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Alkan H, Karaman Y, Güven Ş, Biçici V, Subaşı İÖ, Yaşar NE, Fırat A. Are There Any Significant Risk Factors Associated with Lateral Trochanteric Pain in Patients Who Have Undergone Primary Hip Replacement? Cureus 2023; 15:e44863. [PMID: 37809213 PMCID: PMC10560105 DOI: 10.7759/cureus.44863] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Lateral pain around the greater trochanter (LTP) is a common complication after total hip arthroplasty (THA) that can significantly reduce quality of life. The aim of this study was to analyze the relationship between lateral trochanteric bursa repair, subcutaneous fat thickness, and trochanteric pain during the THA procedure. Materials and methods A total of 98 patients who underwent THA for hip arthrosis between 2021 and 2022 were evaluated retrospectively. For all evaluated patients, subcutaneous thickness was measured between the fascia and the skin at the incision site. Bursa repair was performed in 47 patients, while bursa excision was done in 51 patients. The data obtained included demographic information, functional scores, comorbidities, bursa repair and skin thickness values, radiographic evaluations, and other specific markers. These were compared between patients diagnosed with LTP following THA and the controls. Results No difference was observed between the study groups in terms of subcutaneous fat thickness, bursa repair, and other demographic or radiographic evaluations. As expected, there were statistically significant differences between the groups in terms of the visual analog scale (VAS) score (p=0.030) and the Harris hip score (HHS) (p=0.045). When comparing the groups with and without LTP, the VAS score was higher in the group with LTP, while the HHS was found to be lower. Conclusion Trochanteric pain is not associated with bursa repair or subcutaneous thickness. LTP cannot be predicted based on comorbidities such as smoking, BMI, or radiographic measurements.
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Affiliation(s)
- Hilmi Alkan
- Orthopaedics and Traumatology, Ankara Bilkent City Hospital, Ankara, TUR
| | - Yavuz Karaman
- Orthopaedics and Traumatology, Ankara Bilkent City Hospital, Ankara, TUR
| | - Şahan Güven
- Orthopaedics and Traumatology, Ankara Bilkent City Hospital, Ankara, TUR
| | - Vedat Biçici
- Orthopaedics and Traumatology, Ankara Bilkent City Hospital, Ankara, TUR
| | - İzzet Özay Subaşı
- Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan, TUR
| | - Niyazi Erdem Yaşar
- Orthopaedics and Traumatology, Ankara Bilkent City Hospital, Ankara, TUR
| | - Ahmet Fırat
- Orthopaedics and Traumatology, Ankara Bilkent City Hospital, Ankara, TUR
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Özdemir G, Karlıdağ T, Bingöl O, Sarıkaya B, Çağlar C, Bozkurt İ, Akkurt MO, Mantı N, Gencer B, Biçici V, Çepni Ş, Köse CC, Doğan Ö, İnci F, Ceyhan E, Yavuz İA, Gülçek M, Alkan H, Turan S, Kılıçaslan K, Doğan M, Özkurt B, Tecimel O, Solak AŞ, Uluyardımcı E, Özaslan Hİ, Bozer M, Güven Ş, Erdem E, Ülgen NK, Aydın T, Güllerci AM, Keskin ÖH. Systematic triage and treatment of earthquake victims: Our experience in a tertiary hospital after the 2023 Kahramanmaras earthquake. Jt Dis Relat Surg 2023; 34:480-487. [PMID: 37462656 PMCID: PMC10367139 DOI: 10.52312/jdrs.2023.1102] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the benefits of our triage system in acceleration of intervention for the musculoskeletal injuries and clinical follow-ups of trauma patients admitted to our center after the Kahramanmaras earthquake. PATIENTS AND METHODS Between February 6th, 2023 and February 20th, 2023, a total of 439 patients (207 males, 232 females; mean age: 37.1±19.1 years; range, 1 to 94 years) with earthquake-related musculoskeletal injuries after the Kahramanmaras earthquake were retrospectively analyzed. Data including age, sex, referral city information, removal time from the rubbles, physical examination findings, clinical photos, fasciotomy and amputation stumps and levels, and X-ray images and computed tomography images of all patients were shared and archived in the WhatsApp (Meta Platforms, Inc.® ATTN/CA, USA) group called 'Earthquake' created by orthopedic surgeons. To complete the patient interventions as soon as possible and to ensure order, the patients were distributed with the teams in order through this group by the consultant orthopedic surgeon. The treatments were applied and recorded according to the skin and soft tissue conditions, and fractures of the patients. All treatments were carried out with a multi-disciplinary approach. RESULTS Of the patients, 16.2% were children. Lower limb injuries constituted 59.07% of musculoskeletal injuries. Upper limb, pelvic, and spinal cord injuries were observed in 21.9%, 12.7%, and 6.25%, respectively. Conservative treatment was applied to 183 (41.68%) patients. The most common surgical intervention was debridement (n=136, 53.1%). External fixation was applied in the first stage to 21 (8.2%) patients with open fractures. The mean removal time from the rubbles was 32.1±29.38 h. A total of 118 limb fasciotomy operations were applied to the patients. Fifty limb amputations were performed in 40 patients at the last follow-up due to vascular insufficiency and infection. CONCLUSION Based on our study results, we believe that a triage system using a good communication and organization strategy is beneficial to prevent treatment delay and possible adverse events in future disasters.
