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Demir N, Sayar S, Dokur M, Sezer HB, Koc S, Topkarci YB, Türk MF. Analysis of increased motorcycle accidents during the COVID-19 pandemic: a single-center study from Türkiye. ULUS TRAVMA ACIL CER 2024; 30:114-122. [PMID: 38305652 DOI: 10.14744/tjtes.2024.08791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND The Coronavirus Disease 2019 (COVID-19) pandemic has led to a unique set of circumstances, straining health-care systems and affecting the way of life in societies around the world. Measures such as social isolation, travel restrictions, and workplace closures have led to an increase in motorcycle use. Consequently, motorcycle accidents have become a significant problem during this period. This study presents detailed research conducted to examine motorcycle accidents during the COVID-19 pandemic and to understand the causes and consequences of the increase in these accidents. METHODS This research evaluated records from a single health examination and used various models to analyze motorcycle acci-dents within a specified time period. Additionally, retrospective analyses were conducted to examine associations between motorcycle use and crashes in our country before and after the pandemic. The records of 386 patients who were injured in motorcycle accidents and followed up, received treatment, and were recorded at Biruni University Hospital between November 2015 and April 2023 were retrospectively examined. Noted details included the victims' age, gender, injury mechanism, injury site, injury severity, helmet use, presence and location of fractures, time distribution of the accident, and the severity of other important tissue injuries. The relationship between the injury site, fractures, and accident details, and the "Injury Severity Score" (ISS) was also investigated. RESULTS Among the 386 injured victims in motorcycle accidents, 333 were male and 53 were female. Of these, 168 (43.5%) were motorcycle drivers, 137 (35.5%) were motorcycle couriers, and 81 (21%) were pedestrians. A total of 186 (48%) injuries occurred before the pandemic (November 2015-March 2020), while 200 (52%) were sustained during the pandemic. The study indicates a noticeable increase in motorcycle injuries, particularly among motor couriers, especially during the pandemic quarantine periods. Post hoc analysis revealed that motor couriers had significantly lower ISS compared to other professions (p=0.009 and p=0.045, respectively). Motorcyclists who wore helmets were found to have significantly lower ISS than those who did not wear helmets (p<0.05). Furthermore, it was found that the ISS was positively correlated with the number of bone fractures, total soft tissue injury, and significant clinical characteristics (r=0.758, r=0.756, and p<0.001, respectively). CONCLUSION This clinical study's findings demonstrate that the measures implemented during the pandemic to limit society's mobility have led to an increase in motorcycle accidents. Notably, there has been a significant rise in the number of accidents, particularly involving individual motorcycle use and motorcycle courier services.
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Affiliation(s)
- Necdet Demir
- Department of Orthopaedics and Traumatology, Biruni University Faculty of Medicine, İstanbul-Türkiye
| | - Safak Sayar
- Department of Orthopaedics and Traumatology, Biruni University Faculty of Medicine, İstanbul-Türkiye
| | - Mehmet Dokur
- Department of Emergency Medicine, Biruni University Faculty of Medicine, İstanbul-Türkiye
| | | | - Suna Koc
- Department of Anesthesiology and Reanimation, Biruni University Faculty of Medicine, İstanbul-Türkiye
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Sezer A, Sezer HB. Segmentation of measurable images from standard plane of Graf hip ultrasonograms based on Mask Region-Based Convolutional Neural Network. Jt Dis Relat Surg 2023; 34:590-597. [PMID: 37750263 PMCID: PMC10546856 DOI: 10.52312/jdrs.2023.1308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 07/29/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVES This study proposed a Mask Region-Based Convolutional Neural Network (R-CNN)-based automatic segmentation to accurately detect the measurable standard plane of Graf hip ultrasonography images via segmentation of the labrum, lower limb of ilium, and the iliac wing. PATIENTS AND METHODS The study examined the hip ultrasonograms of 675 infants (205 males, 470 females; mean age: 7±2.8 weeks; range, 3 to 20 weeks) recorded between January 2011 and January 2018. The standard plane newborn hip ultrasound images were classified according to Graf's method by an experienced ultrasonographer. The hips were grouped as type 1, type 2a, type 2b, and type 2c-D. Two hundred seventy-five ultrasonograms were utilized as training data, 30 were validation data, and 370 were test data. The three anatomical regions were simultaneously segmented by Mask-R CNN in the test data and defective ultrasonograms. Automatic instance-based segmentation results were compared with the manual segmentation results of an experienced orthopedic expert. Success rates were calculated using Dice and mean average precision (mAP) metrics. RESULTS Of these, 447 Graf type 1, 175 type 2a or 2b, 53 type 2c and D ultrasonograms were utilized. Average success rates with respect to hip types in the whole data were 96.95 and 96.96% according to Dice and mAP methods, respectively. Average success rates with respect to anatomical regions were 97.20 and 97.35% according to Dice and mAP methods, respectively. The highest average success rates were for type 1 hips, with 98.46 and 98.73%, and the iliac wing, with 98.25 and 98.86%, according to Dice and mAP methods, respectively. CONCLUSION Mask R-CNN is a robust instance-based method in the segmentation of Graf hip ultrasonograms to delineate the standard plane. The proposed method revealed high success in each type of hip for each anatomic region.
