Person: EROL, BÜLENT
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EROL
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BÜLENT
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Publication Metadata only A treatment strategy for proximal femoral benign bone lesions in children and recommended surgical procedures: retrospective analysis of 62 patients(SPRINGER, 2016) EROL, BÜLENT; Erol, Bulent; Topkar, Mert Osman; Aydemir, Ahmet Nadir; Okay, Erhan; Caliskan, Emrah; Sofulu, OmerWe aimed to develop a surgical treatment strategy for benign bone lesions of the proximal femur based upon retrospective review of our data in 62 children. Sixty-two children [38 male, 24 female; median age 9 years (range 5-18 years)] with proximal femoral benign bone lesions were surgically treated between 2005 and 2013. Histopathological diagnoses were simple (31) or aneurysmal (27) bone cysts, and nonossifying fibromas (4). The pathological fracture rate was 77.4 %. Surgical treatment was determined due to four criteria, including patient's skeletal maturity, localization and initial diagnosis of lesion, and amount of bone loss in the femoral neck and lateral proximal femur. Surgical procedure consisted of biopsy, curettage, bone grafting, and internal fixation when required. The median follow-up was 45 months (range 25-89 months). Complete clinical recovery was achieved in 56 (90.3 %) patients between 4 and 8 months postoperatively; full weight-bearing and mobilization, without pain and limping, was possible. The median preoperative and postoperative last follow-up Musculoskeletal Tumor Society (MSTS) scores were 13.3 % (range 10-23.3 %) and 96.6 % (range 90-100 %), respectively (p < 0.0001). The pathological fractures were healed in 10 weeks on average (range 8-12 weeks). Fifty-seven (92 %) patients demonstrated complete or significant partial radiographic healing between 5 and 7 months that maintained throughout follow-up. Local recurrence was not observed, and only 1 (1.6 %) patient required reoperation for partial cyst healing. There were 5 (8 %) complications, 1 (1.6 %) of which required reoperation. This treatment strategy can provide good local control and excellent functional and radiological results in the management of benign bone lesions of the proximal femur in children.Publication Metadata only Biomechanical determination of the relationship between femoral neck lesion size and the risk of pathological fracture(SAGE PUBLICATIONS LTD, 2016) EROL, BÜLENT; Caypinar, Baris; Erol, Bulent; Topkar, Mert; Basci, OnurPurpose: Half of the pathological fractures of the proximal femur occur in the neck region. We evaluate the relationship between the defect size within the femoral neck and the risk of pathological fracture. Methods: After creating metastasis-like lesions in the neck regions of 21 human cadaver femurs, compression was applied to simulate single-limp stance type loading. First, a loading of 600 Newtons (N) was applied to the 35%-defected femoral necks. If the bone fracture did not occur, the defect size was increased to 45% and the 600 N force was applied again. If no fracture was observed then the defect size was increased to 55% and the bones were loaded again. The 55%-defected bones with no fractures were loaded until a fracture was detected. Results: There were no fractures with the 35%- and 45%-defected femurs until 600 N was applied. However, when the defect size was increased to 55%, 3 bones were fractured before reaching 600 N. The fractures occurred at an average of 455 N in the 3 bones. At a compression of 600 N, 18 bones (84%) were intact, and the loading was continued. 18 femurs with 55%-defected neck regions had an average endurance of 1270 N compression (range 750-2800 N). Conclusions: This study showed that even very osteoporotic bones with large metastases can withstand high forces of compressive loading.