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Affiliation(s)
- Güzelali Özdemir
- Ankara Bilkent Şehir Hastanesi, Ortopedi ve Travmatoloji Kliniği, 06800 Çankaya, Ankara, Türkiye.
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Kılıçarslan K, Erdoğan Y, Karaman Y, Alkan H, Biçici V. Comparison of dermatotraction and negative pressure wound therapy for closure of cruris fasciotomy after 2023 Kahramanmaras earthquake. Jt Dis Relat Surg 2023; 34:497-502. [PMID: 37462658 PMCID: PMC10367168 DOI: 10.52312/jdrs.2023.1119] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023] Open
Abstract
OBJECTIVES This study aims to evaluate the results of patients who underwent cruris fasciotomy for acute compartment syndrome (ACS) after the 2023 Kahramanmaras earthquake and used subcuticular polydioxanone (PDS) method or negative pressure wound therapy (NPWT) with vacuum-assisted closure (VAC) for fasciotomy follow-up and closure of the defect. PATIENTS AND METHODS Between March 2023 and April 2023, a total of 52 patients (31 males, 21 females; mean age: 29±14.8 years; range, 5 to 74 years) were retrospectively analyzed. The patients were divided into two groups as the dermatotraction (PDS) group (Group 1, n=30), and the VAC group (Group 2, n=22). Data including demographic, clinical, and operative data such as fasciotomy closure time, graft need, and infection rate were recorded. RESULTS More grafts were needed to close the fasciotomy in patients followed with VAC. The mean closure time of the fasciotomy was 25.9±3.8 days in the PDS group and 27.3±3.5 days in the VAC group, indicating no significant difference between the groups (p=0.738). There was no significant difference in the rate of wound infection between the two groups (p=0.482). CONCLUSION Our study results suggest that more grafts are needed to close the fasciotomy in patients followed with VAC; however, it seems to increase the cost of the treatment.
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Affiliation(s)
- Kasım Kılıçarslan
- Ankara Bilkent Şehir Hastanesi, Ortopedi ve Travmatoloji Kliniği, 06800 Çankaya, Ankara, Türkiye
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Biçici V, Bingöl I, Sazak T. Mid-term results of total hip arthroplasty with subtrochanteric Z-osteotomy in Crowe type 3-4 developmental hip dysplasia. Turk J Med Sci 2021; 51:1976-1983. [PMID: 34333904 PMCID: PMC8569767 DOI: 10.3906/sag-2102-217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/16/2021] [Accepted: 07/31/2021] [Indexed: 11/19/2022] Open
Abstract
Background/aim Total hip arthroplasty (THA) is technically more difficult and has higher complication rates in patients with Crowe type 3–4 developmental dysplasia of the hip (DDH). Due to the difficulties and different treatment options, there is still no consensus on the optimal treatment. We aimed to evaluate the mid-term results of our patients who had undergone subtrochanteric femoral shortening Z-osteotomy. Materials and methods This study included 37 hips of 29 patients with the diagnosis of Crowe 3-4 DDH between June 2010 and December 2016 and who underwent femoral shortening Z-osteotomy with cementless total hip arthroplasty. Acetabular component was determined according to the patient’s age and functional capacity and all patients were operated with a posterior approach. Functional results, postoperative complications, Harris and visual analogue scale (VAS) scores were evaluated. Results The average Harris hip score was 41.3 ± 3.1 preoperatively and 84.7 ± 4.3 postoperatively (p < 0.05). The mean preoperative hip pain score on the VAS was 7.9 (range: 6–9) and this was significantly lower at the last follow-up (mean: 3.4; range: 2–4) (p < 0.05). The final mean limb-length discrepancy was 1.3 cm. The average amount of femoral shortening was 3.2 cm. Regarding complications, 3 (10.3%) patients had dislocations. These patients underwent closed reduction. Sciatic palsy developed in 1 (3.4%) patient. The patient was reoperated on for sciatic nerve dissection in the early period. Conclusion Subtrochanteric shortening Z-osteotomy combined with cementless total hip replacement can be considered an effective and successful method in selected patients with Crowe 3-4 coxarthrosis.