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Affiliation(s)
- Aysun Sezer
- Biruni Üniversitesi, Bilgisayar Mühendisliği, 34010 Zeytinburnu, İstanbul, Türkiye.
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Sezer HB, Bohu Y, Hardy A, Lefevre N, Sezer A. Relationship of Altmetric Attention Score, Twitter Performance, and Dimensions Badge Value With Traditional Metrics in Top-Cited Anterior Cruciate Ligament Research Studies. Orthop J Sports Med 2023; 11:23259671231166701. [PMID: 37162760 PMCID: PMC10164263 DOI: 10.1177/23259671231166701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/27/2023] [Indexed: 05/11/2023] Open
Abstract
Background Alternative citation metrics-such as the Altmetric Attention Score (AAS), number of tweets (TN), and dimensions badge value (DBV)-are emerging as new options for assessing the value of scientific works. Purpose To analyze the AAS of highly cited articles on the anterior cruciate ligament (ACL) and to assess the relationship between alternative and traditional metrics such as journal rankings and article citation performance. Study Design Cross-sectional study. Methods A search was conducted using the Web of Science Core Collection of databases with "anterior cruciate ligament" as the search term. Full-text articles published between 2011 and 2021 were reviewed, and the top 100 cited articles were determined. The articles were analyzed by publication year, study design, research topic, journal impact factor, journal h-index, number of total citations (TC), recent citations (RC) (ie, citations in the latest 2 years), and average citation per year (ACY), as well as AAS, TN, and DBV. Results For articles in the top 100 list, the median TC was 160 (interquartile range [IQR], 117-561) and the median AAS was 24.50 (IQR, 1-730). A higher AAS score was achieved by articles on return to sports and anterolateral ligament (P < .05). The AAS and TN were significantly and positively correlated with the RC (r = 0.459 and P = .001; r = 0.438 and P = .001, respectively) and ACY (r = 0.363 and P = .001; r = 0.393 and P = .001, respectively). Conclusion Alternative metrics were linked to traditional metrics but were not a direct representation of bibliometrics. The AAS was not correlated with TC numbers in the ACL research. Higher AAS and Twitter popularity of an article were related to receiving high-volume RC performance. The DBV represented a stronger correlation with traditional metrics than the AAS.
