Publications by authors named "Mustafa Yerli"

6 Publications

  • Page 1 of 1

Does Sectioning and Then Repairing of the Calcaneofibular Ligament at Subtalar Approach Lead to Residual Lateral Ankle Instability?

Arch Bone Jt Surg 2022 Apr;10(4):347-352

Department of Orthopedic and Traumatology, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul, Turkey.

Background: The calcaneofibular ligament is cut to increase vision in surgical field in minimally invasive surgery of displaced intraarticular calcaneus fractures with subtalar incision. We aimed to investigate whether this causes talar tilt instability in ankle stress radiographs due to the calcaneofibular ligament deficiency in postoperative period.

Methods: The files of 38 patients who were operated with the diagnosis of displaced calcaneus fracture between 2013 and 2018 were examined retrospectively. All the cases underwent with subtalar approach and the calcaneofibular ligament was repaired after the operation. The age, sex, injury mechanism, follow-up length, type of fracture by the Sanders classification, preoperative and postoperative Bohler's and Gissane's angle measurements, talar tilt measurements of intact and fractured side, postoperative calcaneal length, calcaneal height and calcaneal width of the cases were recorded. The obtained data were evaluated statistically.

Results: 31 (81.6%) of the cases were men, seven (18.4%) were women. The average age was 31.92±7.95 years. The average follow-up time was 15.82±3.33 months. The preoperative Bohler's angle was 14.16±3.67 degree, while the postoperative Bohler's angle was 31.53±4.60 degree (). The average talar tilt was 0.96±0.87 degrees on the intact side and 1.19±1.12 degrees on the fractured side (). Although the talar tilt values were statistically higher on the fractured side than the intact side, no radiological instability finding was found in any case. The average postoperative Gissane's angles were 126.45±6.69 degrees. The calcaneal length (), calcaneal width () and calcaneal height () were statistically similar between the postoperative fractured foot and intact foot.

Conclusion: Sectioning of the calcaneofibular ligament in the surgical treatment with subtalar approach does not cause lateral ankle instability in stress radiographs but may cause laxity. Possible postoperative lateral ankle injuries can be prevented by ankle proprioception exercises.
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http://dx.doi.org/10.22038/ABJS.2021.54080.2702DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9169731PMC
April 2022

Effect of psoas and gluteus medius muscles attenuation on hip fracture type.

Hip Int 2022 Jun 5:11207000221101169. Epub 2022 Jun 5.

Department of Orthopaedics and Traumatology, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey.

Introduction: Sarcopenia is defined as a progressive loss of muscle mass and function with increased age. The measurement of muscle mass and attenuation on the axial computed tomography (CT) scan has been reported to be a good indicator for sarcopenia in previous literature. This study aimed to compare muscle mass between the intertrochanteric fracture and femoral neck fracture groups by accurately measuring muscle mass around the hip joint using a CT scan.

Methods: The cases were matched according to age and gender on a 1-to-1 basis. As a result, a total of 400 patients, 200 patients in each group with the same age and gender characteristics, were included in the study. At the disc of L4-L5 level, the cross-sectional area (CSA) of the psoas muscle was evaluated, and at the disc of L5-S1 level, the CSA of the psoas, iliacus and gluteus medius muscles were evaluated. In addition, attenuation was evaluated using the average Hounsfield Unit (HU) for the specific area.

Results: The mean age of 400 patients (262 females, 138 male) included in the study was 78.49 ± 7.67 years. It was observed that the mean HU values of the patients in the femoral neck fracture group were significantly higher than the intertrochanteric fracture group ( < 0.001,  = 0.008; respectively). At the same time, the mean HU values of the gluteus medius muscle were higher in the femoral neck fracture group ( < 0.001), but in contrast with the psoas muscle, the CSA values of gluteus medius muscle were significantly higher in the intertrochanteric fracture group ( = 0.017).

Conclusions: Fatty degeneration of the psoas muscle among the muscles around the hip may affect the type of hip fracture. Elderly patients with strong psoas muscles may experience femoral neck fracture due to contraction and torsion during falling.
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http://dx.doi.org/10.1177/11207000221101169DOI Listing
June 2022

The Effect of Syndesmotic Screw Level on Postoperative Syndesmosis Malreduction.

J Foot Ankle Surg 2022 May-Jun;61(3):482-485. Epub 2021 Sep 22.

Department of Orthopedic and Traumatology, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey.

Tibiofibular injury repair of ankle fractures may result in over-compression when performed via a partially threaded screw depending on its placed level. We aimed to examine the relationship between the screw level relative to the tibiotalar joint and syndesmosis malreduction in postoperative radiographs of ankle fractures treated with partially threaded screws. We retrospectively analyzed 129 patients who underwent surgery due to lateral malleolar fractures between 2011 and 2019. We measured the distance between the screw and the tibiotalar joint and stratified the patients per their screw level as either trans-syndesmotic or suprasyndesmotic. According to Lauge-Hansen, 83 cases were supination-external rotation type (64.3%), and the remaining were pronation-external rotation type (35.7%) injuries. We found postoperative syndesmosis malreduction in 20 cases (15.5%). Eight (6.2%) cases had medial clear space mismatch. As the distance of the screw to the joint increased, postoperative medial clear space values increased (rho: 0.190, p = .031). The relationship between postoperative syndesmosis mismatch and the level of the syndesmotic screw was statistically significant (p = .044). In syndesmosis repair with a partially threaded screw, as the distance of the screw from the joint increases, the over-compression caused by the screw may cause an increase in postoperative syndesmotic malreduction rates.
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http://dx.doi.org/10.1053/j.jfas.2021.09.022DOI Listing
May 2022

Retrospective analysis of 35 pediatric femoral neck fractures.

