Person: ŞİRİN, EVRİM
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ŞİRİN
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EVRİM
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Publication Open Access Surgeons Experience and Consistency to Determine Surgical Procedures for Hallux Valgus(2020) EROL, BÜLENT; Sirin, Evrim; Yılmaz, Barış; Ozdemir, Guzelali; Okay, Erhan; Bildik, Celaleddin; Ak, Dursun; Erol, Bulent; Muratlı, Hasan HilmiPublication Open Access Indications of amputation after limb-salvage surgery of patients with extremity-located bone and soft-tissue sarcomas: A retrospective clinical study(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2021-04-07) EROL, BÜLENT; Baysal, Ozgur; Saglam, Fevzi; Sofulu, Omer; Yigit, Okan; Sirin, Evrim; Erol, BulentObjective: This study aimed to investigate amputation-related factors after limb-salvage surgery (LSS) in patients with extremity-located bone and soft-tissue sarcomas and determine the relationship between these factors and patient survival. Methods: In this retrospective study at our institution, patients in whom LSS was first performed because of an extremity-located musculoskeletal sarcoma, and subsequently amputation was carried out for various indications were included. Patient and tumor characteristics, details of surgical procedures, indications of amputation, number of operations, presence of metastasis before amputation, and post-amputation patient survival rates were analyzed. Results: A total of 25 patients (10 men, 15 women; mean age=41.96 +/- 21.88 years), in whom amputation was performed after LSS as initial resection of an extremity sarcoma or re-resection(s) of a local recurrence, were included in the study. The leading oncological indication for amputation was local recurrence that occurred in 18 (72%) patients. Non-oncological indications included prosthetic infection in 5 (20%), mechanical failure in 1 (4%), and skin necrosis in 1 (4%) patient. The patients underwent a median of 2 (range, 1-4) limb-salvage procedures before amputation. Distant organ metastasis was detected in 22 (88%) patients during follow-up; in 13 (52%) of these patients, metastasis was present before amputation. A total of 11 (44%) patients were alive at the time of study with no evidence of the disease (n=3) or with disease (n=8), and 14 (56%) patients died of disease. The mean overall and post-amputation survival were 47 +/- 20.519 (range, 11-204) months and 22 +/- 4.303 (range, 2-78) months, respectively. The median follow-up was 27 (range, 6-125) months. Conclusion: The most common causes of amputation after LSS were local recurrence and prosthetic infection. Patients who underwent amputation after LSS developed a high rate of distant organ metastasis during follow-up and had reduced survival.Publication Open Access Do Plates Used for Internal Fixation During Fracture Healing Maintain Their Metal Structure and Function?(2019-01-01) ŞİRİN, EVRİM; Yılmaz B., KÖMÜR B., ŞİRİN E., AKTAŞ E., YILMAZ C., HEYBELİ N.Amaç: Ekstremite kırık fiksasyonu için kullanıldıktan sonra çıkarılan düz Dinamik Kompresyon Plaklar (DCP), üst (Grup 1) - alt (Grup 2) ekstremitede kullanımlarına göre 2 gruba ayrıldılar. Kullanımları sürece metalik yapı ve özellikleri radyografik, penetrant ve kimyasal analizleri yapılarak değerlendirildiler. Yöntem: Gruplara göre olguların cinsiyet, yaş ortalamaları, taraf dağılımları ve çıkarılma süreleri arasında istatistiksel olarak anlamlı bir farklılık bulunmamaktadır (p>0.05). Bulgular: Tüm plakların radyolojik ve penetrant değerlendirmelerinde hiçbir mikrokırığa rastlanmadı. Aynı zamanda plakların kimyasal metal analizlerinde hiçbir metal kaybı ya da metal oran değişikliği gözlenmedi. Sonuçta plakların işlev gördükleri süreç içinde zarar görmemiş olması, yapılan tedavilerde metal bileşiminde dayanıklılık açısından ek bir kazanç sağlamadığını göstermiştir. Sonuç: Yüke maruz kalan bölgede