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Affiliation(s)
- Hasan Basri Sezer
- Clinique du Sport Paris V, Chirurgie du Sport, Paris, France
- Hasan Basri Sezer, MD, Clinique du Sport Paris V, Chirurgie du Sport, 28 Boulevard. Saint Marcel, 75005, Paris, France ()
| | - Yoann Bohu
- Clinique du Sport Paris V, Chirurgie du Sport, Paris, France
| | - Alexandre Hardy
- Clinique du Sport Paris V, Chirurgie du Sport, Paris, France
| | - Nicolas Lefevre
- Clinique du Sport Paris V, Chirurgie du Sport, Paris, France
| | - Aysun Sezer
- Department of Computer Engineering, Biruni University, Istanbul, Turkey
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Sezer HB, Hardy A, Lopes R. Baropodometric comparison of orthopedic footwear to assess the effectiveness of pairs of orthopedic shoes for reducing the forefoot pressure. Jt Dis Relat Surg 2022; 33:323-329. [PMID: 35852190 PMCID: PMC9361105 DOI: 10.52312/jdrs.2022.702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/07/2022] [Indexed: 11/15/2022] Open
Abstract
Objectives
This study aimed to evaluate the distribution of foot pressure with the most frequently used orthopedic shoes and demonstrate the effect of offloading philosophy on the pressure distributions of rocker bottom or heel support shoes applied unilaterally or bilaterally. Materials and methods
Three bilateral and four unilateral, a total of seven shoe designs with sensors included in the insole were tested by the same subject in a standard acquisition protocol. Two of the unilateral and one of the bilateral shoes had heel support, while others had a rocker bottom design. A descriptive analysis was performed for each shoe and compared to a reference value obtained from a standard shoe. Results
Shoes with an offloading heel resulted in a greater reduction in pressure on the forefoot than other models. All other shoes increased pressure on the first metatarsophalangeal joint. Heel offloading models performed the best in forefoot offloading, and bilateral heel offloading shoes performed the best in first metatarsal offloading, with the highest scores of 83% and 82%, respectively. Conclusion
This study showed that orthopedic shoes sold in pairs could reduce pressure on the forefoot at a comparable level to unilateral shoes. It supports their use to limit the disadvantages of single orthopedic shoes, such as limb length discrepancies.
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Lopes R, Negru T, Hardy A, Sezer HB. Arthroscopic revision of osteochondral autograft in distal tibia: A case report demonstrating precision of intraoperative 3D fluoroscopy. Jt Dis Relat Surg 2022; 33:238-244. [PMID: 35361101 PMCID: PMC9057531 DOI: 10.52312/jdrs.2022.431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/16/2021] [Indexed: 11/26/2022] Open
Abstract
Graft failures of the tibial plafond are very rare. This article presents the technique of precise antegrade osteochondral auto-grafting under three-dimensional (3D) fluoroscopy. A 20-year-old athletic patient with a recurrent osteochondral lesion of the tibial plafond on a first osteochondral autograft after two years of follow-up was admitted. The revision osteochondral autograft was performed under real-time perioperative arthroscopic and 3D fluoroscopic control for greater precision. Surgery was followed by six weeks of non-weight-bearing in a walking boot. At one-year follow-up, the patient was effusion and pain free and returned to his previous activity level completely. Revision osteochondral autografting under arthroscopic and 3D fluoroscopic control seems to be an effective therapeutic option.
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Sezer A, Sezer HB. Deep Convolutional Neural Network-Based Automatic Classification of Neonatal Hip Ultrasound Images: A Novel Data Augmentation Approach with Speckle Noise Reduction. Ultrasound Med Biol 2020; 46:735-749. [PMID: 31882168 DOI: 10.1016/j.ultrasmedbio.2019.09.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 09/22/2019] [Accepted: 09/24/2019] [Indexed: 06/10/2023]
Abstract
Neonatal hip ultrasound imaging has been widely used for a few decades in the diagnosis of developmental dysplasia of the hip (DDH). Graf's method of hip ultrasonography is still the most reproducible because of its classification system; yet, the reproducibility is questionable as a result of the high dependency on the skills of the sonographer and the evaluator. A computer-aided diagnosis system may help evaluators increase their precision in the diagnosis of DDH using Graf's method. This study describes a fully automatic computer-aided diagnosis system for the classification of hip ultrasound images captured in Graf's standard plane based on convolutional neural networks (CNNs). Automatically segmented image patches containing all of the necessary anatomical structures were given to the proposed CNN system to extract discriminative features and classify the recorded hips. For ease of evaluation, the data set was divided into three groups: normal, mild dysplasia and severe dysplasia. This study proposes a different approach to data augmentation using speckle noise reduction with an optimized Bayesian non-local mean filter. Data augmentation with this filter increased the accuracy of the proposed CNN system from 92.29% to 97.70%. This new approach for automatic classification of DDH, classifies dysplastic neonatal hips with a high accuracy rate and might help evaluators to increase their evaluation success.
