Person: ELMADAĞ, NUH MEHMET
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Publication Metadata only Apophyseal avulsion fracture of the anterior inferior iliac spine due to a simple bone cyst(2015-03-01T00:00:00Z) Elmadag, Mehmet; CEYLAN, Hasan H.; ERDIL, Mehmet; Bilsel, Kerem; ELMADAĞ, NUH MEHMET; BİLSEL, İSMAIL KEREMApophyseal avulsion fractures of the anterior inferior iliac spine are rare; they are usually seen in adolescents as a result of sudden contraction of the rectus femoris muscle. Treatment is usually conservative, but surgical management may be necessary in certain circumstances. We present an unusual case of a 14-year-old male who was referred to our department for a suspicious pathological fracture of his right anterior inferior iliac spine; he was found to have an avulsion fracture of the anterior inferior iliac spine due to simple bone cyst. We discuss the treatment of this rare injury caused by a benign osseous tumour.Publication Metadata only Functional Outcomes to Surgical Treatment of the Distal Humerus Intra-Articular Fractures in Adults(2013-11-01T00:00:00Z) Yigman, Abdulkadir; Tuncer, Nejat; Erdil, Mehmet; Bilsel, Kerem; Elmadag, Mehmet; Sen, Cengiz; BİLSEL, İSMAIL KEREM; ELMADAĞ, NUH MEHMETAim: Displaced and intraarticular humerus distal fractures require surgical treatment. In this study we evaluated to functional results of the surgical treatment of distal humerus intraarticular fractures in adults. Additionally, we evaluated the factors affecting surgical outcomes. Material and Method: Between 2005 to 2010, 22 elbows of 21 patients who were operated for distal humerus intraarticular fractures were evaluated retrospectively. 11(52.4%) patient were male and 10(47.6%) were female, mean age 46.2 (range 17 to 71). Fractures were classified as type B3 for 10, type Cl for 6 and type C2 for 6 subjects according to AO classifications. We performed paralel double locking plate for 9(41%), perpendicular double plate for 2(9%), K wires and screw combination for 7(32%), and single plate for 4(18%) patients. Functional assesment were performed with the MEPS and q-DASH scoring systems. Results: Mean follow-up was 30.4(5-68) months. Fracture healing was observed in all of the patients. Mean elbow flexion of 117 (90145) degrees and extension loss of 24.3 (0-60) were noted. 10 (47.6%) patients were excellent, 6 (28.6%) were goad, 3 (14.3%) were fair and 2(9.5%) were poor according to MEPS. Mean q-DASH scores were 15 (0-69.8) in 21 patients. Good results were obtained in fractures treated with stable fixation, in early performed surgeries, and in early started rehabilitation. Discussion: Treatment of distal humerus intraarticular fractures with anatomical reduction, stable osteosynthesis, and early rehabilitation are very important in obtaining successful outcomes. Additionally, age and fracture type are important factors to conclude good results..Publication Metadata only Comparison of Arthrodesis, Resurfacing Hemiarthroplasty, and Total Joint Replacement in the Treatment of Advanced Hallux Rigidus(2013-09-01T00:00:00Z) ERDIL, Mehmet; Elmadag, NUH MEHMET; POLAT, Gokhan; TUNCER, Nejat; Bilsel, Kerem; Ucan, Vandet; Erkocak, Omer Faruk; SEN, Cengiz; ELMADAĞ, NUH MEHMET; BİLSEL, İSMAIL KEREM; UÇAN, VAHDETThe purpose of the present study was to compare the functional results of arthrodesis, resurfacing hemiarthroplasty, and total joint replacement in hallux rigidus. The data from patients treated from 2006 to 2010 for advanced stage hallux rigidus were retrospectively reviewed. A total of 38 patients who had at least 2 years (range 24 to 66 months, mean 31.1) of follow-up were included in the present study. Of the 38 patients, 12 were included in the total joint replacement group (group A), 14 in the resurfacing hemiarthroplasty group (group B), and 12 in the arthrodesis group (group C). At the last follow-up visit, the functional outcomes were evaluated using the American Orthopaedic Foot and Ankle Society-Hallux Metatarsophalangeal Interphalangeal (AOFAS-HMI) scale, visual analog scale (VAS), and metatarsophalangeal range of motion. Significant improvements were seen in the AOFAS-HMI score, with a decrease in the VAS score in all 3 groups. According to the AOFAS-HMI score, no significant difference was found between groups A and B. However, in group C, the AOFAS-HMI scores were significantly lower than in the other groups owing to the lack of motion. According to the final VAS scores, no significant difference was found between groups A and B; however, the VAS score had decreased significantly more in group