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Affiliation(s)
- Vedat Biçici
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
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Bingöl İ, Biçici V. How does rerupture affect sleep and quality of life in patients undergoing arthroscopic rotator cuff repair? Turk J Med Sci 2021; 51:181-187. [PMID: 33576587 PMCID: PMC7991867 DOI: 10.3906/sag-2012-169] [Citation(s) in RCA: 1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/11/2021] [Indexed: 11/08/2022] Open
Abstract
Background/aim Sleep disturbance and related improvement in quality of life as a result of arthroscopic repair in rotator cuff tear (RCT) patients can be considered as an important parameter. The aim of our study is to evaluate the rotator cuff by ultrasonography (USG) in the first postoperative year and to examine whether there is a difference between sleep disturbance and quality of life between cases of rupture and healthy patients. In addition, we aim to compare the preoperative and at least the first postoperative year’s sleep disturbances and quality of life among patients who underwent arthroscopic RCT repair and to examine the effects of factors affecting this situation. Materials and methods We retrospectively reviewed the records of patients who were operated on for RCT. In this process, 257 patients were examined and 76 patients who met the inclusion criteria were included in the study. The Pittsburgh sleep quality index (PSQI), Constant–Murley shoulder score (CSS), and Oxford shoulder score (OSS) were used to evaluate the results preoperatively and at the last control visit of each patient. In the USG performed in the postoperative first year, the rotor cuff was evaluated in terms of rerupture. Results It was observed that 14 (18.4%) patients’ rotor cuffs were reruptured and those of 62 (81.6%) patients were intact. The preoperative PSQI, CSS, and OSS values of the patients were calculated as an average of 10.79 ± 3.58, 35.61 ± 8.88, and 17.61 ± 4.20 and the mean postoperative values were calculated as 5.45 ± 1.68, 81.55 ± 5.27, and 38.05 ± 3.06, respectively. The postoperative PSQI value was statistically significantly lower in patients with tears of <1 cm (PSQI: 4.29 ± 0.73) than in those with tears of 1–3 cm (PSQI: 5.50 ± 2.17) and 3–5 cm (PSQI: 5.88 ± 1.25) (P < 0.001). The mean CSS and OSS values were significantly higher in postoperative measurements for all tear types. According to the size of the tear, postoperative CSS and OSS values were statistically significantly lower in patients with tears of 3–5 cm (CSS: 78.59 ± 4.50 and OSS: 36.18 ± 2.47) than those with <1 cm (CSS: 85.43 ± 2.14 and OSS: 40.57 ± 1.55) and 1–3 cm (CSS: 83.21 ± 5.35 and OSS: 39.07 ± 2.94) tears (P < 0.001). Conclusion In the USG performed in the postoperative first year, it was determined that the patients with healthy rotator cuffs recovered better than those with rerupture.
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Affiliation(s)
- İzzet Bingöl
- Department of Orthopaedics and Traumatology, 29 Mayıs Goverment Hospital, Ankara, Turkey
| | - Vedat Biçici
- Department of Orthopaedics and Traumatology, Ankara City Hospital, Ankara, Turkey
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Biçici V, Bingöl İ. Do different surgical techniques in tibia pilon fractures change the results of the midterm? Turk J Med Sci 2020; 50:1559-1565. [PMID: 32892545 PMCID: PMC7605097 DOI: 10.3906/sag-2006-212] [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] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/29/2020] [Indexed: 11/03/2022] Open
Abstract
Background/aim Pilon fracture is difficult to treat fractures due to many complications that can develop after surgery. To achieve the best results, different surgical approaches are used.In our study, we aimed to compare the functional results and complication rates of our treatments in patients treated with 3 different surgical tecniques. Materials and methods 89 pilon fractures of 87 patients treated for pilon fracture were evaluated. Patients were examined in 3 different groups (one step, two step surgery and Ilizarov). Functional results, postoperative complications and ankle AOFAS scores were evaluated. Results The mean AOFAS score of the all patients was 77.67. There was no significant difference between 3 surgical techniques (P = 0,880). While skin complication was not seen in patients who underwent double-stage surgery and Ilizarov (0%); It was seen in 6 (15.7%) patients who underwent single-stage surgery. Treatment results were found to be better in type 1 and type 2 fractures, while in type 3 fractures (P = 0.004). Conclusion Despite the different surgical approaches and implants applied, no difference was found between the midterm ankle functional results of the patients. Two-stage surgery and Ilizarov is a safe and effective treatment approach to reduce morbidity and early complications in pilon fractures.