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Affiliation(s)
- Aysun Sezer
- United'Informatique et d'Ingenierie des Systemes, ENSTA-ParisTech, Universite de Paris-Saclay, Villefranche Sur Mer, Provence-Alpes-Côte d'azur, France.
| | - Hasan Basri Sezer
- Orthopaedics and Traumatology Clinic, Şişli Hamidiye Etfal Training and Research Hospital, University of Medical Sciences, Istanbul, Turkey
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Bohu Y, Klouche S, Sezer HB, Herman S, Grimaud O, Gerometta A, Meyer A, Lefevre N. Vancomycin-soaked autografts during ACL reconstruction reduce the risk of post-operative infection without affecting return to sport or knee function. Knee Surg Sports Traumatol Arthrosc 2020; 28:2578-2585. [PMID: 32025764 PMCID: PMC7429534 DOI: 10.1007/s00167-020-05879-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/22/2020] [Indexed: 01/27/2023]
Abstract
PURPOSE To compare return to sport and knee function 1 year after anterior cruciate ligament (ACL) reconstruction using autografts with and without vancomycin presoaking. METHODS A case-control study based on a retrospective analysis of prospective data included athletes over the age of 16 operated from 2012 to 2018 for ACL reconstruction. There were two groups of patients due to a change in treatment protocols: Group 1 « without vancomycin » before November 2016 and Group 2 « with vancomycin» after this date. In Group 2, the graft was soaked in a vancomycin solution for 10 min and then fixed into the bone tunnels. The primary evaluation criterion was the return to sport 1 year after surgery. The secondary criteria were various knee scores. The number of patients needed to perform a non-inferiority study was calculated. RESULTS 1674 patients fulfilled the selection criteria, 1184 in Group 1 and 490 in Group 2. The series included 1112 men and 562 women, mean age 30 ± 9.7 years, 68 professional athletes, 674 competitive athletes and 932 recreational athletes. While seven patients presented with post-operative septic arthritis in Group 1, this complication was not found in Group 2. No significant difference was identified in the return to running between the two groups 1 year after surgery (75.9% vs. 76.1%, n.s.). Significantly more of the patients in Group 2 returned to their preinjury sport (p = 0.04). Knee function was comparable between the groups. CONCLUSION Vancomycin-soaked grafts during ACL reconstruction reduce the risk of post-operative infection of the knee without affecting the return to sport or knee function. LEVEL OF EVIDENCE III. TRIAL REGISTRATION https://clinicaltrials.gov/ , ClinicalTrials.gov Identifier: NCT02511158.
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Affiliation(s)
- Yoann Bohu
- grid.489933.cClinique du Sport Paris, 36 Boulevard Saint Marcel, 75005 Paris, France ,Racing 92, 11 Avenue du Plessis, 92350 Plessis-Robinson, France ,Institut de l’Appareil Locomoteur Nollet, 23, Rue Brochant, 75013 Paris, France
| | - Shahnaz Klouche
- Clinique du Sport Paris, 36 Boulevard Saint Marcel, 75005, Paris, France. .,ELSAN, 58bis Rue de la Boétie, 75008, Paris, France.
| | - Hasan Basri Sezer
- grid.489933.cClinique du Sport Paris, 36 Boulevard Saint Marcel, 75005 Paris, France ,Institut de l’Appareil Locomoteur Nollet, 23, Rue Brochant, 75013 Paris, France
| | - Serge Herman
- grid.489933.cClinique du Sport Paris, 36 Boulevard Saint Marcel, 75005 Paris, France ,Institut de l’Appareil Locomoteur Nollet, 23, Rue Brochant, 75013 Paris, France
| | - Olivier Grimaud
- grid.489933.cClinique du Sport Paris, 36 Boulevard Saint Marcel, 75005 Paris, France ,Institut de l’Appareil Locomoteur Nollet, 23, Rue Brochant, 75013 Paris, France
| | - Antoine Gerometta
- grid.489933.cClinique du Sport Paris, 36 Boulevard Saint Marcel, 75005 Paris, France ,Institut de l’Appareil Locomoteur Nollet, 23, Rue Brochant, 75013 Paris, France
| | - Alain Meyer
- grid.489933.cClinique du Sport Paris, 36 Boulevard Saint Marcel, 75005 Paris, France ,Institut de l’Appareil Locomoteur Nollet, 23, Rue Brochant, 75013 Paris, France
| | - Nicolas Lefevre
- grid.489933.cClinique du Sport Paris, 36 Boulevard Saint Marcel, 75005 Paris, France ,Institut de l’Appareil Locomoteur Nollet, 23, Rue Brochant, 75013 Paris, France
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Bohu Y, Klouche S, Sezer HB, Herman S, Grimaud O, Gerometta A, Meyer A, Lefevre N. Correction to: Vancomycin-soaked autografts during ACL reconstruction reduce the risk of post-operative infection without affecting return to sport or knee function. Knee Surg Sports Traumatol Arthrosc 2020; 28:2586. [PMID: 32140740 PMCID: PMC7429524 DOI: 10.1007/s00167-020-05923-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The article Vancomycin‑soaked autografts during ACL reconstruction reduce the risk of post‑operative infection without affecting return to sport or knee function, written by Yoann Bohu.
