Person: DURAK, KEMAL
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DURAK
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KEMAL
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Publication Entrapment of the brachial artery in the cancellous bone in pulseless supracondylar humerus fractures with well-perfused hands: Report of three cases(Turkish Joint Diseases Foundation, 2022-01-01) Ermutlu, Cenk; ERMUTLU, CENK; Sarısözen, Bartu; ATICI, TEOMAN; SARISÖZEN, MEHMET BARTU; Atıcı, Teoman; Durak, Kemal; DURAK, KEMAL; ÇAKAR, ADNAN; Çakar, Adnan; 0000-0001-8259-3695; 0000-0003-4071-8052; ABI-7283-2020Management of pediatric pulseless supracondylar humerus fractures is a point of continuous debate. In this article, we present three cases admitted to the emergency department with pulseless, but well-perfused hands. The fractures were reduced and fixed using the antecubital approach. Prior to reduction, the brachial arteries of all three patients were entrapped in the cancellous bone of the proximal fragment segment. The arteries could only be released after freeing the adventitia by carefully scraping the adjacent bone with the tip of a hemostat. One case required thrombectomy through an arteriotomy using No. 3 Fogarty catheter. In two cases, the pulse returned after a brief period of waiting with no need for vascular intervention. Proceeding with closed reduction, as proposed by the recent guidelines, would result in further damage to the entrapped vasculature, which may go unnoticed due to collateral circulation.Publication Less malunion and shorter bone union time with titanium elastic nail treatment for isolated femoral shaft fractures in three- to six-year-old children(Springernature, 2022-02-18) Eken, Gökay; EKEN, GÖKAY; Ermutlu, Cenk; ERMUTLU, CENK; Sarısözen, Bartu; SARISÖZEN, MEHMET BARTU; Atıcı, Teoman; ATICI, TEOMAN; Çakar, Adnan; DURAK, KEMAL; ÇAKAR, ADNAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; 0000-0003-4071-8052; 0000-0002-3396-3407; AEQ-5464-2022; ABE-9918-2021Purpose Titanium elastic nail (TEN) is a good option for femoral shaft fractures in school-age children, whereas a spica cast is favored for younger patients. We aimed to compare these treatment modalities in a group of children aged three to six years. Methods 34 patients aged 3-6 years with an isolated closed femoral shaft fracture treated with TEN or one-leg spica cast immobilization were retrospectively assessed. Age, gender, weight, mechanism of injury, hospital stay time, bone union time, radiographic shortening, malunion, and complications were compared between the treatment groups. Results 16 (47.1%) patients who were treated with TEN (Group T) and 18 (52.9%) patients with spica casting (Group S) were included with a mean of 51 (24-94) months follow-up. The mean age was 4.98 years and statistically similar between both groups (mean, 5.2 vs. 4.8 years; p = 0.234). The patients in Group T were heavier (mean, 19.3 vs. 17.2 kg; p < 0.001) and were more likely to have a higher-energy mechanism of injury (p = 0.006). The mean late femoral shortening of Group S patient's was 6.5 +/- 3.5 mm and significantly higher than Group T, which was 2.0 +/- 2.9 (p = 0.050). However, effective late femoral shortening rates were not statistically different between groups (p = 0.347). Malunion was seen in six (33.3%) patients in Group S, whereas none of the patients in Group T had malunion at the last follow-up examination and were statistically different (p = 0.011). Conclusion Our study identified radiographic evidence favoring TEN over spica cast immobilization in treating preschool-age children with an isolated femoral shaft fracture in terms of malunion.Publication Outcomes of cable fixation after vancouver type b1 periprosthetic femoral fractures(Turkish Assoc Trauma Emergency Surgery, 2023-11-01) Yenigül, Ali Erkan; Ermutlu, Cenk; Önder, Cem; Atıcı, Teoman; Durak, Kemal; YENİGÜL, ALİ ERKAN; ERMUTLU, CENK; ÖNDER, CEM; ATICI, TEOMAN; DURAK, KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; 0000-0002-3396-3407; 0000-0002-8289-8867; AFH-1678-2022; A-5095-2018; AEQ-5464-2022; JKS-7654-2023; COU-4147-2022BACKGROUND: In this study, it was aimed to evaluate the patients who underwent cable plate fixation due to a Vancouver-type B1 periprosthetic femur fracture and their clinical results.METHODS: Vancouver-type B1 patients who were operated on for periprosthetic fractures between 2014 and 2019 were investigated. Age, gender, body mass index (BMI), follow-up time, operation time, bleeding amount, non-union fracture, last surgery before fracture, the time between previous surgery and fracture, implant survival, patient survival, and complications were recorded. In addition, the postoperative clinical functions of these patients were compared. RESULTS: 23 patients who met the study criteria (Vancouver type B1 fracture) were identified. The mean age of the patients was 60 (49-76) years, the mean BMI was 26.3 (17.5-40.7), and the postoperative mean follow-up period was 14 (6-36) months. Considering the gender distribution, there were 5 (22%) men and 18 (78%) women. The mean time between the last surgery before the fracture and the fracture was 6 months (0-30). While the mean operation time was 95 min (60-180), the average amount of bleeding was 310 mL (150-600). Functional evaluations of patients: In total, five patients had decreased ambulatory abilities after surgery. Nonunion was observed in 2 patients during the follow-ups, and these patients underwent open surgery for treatment.CONCLUSION: Cable and locking plate applications are successful in Vancouver type B1 fractures, which are one of the most common forms of periprosthetic fractures. In this technique, the duration of the operation can be shortened under ideal conditions, and the need for blood and blood products is reduced as blood loss is reduced. If there is a complication, you still have the chance to treat it with the option of revision arthroplasty.