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Affiliation(s)
- Vedat Biçici
- Department of Orthopaedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - İzzet Bingöl
- Department of Orthopaedics and Traumatology, 29 Mayıs Goverment Hospital, Ankara, Turkey
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Çiçekli Ö, Özdemir G, Uysal M, Biçici V, Bingöl İ. Percutaneous cannulated screw fixation for pediatric epiphyseal ankle fractures. Springerplus 2016; 5:1925. [PMID: 27917331 PMCID: PMC5099300 DOI: 10.1186/s40064-016-3623-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 11/01/2016] [Indexed: 11/21/2022]
Abstract
Background Ankle injuries are among the most common injuries in children. The aim of this study was to compare the efficacies of two percutaneous fixation methods after closed reduction in physeal ankle fractures. Methods We reviewed the cases of 24 patients with a mean age of 12.29 years; 16 were male, and 8 were female. Only patients with fractures of Salter-Harris types 2, 3, and 4 with displacements greater than 2 mm were included in the study. Patients were treated with closed reduction manipulation and percutaneous screw fixation. For each patient, either cannulated or headless full threaded compressive screws were used for percutaneous fixation. Radiological and clinical healing time, range of motion (ROM), American Orthopaedic Foot and Ankle Society (AOFAS) score and physeal arrest were then measured. Results The mean follow-up time was 13 months. The mean time until cast removal was 3.5 weeks (range 2–5). A full ROM was achieved at an average of 5.7 weeks postoperatively (range 4–8). The radiologic healing time was 6.1 weeks (range 4–7). The patients’ clinical healing time averaged 6.8 weeks (range 5–8). Differences in radiologic healing time (p = 0.487), clinical healing time (p = 0.192), AOFAS score (p = 0.467), and complication rate (p = 0.519) between patients who received the headless compressive screw and those who received the cannulated screw for fixation were not statistically significant. Conclusions We demonstrate good clinical results with closed reduction and the percutaneous screw fixation method. Both cannulated and headless compressive screws can be used safely as a treatment method in physeal ankle fractures.
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Affiliation(s)
- Özgür Çiçekli
- Department of Orthopaedic Surgery and Traumatology, Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Güzelali Özdemir
- Department of Orthopaedic Surgery and Traumatology, Numune Training and Research Hospital, Ankara, Turkey
| | - Mustafa Uysal
- Department of Orthopaedic Surgery and Traumatology, Sakarya University School of Medicine Training and Research Hospital, Sakarya, Turkey
| | - Vedat Biçici
- Department of Orthopaedic Surgery and Traumatology, Yenimahalle Training and Research Hospital, Ankara, Turkey
| | - İzzet Bingöl
- Department of Orthopaedic Surgery and Traumatology, 29 Mayıs State Hospital, Ankara, Turkey
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Aksekili MAE, Uğurlu M, Işık Ç, Yüksel K, Biçici V, Bozkurt M. Posterior bone block of chronic locked posterior shoulder dislocations with glenoid augmentation: a retrospective evaluation of ten shoulders. International Orthopaedics (SICOT) 2015; 40:813-20. [DOI: 10.1007/s00264-015-2907-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 06/24/2015] [Indexed: 10/23/2022]
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Aksekili MAE, Biçici V, Işık Ç, Aksekili H, Uğurlu M, Akkurt A, Doğan M. Comparison of early postoperative period electrophysiological and clinical findings following carpal tunnel syndrome: is EMG necessary? Int J Clin Exp Med 2015; 8:10011-10015. [PMID: 26309691 PMCID: PMC4538065] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 06/03/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND In this study, we aimed to compare the clinical findings and ENMG results of the patients who underwent surgery due to CTS, in the preoperative and early postoperative period. METHODS 33 wrists of 29 patients who underwent open carpal tunnel surgery in our clinic due to CTS, between 2009 and 2011, were evaluated. Electrophysiological progress was evaluated with ENMG and clinical state with Boston scale. RESULTS A significant decrease was observed in the postoperative BS symptomatic (SSS) and functional (FSS) scores of patients as compared to preoperative period (P=0.00), In the electrophysiological findings, statistically significant improvement was observed in all groups but very severe CTS group (P<0.05). When preoperative and postoperative EMG findings were compared, changes in DSL and DSA values were statistically significant (P<0.05). However, no statistically significant difference was seen between DML (P=0.085) and DMA (P=246) values on the 3rd month. When an examination was conducted on the patients whose DML and DSL values could not be obtained in the preoperative EMG, DML values were obtained in the early postoperative period in 6 of 7 cases (85.71% P<0.001), and DSL values were obtained in 17 of 24 cases (70.8% P<0.000). CONCLUSIONS Sensory nerve findings were more significant, showed faster recovery compared to motor nerve findings, and accompanied the clinical recovery. Performance of an EMG test, especially on sensory nerves, will be more effective in patients selected in the early period, with the exception of patients with very severe CTS.