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Affiliation(s)
- Yoann Bohu
- Clinique du Sport Paris, 36 Boulevard Saint Marcel, 75005, Paris, France
- Racing 92, 11 Avenue du Plessis, 92350, Plessis-Robinson, France
- Institut de l'Appareil Locomoteur Nollet, 23, Rue Brochant, 75013, Paris, France
| | - Shahnaz Klouche
- Clinique du Sport Paris, 36 Boulevard Saint Marcel, 75005, Paris, France.
- ELSAN, 58bis Rue de la Boétie, 75008, Paris, France.
| | - Hasan Basri Sezer
- Clinique du Sport Paris, 36 Boulevard Saint Marcel, 75005, Paris, France
- Institut de l'Appareil Locomoteur Nollet, 23, Rue Brochant, 75013, Paris, France
| | - Serge Herman
- Clinique du Sport Paris, 36 Boulevard Saint Marcel, 75005, Paris, France
- Institut de l'Appareil Locomoteur Nollet, 23, Rue Brochant, 75013, Paris, France
| | - Olivier Grimaud
- Clinique du Sport Paris, 36 Boulevard Saint Marcel, 75005, Paris, France
- Institut de l'Appareil Locomoteur Nollet, 23, Rue Brochant, 75013, Paris, France
| | - Antoine Gerometta
- Clinique du Sport Paris, 36 Boulevard Saint Marcel, 75005, Paris, France
- Institut de l'Appareil Locomoteur Nollet, 23, Rue Brochant, 75013, Paris, France
| | - Alain Meyer
- Clinique du Sport Paris, 36 Boulevard Saint Marcel, 75005, Paris, France
- Institut de l'Appareil Locomoteur Nollet, 23, Rue Brochant, 75013, Paris, France
| | - Nicolas Lefevre
- Clinique du Sport Paris, 36 Boulevard Saint Marcel, 75005, Paris, France
- Institut de l'Appareil Locomoteur Nollet, 23, Rue Brochant, 75013, Paris, France
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Sirvan SS, Dagdelen D, Akgun Demir I, Cezairlioglu MA, Sezer HB, Karsidag S. Utilization of arterial grafts in foot replantation. J Vasc Surg Cases Innov Tech 2018; 3:44-46. [PMID: 29349374 PMCID: PMC5757817 DOI: 10.1016/j.jvscit.2016.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 11/02/2016] [Indexed: 11/16/2022]
Abstract
Our subject is a 36-year-old man who presented to the emergency department with bilateral lower extremity amputation at the level of the distal third of the tibia after a car accident. Surgery was planned for below-knee amputation of the right lower extremity and replantation of the left foot. The arteries dissected from the iatrogenically amputated segment were used as grafts to repair vascular gaps during the replantation. The patient's follow-up had been problem free. We concluded that whenever possible, amputated parts unsuitable for replantation should be examined thoroughly and neurovascular structures that might be used as grafts should be preserved.
