Person: GÜRKAN, VOLKAN
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Publication Metadata only Evaluation of patients with pathological fractures treated by standard trauma principles but neglecting the underlying malign bone disease(2022-11-01) DEMİRÖZ S.; ÖKTEM F.; Celik A.; Erdogan O.; ÖZKAN K.; GÜRKAN V.; GÜRKAN, VOLKANIntroduction: There are several studies in the literature about pathological fractures but almost no in-formation about patients whose pathological fracture caused by a malignant lesion misdiagnosed and treated as a simple fracture. The aim of this study was to investigate patient and fracture characteristics, and outcomes in cases where fractures occurred in the presence of a malign pathology but were treated as simple fractures. Patients andMethods: Cases of malign bone lesions between 20 0 0 and 2020 were retrospectively re-viewed. Patients with a final diagnosis of malign bone lesion but whose pathological fractures were treated ignoring the underlying malign bone disease were included. Demographic, clinical and outcome data were collected from patient\"s medical records and analyzed.Results: Six patients met the inclusion criteria. Three of the patients were female and the cohort mean age was 56.8 +/- 21.8 years at the time of admission. Patient diagnoses were: renal cell carcinoma metas-tasis ( n = 1); colon cancer metastasis ( n = 1); chondrosarcoma ( n = 2); osteosarcoma ( n = 1); and undif-ferentiated pleomorphic sarcoma of bone ( n = 1). In all cases surgical management differed from those that should have been applied if the pathological fracture had been identified. Furthermore, surgical man-agement after definitive histological diagnosis were more aggressive compared to if the malignancy had been identified at first admission. All patients died after a mean follow-up of 16.67 +/- 11.7 months and the complication rate was 100%.Conclusion: When a pathological fracture is misdiagnosed and managed as a simple bone fracture, out-comes are extremely poor. In these situations, remedial surgery is more extensive, with increased com-plication rates and there is poor life expectancy.(c) 2022 Elsevier Ltd. All rights reserved.Publication Metadata only Mid-term implant survival, functional and radiological results and mechanical complications of mega-prosthetic reconstruction around the knee with the PENTA® system(2022-09-01) Özger H.; ALPAN B.; Salduz A.; GÜRKAN V.; Sungur M.; Valiyev N.; Eralp L.; GÜRKAN, VOLKAN© 2021, The Author(s).Aim: Mega-prosthetic reconstruction is the most common treatment method for massive osteoarticular defects caused by tumor resection around the knee. The new implant is a highly modular rotational-hinged megaprosthesis system with a distinct pentagonal stem geometry and variable implantation options. The aim of this study is to present the mid-term implant survival characteristics, functional and radiological results and mechanical complication profile of the new megaprosthesis. Methods: One hundred and one mega-prosthetic knee reconstruction procedures in 90 patients (M/F: 51/39) utilizing the new implant system were retrospectively analyzed. In 68 patients, the megaprosthesis was used for primary reconstruction following tumor resection while it was used for revision of other implants in 22. The mean age was 28.5 (7–66) years and the mean follow-up was 59.2 (24–124) months. The most common primary pathology was osteosarcoma with 63–70% patients, the most common anatomical site of involvement was the distal femur with 56–62% patients. Results: Henderson Type 2 failure (aseptic loosening) was seen in only 2–2.2% patients while Type 3 (structural failure) was seen in 29–32.2% Although the 5-year anchorage survival rate was 94.3%, overall mechanical implant survival was 76.1% at 5 years due to a relatively high failure rate in the first-generation hinge mechanism of the implant. The 5-year hinge survival rate demonstrated a significant improvement rate from 61.7% to 87.2% between the first and second generations of the implant (p = 0.027). The mean MSTS score was 24 out of 30 (14–29). The mean cumulative ISOLS radiographic score for index megaprosthesis operations was 19.7 (12–24), which corresponded to excellent outcome. Conclusion: The new megaprosthesis system is a reliable choice for the reconstruction of tumor-related massive osteoarticular defects around the knee. Although long-term follow-up is necessary for a definitive evaluation of the implant\"s survival characteristics, midterm follow-up yields exceptional anchorage properties related to pentagonal stem geometry with very good functional outcomes.Publication Unknown Use of cement combined grafting in upper and lower extremity benign bone tumors(2020-01-01T00:00:00Z) Pulatkan, Anil; Ucan, Vandet; TOKDEMİR, SEVİL; ELMALI, NURZAT; GÜRKAN, Volkan; UÇAN, VAHDET; TOKDEMİR, SEVİL; ELMALI, NURZAT; GÜRKAN, VOLKANObjectives: This study aims to investigate the effectivity of cement combined demineralized bone matrix (DBM) treatment on new bone formation in the cortical window as well as to evaluate the effect of new bone formation on functional outcomes. Patients and methods: Thirty-two benign bone tumor patients (15 males, 17 females; median age 38 years; range, 12 to 68 years), who were treated with cement combined DBM between February 2010 and December 2014, were evaluated retrospectively. Patient characteristics were recorded as age, gender, tumor localization, histological diagnosis, Enneking stage, tumor size, size of the cortical window, usage of prophylactic fixation, time to return to work, Musculoskeletal Tumor Society (MSTS) functional score, tumor relapse, and new bone formation on the cortical window in the computed tomography scans after one year of surgery. Results: Median tumor volume was 17.2 cm 3 (range, 2.8 to 139.6 cm 3 ), median area of the cortical window was 8.3 cm 2 (range, 1.6 to 28.4 cm 2 ), and median postoperative one-year MSTS score was 84.5 (range, 66 to 97). MSTS scores were significantly worse with the usage of prophylactic fixation (p<0.001). There was a statistically significant difference between the usage of prophylactic fixation and cortical window size (p=0.013). There was a low-level negative correlation in terms of age and bone formation on the cortical window (p=0.046, r= -0.356) and mid -level negative correlation between cortical window size and functional scores (p=0.001, r= -0.577). Conclusion: Application of cement combined with DBM procedure is an effective, alternative, and biological treatment in bone tumors that provides immediate stability and stimulates new bone formation on the cortical window.Publication Unknown Early Suspicion of Heparin-Induced Thrombocytopenia for Successful Free Flap Salvage: Reports of Two Cases(2020-06-01T00:00:00Z) Mehdizade, Turan; Kelahmetoğlu, Osman; Gürkan, Volkan; Çetin, Güven; Güneren, Ethem; KELAHMETOĞLU, OSMAN; GÜRKAN, VOLKAN; ÇETİN, GÜVEN; GÜNEREN, ETHEMHeparin-induced thrombocytopenia (HIT) is an underestimated complication of heparin treatment. Flap loss and related morbidity (even mortality) are caused by occlusion of the capillary vessels by a highly immunogenic complex formed by adherence of antiheparin antibodies to platelet factor 4. Early suspicion and effective treatment of HIT developing in two free flaps are described. We report on the management of two patients with HIT. Both patients were treated successfully by early suspicion and hematology consultation. Heparin products were discontinued; the patients were switched to a nonheparin anticoagulant. We emphasize the importance of early diagnosis, hematologist assessment, and a change to a nonheparin anticoagulant to prevent flap failure and possibly the catastrophic consequences of such failure.Publication Unknown Results of the Local Steroid Injections in the Simple Bone Cyst(2020-01-01T00:00:00Z) UÇAN, VAHDET; Pulatkan, Anil; ERDEM, Ahmet Can; KAPICIOĞLU, Mehmet; GÜRKAN, Volkan; UÇAN, VAHDET; ERDEM, AHMET CAN; KAPICIOĞLU, MEHMET; GÜRKAN, VOLKANObjective: Steroid injections represent one of the simple treatment alternatives for simple bone cysts (SBC). The aim of this study was to evaluate the results of local steroid injections in the treatment of SBC. Methods: Seventeen patients (11 males, 6 females; mean age 12.4 years; range=2 to 39 years) with SBC were treated with injection of methylprednisolone acetate (MPA) with the use of the two-needle technique. The cysts were localized in the proximal humerus (n=6), the calcaneus (one patient had bilateral lesions) (n=2), proximal femur (n=7) and the tibia (n=2). Pathological fractures occurred in three patients before steroid injection. These three patients with pathological fractures were treated with injection of MPA after fractures healed. Each patient received a maximum of four injections at eight week intervals, each consisting of 40-160 mg of MPA. The patients were followed up with plain radiographs obtained in the first month, third month, sixth month, and at the end of a year. After the first year, patients were followed up with plain radiographs once a year. The mean follow-up duration was twenty two months (range=3 to 48 months). Cyst healing was assessed according to the modified Neer classification. Results: Treatment with MPA resulted in complete recovery in ten cysts (55%) and recovery with residual lesions in three cysts (17%). Three cysts (17%) did not respond to steroid treatment and two patients (11%) developed recurrence. The results were satisfactory (72%) in patients with complete recovery and partial recovery with residual lesions, and unsatisfactory in five patients (28%). The patients with recurrence were treated with curettage and grafting or cementation. No procedure-related complications were encountered. Conclusion: Our findings suggest that, the treatment with local steroid injection in SBC provides satisfactory results, thus this treatment with low morbidity can be applied to these patients before aggressive treatment.Publication Unknown Radiological Appearences of Benign Soft-tissue Tumors of the Hand and Wrist with Special Emphasis on NRI(2022-04-01T00:00:00Z) YILMAZ, TEMEL FATİH; TOPRAK, HÜSEYİN; Atasoy, Bahar; SÖNMEZ, FATMA CAVİDE; ARALAŞMAK, Ayşe; GÜRKAN, Volkan; YILMAZ, TEMEL FATİH; TOPRAK, HÜSEYİN; ATASOY, BAHAR; SÖNMEZ, FATMA CAVİDE; ARALAŞMAK, AYŞE; GÜRKAN, VOLKANTumoral and pseudotumoral lesions of the hand and wrist are commonly encountered in routine clinical practice. Although most of them arc benign, radiological differential diagnosis of these lesions is difficult, because of their nonspecific imaging findings, except ganglia, localized type of tenosynovial giant cell tumors and lipomas. Digital radiography, computed tomography, and ultrasound may be useful in identification of the lesions in the wrist and hand, but magnetic resonance imaging with superior contrast and spatial resolution is the most important imaging modality.Publication Metadata only Benign bone tumors of hand and wrist: evaluation of diagnosis and treatment(2020-04-01T00:00:00Z) Abdallah, Anas; Sofuoglu, Ozden Erhan; Abdallah, Betul Guler; Emel, Erhan; Gunduz, Hasan Burak; Asilturk, Murad; GÜRKAN, VOLKANObjectives: This study aims to investigate the choke of graft or cement, the relationship between the graft types and union rates, functional results. and complications in hand and wrist benign bone lesions while also evaluating the diagnosis and treatment modalities of lesions with high recurrence potential like giant cell-containing lesions.