zarar görmeyen plakların aynı dayanıklılıkta yüke maruz kalmayan bölgede de kullanılıyor olması bu bölgeler için dayanıklılık özelliklerini kaybetmeden daha az metalik içerikli, ince profilli ve daha ucuza mal edilebilir plaklar üretilmesi yönünde çalışmalar yapılabilirPublication Open Access Lateral Antebrachial Cutaneous Nerve as a Donor Source for Digital Nerve Grafting: A Concept Revisited(2017) CANSÜ, CENGİZ EREN; Unal, Mehmet Bekir; Gokkus, Kemal; Sirin, Evrim; Cansü, ErenObjective: The main objective of this study is to evaluate the availability of lateral antebrachial cutaneous nerve (LACN) autograft for acute or delayed repair of segmented digital nerve injuries. Patients and Methods: 13 digital nerve defects of 11 patients; treated with interposition of LACN graft that harvested from ipsilateral extremity were included in the study. Mean follow up period was 35, 7 months. The mean time from injury to grafting is 53, 3 days. The results of the mean 2PDT and SWMT values of injured /uninjured finger at the end of follow up period were evaluated with Paired T test. The correlation between the defect length and the difference of 2PDT, SWMT values between the uninjured and injured finger at the end of follow up period; were evaluated with Pearson - correlation analysis. Results: The mean value of our 2PDT and SWMT results are ~5,923, ~3, 52, respectively in which can be interpreted between the normal and diminished light touch. The defect length and difference percentage of SWMT values is positively and significantly correlated statistically. Mean length of interposed nerve grafts was 18.5 mm. The age of the patient and the mean values of 2PDT and SWMT with the difference % of 2PDT and % of SWMT are not statistically correlated. Conclusion: Based on results regarding sensory regaining at recipient side and negligible sensory deficit at harvesting side, we suggest that lateral antebrachial cutaneous nerve might be a valuable graft option for digital nerve defects.Publication Open Access Floating phalanx; simultaneous double dislocation of the interphalangeal joint in a finger: A case report and literature review(2022-06-01) ŞİRİN, EVRİM; Saglam F., Baysal Ö., Saglam S., Sirin E., Sofulu O.Isolated proximal and distal interphalangeal joint (DIPJ) dislocations are widely seen as a result of sporting injuries and major trauma. The combination of dorsal dislocation of the DIPJ in the same finger concomitant to traumatic dorsal dislocation of the proximal interphalangeal joint (PIPJ) is a rarely seen injury. The case is, here, presented of a 65-year-old female patient with proximal and DIPJ dislocation of the right-hand ring finger accompanied by volar and dorsal plate injuries in the proximal and distal joints.With this case, it was aimed to introduce a new term of \"floating phalanx\" into medical literature.The treatment was applied to the patient of closed reduction under peripheral block and the application of an aluminium finger splint in semiflexion. In a 24-month follow-up period, the 4th finger of the patient was observed to be stable and has pain-free range of movement. This case is an uncommon case of volar and dorsal plate avulsion fractures with PIPJ and DIPJ dorsal dislocation treated successfully with closed reduction and conservative treatment with excellent functional results.Publication Open Access The mid-term results of minimal medial epicondylectomy and decompression for cubital tunnel syndrome(2004-01-01) EROL, BÜLENT; ŞİRİN, EVRİM; EROL B., TETİK C., ŞİRİN E.Objectives: We evaluated the mid-term follow-up results of patients who were treated by minimal epicondylectomy and decompression for cubital tunnel syndrome. Methods: The study included 17 elbows of 15 patients (9 females, 6 males; mean age 45 years; range 35 to 63 years) who underwent minimal medial epicondylectomy and in situ decompression for cubital tunnel syndrome, which was diagnosed