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Affiliation(s)
- Selami S Sirvan
- Plastik, Rekonstruktif ve Estetik Cerrahi Klinigi, Sisli Hamidiye Etfal Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | - Daghan Dagdelen
- Plastik, Rekonstruktif ve Estetik Cerrahi Klinigi, Sisli Hamidiye Etfal Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | - Isil Akgun Demir
- Plastik, Rekonstruktif ve Estetik Cerrahi Klinigi, Sisli Hamidiye Etfal Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | - Mecd Atif Cezairlioglu
- Plastik, Rekonstruktif ve Estetik Cerrahi Klinigi, Sisli Hamidiye Etfal Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | - Hasan Basri Sezer
- Ortopedi ve Travmatoloji Klinigi, Sisli Hamidiye Etfal Egitim ve Arastirma Hastanesi, Istanbul, Turkey
| | - Semra Karsidag
- Plastik, Rekonstruktif ve Estetik Cerrahi Klinigi, Sisli Hamidiye Etfal Egitim ve Arastirma Hastanesi, Istanbul, Turkey
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Oc Y, Kilinc BE, Ertugrul R, Sezer HB, Eren OT. Epithelioid Angiosarcoma in Femur: A Case Presentation. World J Oncol 2018; 8:196-198. [PMID: 29317966 PMCID: PMC5755628 DOI: 10.14740/wjon1066e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 11/24/2017] [Indexed: 12/02/2022] Open
Abstract
Primary malignant vascular tumors which constitute less than 1% of the primary bone tumors are very rarely encountered. Epithelioid angiosarcoma is a very uncommon subtype of angiosarcomas presenting with an epithelioid phenotype and mimicking carcinomas clinically. These tumors select mostly extra-skeletal locations but rarely bones as their medium. A 31-year-old male patient applied to our clinic with a nonspecific left hip pain. X-ray evaluation revealed a cystic expansile mass in the trochanteric region of the femur extending to the femoral neck. Computed tomography examination proved that the mass was cystic and 7 cm in its greatest width and contained septum. Moreover, magnetic resonance imaging examination was reported as a mass resembling aneurysmal bone cyst. The final diagnosis of epithelioid angiosarcoma was made by histological examination and biopsy of the mass. The excised specimen was examined further to verify the preoperative diagnosis.
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Affiliation(s)
- Yunus Oc
- Orthopaedics and Traumatology Department, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Bekir Eray Kilinc
- Orthopaedics and Traumatology Department, Golhisar State Hospital, Burdur, Turkey
| | - Rodi Ertugrul
- Orthopaedics and Traumatology Department, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Hasan Basri Sezer
- Orthopaedics and Traumatology Department, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Osman Tugrul Eren
- Orthopaedics and Traumatology Department, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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Seker A, Kara A, Armagan R, Oc Y, Varol A, Sezer HB. Reconstruction of neglected achilles tendon ruptures with gastrocnemius flaps: excellent results in long-term follow-up. Arch Orthop Trauma Surg 2016; 136:1417-23. [PMID: 27402211 DOI: 10.1007/s00402-016-2506-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Indexed: 02/09/2023]
Abstract
OBJECTIVE Repair of the neglected achilles tendon ruptures can be challenging due to retraction of tendon stumps. Different repair and augmentation techniques were described. This study aims to investigate long-term results of neglected achilles tendon rupture repair with gastrocnemius flaps. PATIENTS AND METHODS Between 1995 and 2005, 21 neglected achilles tendon rupture reconstructions were performed with using gastrocnemius fascial flaps. Mean age was 32.1 years. Mean period between rupture and operation was 8.4 weeks. Ankle range of motion, calf circumference, heel raise test, Visual Analog Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) hindfoot and Foot and Ankle Disability Index (FADI) scores were checked. RESULTS The average gap length was 6.4 cm. Mean follow-up was 145.3 months. Median dorsiflexion/plantar flexion values for operated and uneffected sides were 18°/30° and 19°/30°, respectively. The mean values for AOFAS and FADI scores were 98.5 points and 98.9 %, respectively. VAS score was 0 point for all patients. With the numbers available, no significant difference could be detected in terms of ankle range of motion, calf circumference measures and dynamometric analysis. Mean time for return to daily activities was 11.1 (8-16) weeks after surgery. Prerupture activity level was achieved 14.1 months postoperatively. All patients were able to perform heel raise test. CONCLUSION Repair of neglected achilles tendon ruptures with gastrocnemius flaps has satisfactory long-term results.
