Person: AKGÜLLE, AHMET HAMDİ
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AKGÜLLE
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AHMET HAMDİ
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Publication Open Access Effect of rotational deformities after pediatric femoral fracture on clinical outcome(2022-03-01) AKGÜLLE, AHMET HAMDİ; KESİMER, MEHMET DENİZ; Igrek S., AKGÜLLE A. H., KESİMER M. D.Femoral shaft fractures are the most common pediatric injuries that require hospitalization. Early closed reduction and spica casting are one of the most popular treatment options. One of the significant complications of spica casting is rotational deformities of the fracture. The present study aimed to determine the potential effects of rotational deformities in pediatric patients who underwent early spica casting after a femoral shaft fracture. Pediatric patients who underwent early spica casting following femoral shaft fractures were screened retrospectively. Radiological measurements were made on the patients\" initial postop radiographs who could be measured rotationally according to the defined radiological method. Twenty-three patients with more than 10 degrees of rotation in their measurements were included in the study. Differences in leg length and rotation between both legs were calculated with clinical examination methods for all patients in the study. The gaits of the patients were observed; patient and family complaints were obtained. We found a strong and positive correlation between the rotational measurement made on the X-ray and the clinical measurement (R: 0.634, P: 0.001). For measurements made on X-ray, the mean rotational value was calculated as 27.2 +/- 6.9 degrees. After the patients\" clinical examination, an average of 3.0 +/- 1.7 degrees rotational difference was found between the broken limb and the healthy limb. No patient or family complained of trauma. Early spica casting, according to the age of the patient, is an effective treatment method. There may still be certain degrees of deformity after treatment, but patients well tolerate them even at high degrees. Accordingly, it was concluded that the rotational deformities less than 30 degrees would not cause clinical problems on children under 4 years of age which may require postoperative revisions or the use of various costly imaging techniques and include radiation.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 Metadata only Pros and cons of botulinum toxin injection therapy in cerebral palsy: A qualitative study exploring caregivers' perspective(WILEY) AKGÜLLE, AHMET HAMDİ; Karadag-Saygi, Evrim; Kenis-Coskun, Ozge; Unalan, Pemra C.; Evkaya-Acar, Ayca; Giray, Esra; Akgulle, Ahmet HamdiBackground To describe and understand the experiences and beliefs of caregivers of children with cerebral palsy following botulinum toxin injection. Methods A descriptive case study approach with focus group interviews was employed. A semi-structured questionnaire was conducted to collect data. Twenty-one caregivers of children (3-13 years old) with cerebral palsy were recruited with a maximum variation sampling strategy to gain insight through different perspectives. Qualitative analysis with verbatim transcripts was analysed using a thematic approach. Findings Four themes emerged from qualitative analyses: acceptance of diagnosis, perceptions about treatment, caregivers' experiences with the health environment, and feelings and thoughts after the treatment. Conclusions This study highlights caregivers' requests for information about the possible long-term effect of botulinum toxin, as well as information and support to provide the best rehabilitation programme immediately after injection.Publication Open Access Cystic Fibrosis with Paediatric Femoral Neck Stress Fracture: A Case Report and the Review of Literature(GALENOS YAYINCILIK, 2021-08-01) AKGÜLLE, AHMET HAMDİ; Sahbat, Yavuz; Akgulle, Ahmet HamdiCystic fibrosis is a common genetic disease of the white population with autosomal recessive inheritance. It may present with sinopulmonary, gastrointestinal, genitourinary, bone and joint findings. Osteoporosis, osteopenia, and fractures are musculoskeletal problems related to the disease. Although vertebral fractures are common, non-vertebral fractures have been reported rarely. In this case report, we present the case of a 9-year-old girl with osteopenia-induced femoral neck stress fracture caused by cystic fibrosis. During hospitalization for sinopulmonary infection, the patient presented to our clinic with left thigh pain without trauma. The left hip joint was examined and found to be clear. Anterior posterior X-ray examination of the patient, who had difficulty in stepping, revealed no displaced fracture. The patient was later diagnosed with type 2 Fullerton & Snowdy fracture, and surgical fixation was ruled out. The patient was successfully treated with non-steroidal anti-inflammatory drugs and immobilization.Publication Open Access Does ultrasound imaging of the spastic muscle have an additive effect on clinical examination tools in patients with cerebral palsy?: A pilot study(2022-01-01) AKBAŞ, FIRAT; YAĞCI, İLKER; AKGÜLLE, AHMET HAMDİ; KARADAĞ SAYGI, NAİME EVRİM; Atalay K. G., Saygi E. K., AKBAŞ F., Coskun O. K., AKGÜLLE A. H., YAĞCI İ.OBJECTIVE: The Modified Ashworth Scale, the Modified Tardieu Scale, and measuring the passive range of motion is commonly preferred examination tools for spasticity in cerebral palsy (CP). Ultrasonography has become increasingly used to provide relevant insight into spastic muscle morphology and structure recently. It was aimed to reveal associations between the clinical and ultrasonographic parameters of gastrocnemius medialis (GM) and lateralis muscles in this population. METHODS: Thirty-four children with spastic CP aged between 4 and 12 years who did not have botulinum neurotoxin A intervention within 6 months or had no previous history of any orthopedic or neurological surgery were included. The spasticity of GM and lateralis was evaluated firstly by the Modified Ashworth Scale, Modified Tardieu Scale, and ankle passive range of motion. Then, the cross-sectional area (CSA), muscle thickness (MT), qualitative and quantitative echo intensity (EI) values of both muscles were measured from their ultrasonographic images. RESULTS: The CSA of GM, and qualitative EI of both muscles were found to be mild-to-moderately correlated to all clinical examination tools (p<0.01), whereas the CSA of gastrocnemius lateralis was mildly related to Modified Ashworth Scale (p=0.009). The MT and quantitative EI of both muscles were not associated with any of the clinical tools (p>0.05). CONCLUSION: Ultrasonographic measurements of GM and lateralis partially reflect ankle spasticity in children with CP. Ultrasonography can be used as an alternative tool in this patient population where the clinical evaluation can not perform ideally.