Eur J Orthop Surg Traumatol 2021 Sep 20. Epub 2021 Sep 20.

Department of Orthopedic and Traumatology, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey.

Objective: Pediatric proximal femur fracture is extremely rare trauma comparing to other fractures. The proximal femur fracture is 1% of all pediatric fractures. The aim of current study is to compare the incidence of early complications and outcomes of pediatric proximal femur fractures regarding fracture types retrospectively.

Design: Our study includes 35 cases which are criticized by Delbet classification system, modalities of treatment, duration of waiting for surgery, duration of follow-up and also complications. Our inclusion criteria are age below 16 years old, proximal femur fractures with no evidence of tumoral, romathologic and methabolic conditions. Age, sex and surgery type (open-closed) were noted, and the data were statistically assessed. Assessment of the final outcome was made at the last follow-up visit using the Ratliff's method.

Results: The mean of age of patients in our study is 9.5 ± 5.06 years. The average follow-up was 25.6 ± 13.2 months. 15 patients (42.9%) are type 2 Delbet fracture, 5 patients (14.2%) are Delbet type 3 and 15 patients (42.9%) are Delbet type 4 fracture. Using the Ratliff's method, 25 patients (71.4%) had satisfactory outcomes. Ten patients (28.6%) had unsatisfactory outcomes. The complications as AVN, coxa vara and premature closure of physis, non-union and postoperative infections have been detected in this study. AVN was seen in four (11.4%) patients. In addition, coxa vara was seen in six (17.2%) patients.

Conclusion: Pediatric femoral neck fractures are extremely rare fractures and can be treated with low complication rates in cases with early treatment and anatomic reduction.
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http://dx.doi.org/10.1007/s00590-021-03126-6DOI Listing
September 2021

Distal metatarsal osteotomy and dorsal neutralization plate in the treatment of hallux valgus.

Eur J Orthop Surg Traumatol 2022 May 13;32(4):753-758. Epub 2021 Jun 13.

Department of Orthopedic and Traumatology, Prof. Dr. Cemil Tascioglu City Hospital, Darülaceze Street No:27, 34384, Sisli, İstanbul, Turkey.

Purpose: Hallux valgus is a disease that can be treated with many different surgical procedures. In our study, we aimed to compare patients with and without dorsal neutralization plate after distal metatarsal osteotomy and fixation with compression screws.

Methods: The files of 59 patients with 89 feet operated with the diagnosis of moderate degree hallux valgus have been examined retrospectively. Hallux valgus angles, AOFAS, VAS and satisfaction scores, time to return to work of both groups were compared. The cases in which only screw fixation was performed were mobilized with the hallux valgus apparatus for 6 weeks postoperatively, while the cases in which dorsal neutralization plate was performed were immediately mobilized full weightbearing without using an additional apparatus. Patients with a minimum follow-up of 2 years were included in the study.

Result: There was no statistically significant difference between the two groups in terms of being bilateral (p = 0.457), mean age (p = 0.105) and gender data (p = 0.105). There was no significant difference in the preop and postop second year hallux valgus angles, AOFAS, VAS and satisfaction scores of the patients. There was a significant difference in the time to return to work (p < 0.001) and the 6th week AOFAS (p < 0.001), VAS (p < 0.001) and postop satisfaction (p < 0.001) scores between the two groups.

Conclusion: The dorsal neutralization plate performed in addition to the compression screw after distal metatarsal osteotomy can cause painless early postoperative results that do not require the use of an additional apparatus, and early good functional results.
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http://dx.doi.org/10.1007/s00590-021-03044-7DOI Listing
May 2022

Does Localisation of Fracture Line, According to Epicondyles, Affect Ligamentotaxis Negatively in Displaced Pediatric Supracondylar Humerus Fractures?

J Coll Physicians Surg Pak 2021 Jan;31(1):45-50

Department of Orthopedic and Traumatology, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey.

Objective: To investigate the effect of localisation of the fracture line according to the trans-epicondylar line on open reduction rates and postoperative reduction quality.

Study Design: Observational study.

Place And Duration Of Study: Department of Orthopedic and Traumatology, Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul, Turkey, from January 2011 to December 2018.

Methodology: Pediatric cases (37 females-54 males) which underwent surgery with Gartland type three supracondylar humerus fracture having extension deformity, were included and examined retrospectively. Localisation of fracture line according to trans-epicondylar line, presence of postoperative rotation, sagittal and coronal deformity, reduction type and surgery duration were noted.

Results: According to trans-epicondylar level, fracture line passed through upper level of the line in 68 cases, while it passed through lower level in 23 cases. Rotation rate of patients, whose fraction line localisation was lower according to trans-epicondylar level (60.87%), was higher than upper localization patients (8.82%, p<0.001). It has been observed that the relation between localisation of fracture line according to trans-epicondylar level and sagittal deformity, coronal deformity, reduction type and surgery durations were similar (p>0.05).

Conclusion: Determination of localisation of fracture line according to trans-epicondylar level in preoperative roentgenograms may allow the surgeon to predict the possibility of postoperative rotation deformity. Key Words: Fracture line, Humerus, Supracondylar, Pediatric, Epicondyle.
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http://dx.doi.org/10.29271/jcpsp.2021.01.45DOI Listing
January 2021
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