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Affiliation(s)
- Ali Seker
- Department of Orthopaedics and Traumatology, Istanbul Medipol University, Istanbul, Turkey. .,Medipol Mega Hastane, TEM Avrupa Otoyolu Goztepe Cikisi No: 1, Bagcilar, Istanbul, Turkey.
| | - Adnan Kara
- Department of Orthopaedics and Traumatology, Medipol Mega Hastane, Istanbul, Turkey
| | - Raffi Armagan
- Orthopaedics and Traumatology Clinic, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Yunus Oc
- Orthopaedics and Traumatology Clinic, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ali Varol
- Orthopaedics and Traumatology Clinic, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Hasan Basri Sezer
- Orthopaedics and Traumatology Clinic, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
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Kara A, Celik H, Seker A, Sezer HB, Kilinc E, Uzun M. Ochronosis diagnosed after knee arthroscopy. Int J Surg Case Rep 2014; 5:497-9. [PMID: 24993694 PMCID: PMC4147474 DOI: 10.1016/j.ijscr.2014.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 06/09/2014] [Accepted: 06/09/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Ochronosis is a rare disorder which is defined as the deposition of metabolites of oxidation and polymerization of homogentisic acid, which have high affinity to collogen, in the connective tissues. It is a clinical condition characterized with ochronotic pigmentation of tissues, degenerative arthropathy of especially large joints and black discoloration of urine. In this paper we present a case of ochronosis diagnosed with biopsy and additional tests when a black discoloration of menisci and joint cartilage were detected during arthroscopic intervention for a degenerative meniscus tear. PRESENTATION OF CASE A forty two year-old male patient was operated for lateral meniscus tear of his right knee. The arthroscopic examination of right knee revealed black colored synovial hypertrophy and torn lateral meniscus. Partial meniscectomy was performed. The diagnosis of ochronosis was made after histopathologic examination. DISCUSSION Ochronotic pigment can accumulate in hyaline cartilage, tendon, skin, teeth, nail, sclera, tympanic membrane, heart valves, renal tubular cells, duramater, pancreas and walls of large arteries. In ochronosis the most frequently involved joints are knee and hip. In ochronotic arthropathy, articular cartilage become more sensitive to mechanical stresses. Our patient had meniscal tear, cartilage damage and black discoloration of synovial tissues and meniscus. CONCLUSION Arthroscopy may be helpful in diagnosis of ochronotic arthropathy.
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Affiliation(s)
- Adnan Kara
- Department of Orthopaedics and Traumatology, Istanbul Medipol University, Istanbul, Turkey
| | - Haluk Celik
- Sisli Etfal Training and Research Hospital Orthopaedics and Traumatology Clinic, Istanbul, Turkey
| | - Ali Seker
- Department of Orthopaedics and Traumatology, Istanbul Medipol University, Istanbul, Turkey.
| | - Hasan Basri Sezer
- Sisli Etfal Training and Research Hospital Orthopaedics and Traumatology Clinic, Istanbul, Turkey
| | - Eray Kilinc
- Sisli Etfal Training and Research Hospital Orthopaedics and Traumatology Clinic, Istanbul, Turkey
| | - Metin Uzun
- Acibadem Maslak Hospital, Istanbul, Turkey
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Sezer HB, Arikan Y, Armagan R, Eren OT. Bilateral bucket handle medial meniscal tears of the knee: A case report. Int J Surg Case Rep 2013; 4:926-8. [PMID: 24012575 DOI: 10.1016/j.ijscr.2013.06.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 05/30/2013] [Accepted: 06/02/2013] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Meniscal tears may cause knee pain and functional impairment. Bilateral bucket-handle meniscal tears is an uncommon condition. PRESENTATION OF CASE This report presents the case of a 35-year-old male patient with bilateral bucket handle medial meniscal tears that occurred nonsimultaneously. The lesions were treated arthroscopically with partial resection in one knee and meniscal suture in the other. DISCUSSION Bucket handle meniscal tear of meniscus without underlying meniscal, ligamentous pathology or lower limb deformity is a rare condition. CONCLUSION To our knowledge, bilateral bucket handle medial meniscal tears without underlying meniscal anomalies have been reported in only two cases before, and our case is the third one.
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Affiliation(s)
- Hasan Basri Sezer
- Sisli Etfal Training and Research Hospital, Orthopaedics and Traumatology Department, Istanbul, Turkey.
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