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Affiliation(s)
| | - Vedat Biçici
- Atatürk Training and Research Hospital, Orthopeady and TraumatologyAnkara, Turkey
| | - Çetin Işık
- Department of Orthopedics, Yildirim Beyazit University School of MedicineAnkara, Turkey
| | - Hatice Aksekili
- Atatürk Training and Research Hospital, Physical Therapy and RehabilitationAnkara, Turkey
| | - Mahmut Uğurlu
- Department of Orthopedics, Yildirim Beyazit University School of MedicineAnkara, Turkey
| | - Adem Akkurt
- Departmet of Neurology, Samsun Medical Park HospitalSamsun, Turkey
| | - Metin Doğan
- Department of Orthopedics, Yildirim Beyazit University School of MedicineAnkara, Turkey
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Aksekili MAE, Biçici V, Işık Ç, Aksekili H, Uğurlu M, Doğan M. Comparison of early postoperative period electrophysiological and clinical findings following carpal tunnel syndrome: is EMG necessary? Int J Clin Exp Med 2015; 8:6267-6271. [PMID: 26131237 PMCID: PMC4484005] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 04/05/2015] [Indexed: 06/04/2023]
Abstract
UNLABELLED In this study, we aimed to compare the clinical findings and ENMG results of the patients who underwent surgery due to CTS, in the preoperative and early postoperative period. METHODS 33 wrists of 29 patients who underwent open carpal tunnel surgery in our clinic due to CTS, between 2009 and 2011, were evaluated. Electrophysiological progress was evaluated with ENMG and clinical state with Boston scale. RESULTS A significant decrease was observed in the postoperative BS symptomatic (SSS) and functional (FSS) scores of patients as compared to preoperative period (P=0.00). In the electrophysiological findings, statistically significant improvement was observed in all groups but very severe CTS group (P<0.05). When preoperative and postoperative EMG findings were compared, changes in DSL and DSA values were statistically significant (P<0.05). However, no statistically significant difference was seen between DML (P=0.085) and DMA (P=246) values on the 3rd month. When an examination was conducted on the patients whose DML and DSL values could not be obtained in the preoperative EMG, DML values were obtained in the early postoperative period in 6 of 7 cases (85.71%, P<0.001), and DSL values were obtained in 17 of 24 cases (70.8%, P<0.000). CONCLUSIONS Sensory nerve findings were more significant, showed faster recovery compared to motor nerve findings, and accompanied the clinical recovery. Performance of an EMG test, especially on sensory nerves, will be more effective in patients selected in the early period, with the exception of patients with very severe CTS.
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Affiliation(s)
| | - Vedat Biçici
- Atatürk Training and Research Hospital, Orthopeady and TraumatologyAnkara, Turkey
| | - Çetin Işık
- Department of Orthopedics, Yildirim Beyazit University School of MedicineAnkara, Turkey
| | - Hatice Aksekili
- Atatürk Training and Research Hospital, Physical Therapy and RehabilitationAnkara, Turkey
| | - Mahmut Uğurlu
- Department of Orthopedics, Yildirim Beyazit University School of MedicineAnkara, Turkey
| | - Metin Doğan
- Department of Orthopedics, Yildirim Beyazit University School of MedicineAnkara, Turkey
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