C than in the other groups. No major complications occurred in any of the 3 groups. After 2 years of follow-up, all the groups had good functional outcomes. Although arthrodesis is still the most reliable procedure, implant arthroplasty is also a good alternative for advanced stage hallux rigidus. (C) 2013 by the American College of Foot and Ankle Surgeons. All rights reserved.Publication Metadata only The olecranon osteotomy provides better outcome than the triceps-lifting approach for the treatment of distal humerus fractures(2014-01-01) Elmadag, Mehmet; ERDIL, Mehmet; Bilsel, Kerem; Acar, Mehmet Ali; TUNCER, Nejat; TUNCAY, İBRAHİM; ELMADAĞ, NUH MEHMET; BİLSEL, İSMAIL KEREM; TUNCAY, İBRAHİMPublication Metadata only Bilateral Shoulder Dislocation(2015-11-01) Bilsel, Kerem; SAYAR, Safak; CEYLAN, Hasan Huseyin; ERDIL, Mehmet; Elmadag, Mehmet; BİLSEL, İSMAIL KEREM; ELMADAĞ, NUH MEHMETAim: The aim of this case report is to discuss the evaluation of potential complications and treatment options associated with bilateral anterior shoulder dislocation. Material and Method: The data for this rarely encountered case was collected, during the consultation and treatment phases for a 66-year-old female patient who first presented at the emergency department of Bezmiaiem Vakif University Medical Center with restriction of movements in her both shoulders after falling down the stairs in her home. Results: Evaluation of the patient-s pre-operative X-rays and computed tomography (CT scan) images and post operative evaluation of the shoulders was achieved using DASH and the Constant shoulder score. Discussion: Osteoporotic elderly patients and their relatives should be informed of possible complications when considering closed reduction of severe glenoid and humeral head fractures. Instead, an associated risk will most likely necessitate open reduction in this patient population after anesthesia has been administered for closed reduction. Hence, obtaining consent and educating the patient about a possibile need for internal fixation and prosthetic joint replacement using surgical implants should be included in the preoperative consultation and treatment planning session before the patient receives sedation.Publication Open Access Excess retained cement in the posteromedial compartment after unicondylar knee arthroplasty(2013-07-01) Elmadag, Mehmet; IMREN, Yunus; ERDIL, Mehmet; Bilsel, Kerem; Tuncay, Ibrahim; ELMADAĞ, NUH MEHMET; BİLSEL, İSMAIL KEREM; TUNCAY, İBRAHİMAcute mechanical symptoms due to excess retained cement in the posterior compartment of the knee joint following unicondylar knee arthroplasty (UKA) are uncommon. Infection, aseptic loosening, polyethylene wear and progressive arthritis are well-documented complications of UKA procedure. We present a patient with acute pain and 'clicking' sensation in the knee joint due to cement extrusion in the posteromedial compartment after UKA. Full functional recovery was achieved after arthroscopic removal of the cement debris. Of retrospectively screened 43 UKA cases, asymptomatic cement extrusion was detected in 8 patients in the posteromedial compartment on direct X-rays. Careful inspection of components is essential to minimize the risk of cement extrusion into the posterior compartment and perioperative fluoroscopy may be helpful during UKA procedure.Publication Metadata only Acetabuloplasty at the anatomic centre for treating Crowe class III and IV developmental hip dysplasia: a case series(2016-08-01) Sen, Cengiz; Bilsel, Kerem; Elmadag, Mehmet; Gunes, Taner; SAYGI, Baransel; BİLSEL, İSMAIL KEREM; ELMADAĞ, NUH MEHMETIntroduction: Total hip replacement in patients with developmental dysplasia of the hip (DDH) is a difficult technical procedure for surgeons to perform because of the potential for these patients to have severe anomalies in their bones and soft tissues.Publication Metadata only Biomechanical Comparison of 2 Different Femoral Stems in the Shortening Osteotomy of the High-Riding Hip(2016-06-01) Tuncay, Ibrahim; Yildiz, FATİH; Bilsel, Kerem; Uzer, GÖKÇER; Elmadag, Mehmet; Erden, TUNAY; Bozdag, Ergun; TUNCAY, İBRAHİM; YILDIZ, FATİH; BİLSEL, İSMAIL KEREM; UZER, GÖKÇER; ELMADAĞ, NUH MEHMET; ERDEN, TUNAYBackground: We hypothesized that a rectangular cross-sectional femoral stem may produce more initial stability of the transverse subtrochanteric femoral shortening osteotomy rather than a circular cross-sectional stem.Publication Open Access Comparison of two types of proximal femoral hails in the treatment of intertrochanteric femur fractures(2015-09-01) Uzer, GÖKÇER; Elmadag, NUH