through history, physical examination, and electrodiagnostic tests. Before surgery, all the patients received various conservative treatments for at least six months, with no beneficial effect. Thirteen patients had unilateral, two patients had bilateral involvement, with 11 elbows on the dominant side. The mean duration of symptoms was 14 months (range 8 to 36 months). Preoperative grading of nerve compression according to the McGowan system was as follows: three patients (20%) grade I, 11 patients (73.3%) grade II, and one patient (6.7%) grade III. The results of surgical treatment was evaluated according to the Wilson-Krout criteria. The mean follow-up was 32 months (range 25 to 64 months). Results: Symptomatic improvement was achieved in all the patients. The results were excellent in 11 elbows (64.7%), good in five elbows (29.4%), and fair in one elbow (5.9%). None of the patients developed ulnar nerve palsy or subluxation, medial elbow instability, or weakness of the flexor-pronator origin. Pain and tenderness detected at the osteotomy site in four elbows disappeared after a mean of three months. Conclusion: Minimal medial epicondylectomy and decompression was found to be a safe and effective method with a low complication rate in the treatment of cubital tunnel syndrome.Publication Open Access Immobilization after pediatric supracondylar humerus fracture surgery: Cast or splint(2022-01-01) ŞİRİN, EVRİM; POLAT, MURAT; ŞAHBAT, YAVUZ; EROL, BÜLENT; AKGÜLLE, AHMET HAMDİ; AKGÜLLE A. H., ŞİRİN E., Baysalo O., POLAT M., Sahbat Y., EROL B.Objective: While surgical treatment is the most accepted treatment method for displaced supracondylar humerus fractures in children, there is little data about immobilization method after surgery. The aim of the study is to determine whether there is any difference in preventing loss of reduction between long-arm cast and long-arm splint following pediatric supracondylar humerus fracture surgery. Patients and Methods: We conducted a retrospective analysis of pediatric patients with supracondylar humerus fractures treated operatively between 2012 and 2019 at a university hospital. According to Skaggs criteria, early postoperative and 3rd-week follow-up X-rays were evaluated for the loss of reduction (LOR). Postoperative immobilization method; splint or cast was compared in the context of LOR. Results: Cast immobilization was found to be superior in preventing LOR in the first three weeks postoperatively (p˂0.05). There was no significant difference for other factors like fracture configuration, patient age and surgical technique. Conclusion: Cast immobilization is superior to splint immobilization in preventing radiologic LOR after pediatric supracondylar humerus fracture surgery however, clinical relevance of this conclusion is yet to be proved.Publication Open Access Reconstruction of Advanced Periacetabular Metastatic Lesions with Modified Harrington Procedure(2017-05-01) TOPKAR, OSMAN MERT; ŞİRİN, EVRİM; EROL, BÜLENT; AYDEMİR A. N. , TOPKAR O. M. , TOKYAY A., ŞİRİN E., EROL B.Objective: The purpose of this study was to assess the outcomes of patients who had been treated by a modified Harrington procedure for advanced periacetabular metastases. Methods: Between 2006 and 2013, 16 patients with a mean age of 57 years (range: 28–73 years) were treated using a modified Harrington technique. Extensive (class II/III) periacetabular defects were due to metastatic carcinoma or multiple myeloma. Surgical procedure included total hip replacement and acetabular reconstruction using threaded pins, cemented acetabular reinforcement ring, and/or polyethylene cup. Results: All patients improved in regard to pain and walking ability. Mean preoperative and postoperative Musculoskeletal Tumour Society (MSTS) functional scores were 52.8% (range: 33.3–73.3%) and 72% (range: 56.6–90%), respectively (p<0.05). There were 5 (31%) early or late