractures, with those given hemiarthroplasty. The study retrospectively investigated 202 patients over the age of 60 who completed at least 3 years of follow-up after hemiarthroplasty or PFN for intertrochanteric fractures between 2007 and 2012. While 132 patients underwent cemented hemiarthroplasty, 70 had PFN. The monitoring duration for those with PFN surgery was 31.25 +/- 1.3 months while the duration of follow-up for those with hemiarthroplasty surgery was 20.0 +/- 1.2 months. At the end of 3 years of monitoring of the 202 patients, 99 were deceased. There was a statistically significant difference found in terms of patient life expectancy between those with PFN and those with hemiarthroplasty; Cox regression analysis identified that the mortality rate of those with hemiarthroplasty was 5.1 times greater. As a result, patients undergoing hemiarthroplasty should be carefully chosen and if possible, PFN should be preferred.