MEHMET; Yildiz, FATİH; Bilsel, Kerem; Erden, TUNAY; Toprak, HÜSEYİN; UZER, GÖKÇER; ELMADAĞ, NUH MEHMET; YILDIZ, FATİH; BİLSEL, İSMAIL KEREM; ERDEN, TUNAY; TOPRAK, HÜSEYİNBackground: Hip nailing is frequently used to treat unstable intertrochanteric femoral fractures (ITF) in elderly patients. In this retrospective study, we compared the functional and radiological results, and the complications, of patients treated using proximal femoral nails (PFN) with an integrated, interlocking, compression lag screw, or two separate lag screws, which allow linear compression at the fracture site. Methods: A total of one hundred and eighteen patients were operated on for AO/OTA 31-A2 ITF between May 2010 and April 2012, and eighty-two of these patients, for whom sufficient follow-up data and documentation were available, were included into the study. PFNs with interlocking, integrated lag screws (Group I) were used in forty-four patients, and PFNs with two separate lag screws (Group II) in thirty-eight. Outcome parameters were the extent of varus collapse and leg length discrepancy on radiographs, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Harris hip scores (HHS) as functional results. Results: Mean follow-up duration was 20 months (range, 12-36 months); fractures healed in all patients. Mean varus collapse values were 2.03±5.68° and 5.21±5.27° (p=0.01), Harris hip scores 73.2±11.65 and 74.72±11.15 (p=0.54), and WOMAC scores 70.78±11.41 and 71.78±11.19 (p=0.69) in Groups I and II, respectively. No difference was detected between the groups in terms of outcome parameters or complication rate. Conclusion: In the treatment of ITF, PFNs with an integrated, interlocking, compression lag screw, or two separate lag screws did not differ in terms of functional and radiological results or complication rate.Publication Open Access Metatarsal head resurfacing hemiarthroplasty in the treatment of advanced stage hallux rigidus: outcomes in the short-term(2012-07-01) ERDIL, Mehmet; Bilsel, Kerem; IMREN, Yunus; MUTLU, Serhat; GULER, Olcay; Gurkan, VOLKAN; Elmadag, NUH MEHMET; Tuncay, Ibrahim; BİLSEL, İSMAIL KEREM; GÜRKAN, VOLKAN; ELMADAĞ, NUH MEHMET; TUNCAY, İBRAHİMObjective: The aim of this study was to evaluate the short-term outcomes of metatarsal head metal resurfacing hemiarthroplasty in patients with advanced stage hallux rigidus. Methods: The study included 14 feet (4 left, 10 right) of 12 patients (10 female, 2 male; mean age: 63 ± 5; range: 55 to 71 years) who underwent metatarsal head metal resurfacing hemiarthroplasty (HemiCAP(®)) between 2007 and 2010. Additionally, capsular release and periarticular osteophyte debridement were performed. Staging was made according to Coughlin and Shurnas' clinical and radiological grading system. Hallux valgus and intermetatarsal angles were measured using pre and postoperative standing AP and lateral foot views. Clinical assessment was made with first metatarsophalangeal joint range of motion, the AOFAS (American Orthopaedic Foot and Ankle Society) hallux metatarsophalangeal-interphalangeal scale and satisfaction level. Results: Mean follow up was 19.5 (range: 14 to 26) months. Two patients had bilateral involvement. According to Coughlin and Shurnas' clinical and radiological grading system, nine feet were Stage 3 and five feet were Stage 4. According to the AOFAS scale, results of eight feet (57.1%) were excellent, four feet (28.6%) were good and two feet (14.3%) were moderate. Mean total AOFAS score increased by 26.2 points postoperatively (p<0.05). Mean range of motion of the first metatarsophalangeal joint improved significantly from a preoperative 22.2 ± 5.6 (range: 10 to 28) degrees to a postoperative 56.3 ± 9.6 degrees (p<0.05). Mean hallux valgus angle decreased from a preoperative 14.3 (range: 9 to 17) degrees to a postoperative 11.1 (range: 4 to 13) degrees and the mean intermetatarsal angle increased from a preoperative 10.5 (range: 8 to 14) degrees to a postoperative 10.8 (range: 8 to 15) degrees. Patient satisfaction levels were very good in 10 feet (71.4%), good in 3 (21.4%), and moderate in one (7.2%). Complications included metatarsalgia aggravated by long walks in one patient and hypoesthesia of the great toe in three patients. Push-off power of the great toes was measured as 4/5 in three cases, and 5/5 in others. Conclusion: Metatarsal head metal resurfacing hemiarthroplasty provides high patient satisfaction level and good functional outcome in the short-term, in the surgical treatment of advanced stage hallux rigidus refractory to conservative treatment options.