complications requiring additional surgery. Implant survival was 75% and 37.5% at 12 and 18 months, respectively. Mean survival of the patients was 21 months (range: <1–6 years). Six remained alive, with a mean survival of 27 months (range: 18 months to 5 years). Conclusion: This modified Harrington procedure can be used for reconstruction of advanced periacetabular metastatic lesions. Keywords: Harrington procedure; periacetabular metastasis; surgical treatment. Level of Evidence: Level IV - Case series, Therapeutic study.Publication Open Access 1. Ulusal Çocuk Ortopedisi Kongresi’nde Sunulan Bildirilerin YayınaDönüşme Oran ve Özellikleri: Bibliyometrik Analiz(2021-01-01) ŞİRİN, EVRİM; AKGÜLLE, AHMET HAMDİ; AKGÜLLE A. H., ŞİRİN E.GİRİŞ ve AMAÇ: Bir kongrede sunulan bildirilerin yayına dönüşme oranları, aldıkları atıf sayıları ve yayınlandıkları dergilerin kaliteleri, kongrenin değerini belirleyen faktörler arasında kabul edilirler. Bu çalışmanın amacı; 1. Ulusal Çocuk Ortopedisi Kongresi’nde sunulan sözel ve poster bildirilerin yayına dönüşme oran ve özelliklerini değerlendirmektir. YÖNTEM ve GEREÇLER: Birinci Ulusal Çocuk Ortopedisi Kongresi bildiri özetlerine Çocuk Ortopedisi Derneğinin resmi internet sitesinden ulaşıldı. Yazar isimleri kullanılarak yayınlar bilimsel arama motorları üzerinden tarandı. Çalışmalar; dergi, kongre ile yayın olmaya kadar geçen süre, dergilerin etki faktörü ve Scimago puanı, kayıtlı oldukları indeks, atıf sayısı ve ilk yazarın bağlı oldukları kurum özellikleri açısından değerledirildi. BULGULAR: Kongre ile çalışma arası sürede bildirilerin %36,7'si yayına dönüşmüştü. Sözlü bildirileri yayınlayan dergilerin etki faktörü 1,524 (0,39-4,154) ve Scimago puanı 0,75 (0,265-1,57) iken bu değerler poster sunumlar için sırası ile 1,051 (0,39-2,383) ve 0,663 (0,355-1,129) olarak hesaplandı. Sözel bildirler kongre sonrası ortalama 20,9 ayda yayınlanırken, poster bildiriler için bu süre 23,75 aydı. Dört yıllık sürenin sonunda sözel bildiriler 0-25, poster bildiriler 0-8 atıf almışlardı. İlk yazarların bağlı olduğu kurumlar; 32 üniversite hastanesi, 18 eğitim araştırma hastanesi, 6 devlet hastanesi ve 5 özel hastane şeklindeydi. TARTIŞMA ve SONUÇ: Birinci Ulusal Çocuk Ortopedisi kongresinde sunulan sözel bildirilerde daha fazla olmak üzere yüksek oranda yayına dönüşmüşlerdir. Kongre ile ile yayına dönüşme arası süre biraz uzun olsa dahi, yüksek kalitede dergilerde yayınlanmışlardır.Publication Open Access The anatomical relationship of the neurovascular structures in direct posterior lateral gastrocnemius split approach for posterolateral tibial plateau fractures(2018-06-01) ŞİRİN, EVRİM; Ozdemir G., Yilmaz B., Sirin E., KESKİNÖZ E. N. , Kirikci G., BAYRAMOĞLU A.Purpose To evaluate the distances between the incision and neurovascular structures in direct posterior split-gastrocnemius approach for tibial plateau fractures. Methods Thirteen fresh-frozen cadavers were used in the study. The distance between the neurovascular structures medial and lateral to the incision was measured from the tibial joint line and at a level 5 cm distal to the joint line. Results The mean distance between the incision and medial neurovascular structures was 10.09 ± 3.47 mm (range 5.63–16.51 mm) at the level of the tibial joint line and 10.39 ± 2.57 mm (range 5.79–14.09 mm) at a level 5 cm distal to the joint line. The mean distance between the incision and the common peroneal nerve was 13.44 ± 4.17 mm (range 6.28–20.72 mm) at the level of the tibial joint line and 19.56 ± 5.24 mm (range 12.58–26.74 mm) at a level 5 cm distal to the joint line. Conclusions In isolated posterolateral tibial plateau fractures, it is possible to apply anatomical reduction and buttress plating on the posterior surface with a direct posterior split-gastrocnemius approach. With a thorough understanding of the regional anatomy, this approach can be safely performed by experienced orthopaedists