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EROL, BÜLENT

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Now showing 1 - 10 of 23
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    PublicationOpen 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 Hilmi
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    PublicationOpen Access
    Management of orthopedic oncology patients during coronavirus pandemic
    (WILEY, 2020-09) EROL, BÜLENT; Sahbat, Yavuz; Buyuktopcu, Omer; Topkar, Osman Mert; Erol, Bulent
    The new measures implemented in hospitals also altered the operation of orthopedics and traumatology departments. The main purpose of this article is to discuss how orthopedic oncology clinics should be organized during the pandemic and to present the process management scheme for patients requiring orthopedic surgery, including trauma surgery, from diagnosis to treatment, together with our experiences. Instead of thinking about the global emergence of the epidemic, it is time to act decisively. At first glance, the coronavirus disease 2019 (COVID-19) pandemic and orthopedics may seem to be unrelated disciplines, but the provision of healthcare services to patients who require them proves that these two fields are parts of the same whole. Our experiences in treating neutropenic, lymphocytopenic, and chemotherapy patients seem to have proven beneficial during this process. We operated on 10 biopsy patients, 15 primary bone sarcomas, 9 soft tissue sarcomas, and 82 trauma patients within this time frame. Only three patients were suspected to have COVID-19 before admission. The early identification, strict isolation, and effective treatment of these patients prevented any nosocomial infections and disease-related comorbidities. This success is the result of the multidisciplinary cooperation of the Ministry of Health, our hospital, and our clinic.
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    PublicationOpen 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, Bulent
    Objective: 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.
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    PublicationOpen Access
    Evaluation of factors affecting survival rate in primary bone sarcomas with extremity and pelvis involvement
    (TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2020-06-15) EROL, BÜLENT; Sofulu, Omer; Erol, Bulent
    Objective: This study is an evaluation of the overall survival rate and factors affecting survival in patients with osteosarcoma, chondrosarcoma, or Ewing's sarcoma. 'This study aimed to determine the effect of factors related to the preoperative period, patient, tumor, treatment, and postoperative period on survival. Methods: A total of 114 patients (64 male and 50 female) with osteosarcoma, chondrosarcoma, or Ewing's sarcoma treated between 2005 and 2013 were included in this study. All the patients received standard treatment and were followed up regularly. In all, 44 cases of (conventional and telangiectatic) osteosarcoma, 30 cases of Ewing's sarcoma, and 40 cases of high-grade chondrosarcoma were identified using the Bone and Soft Tissue Tumor Registry. Gender, age, tumor size and localization, pathological fractures, histopathological type, grade, surgical treatment, adjuvant treatments, relapse of the disease, and postoperative complication data were obtained from follow-up forms. The learning curve of institutional expertise was also evaluated. The patient survival rate was calculated using the Kaplan-Meier method, and log-rank statistical methods were used to compare survival rates. Results: The mean length of survival of the patients was 72 months. There was a 56% 5-year survival rate, and the event-free survival rate was 53%. The survival of patients with Ewing's sarcoma whose prodromal period was less than 12 weeks was significantly higher than that of the other groups (p=0.031). The survival of patients with tumor size greater than 150 cc, with local recurrence and distant metastases was low for all groups. Survival rates were significantly lower in osteosarcoma and Ewing's sarcoma patients with stage III tumor or metastasis at diagnosis. The survival of patients with osteosarcoma diagnosed between 2010 and 2013 was significantly higher than that of the earlier group (p=0.02). Conclusion: Decreasing the prodromal period (early diagnosis) can improve survival by preventing the local and systemic spread of the tumor. Increase in the surgical experience is likely to have a positive effect on survival rates, especially for patients with osteosarcoma. The relapse of the disease is a poor prognostic factor for survival despite aggressive surgery and adjuvant therapies.
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    PublicationOpen Access
    Isolated volar surgical approach for the treatment of perilunate and lunate dislocations
    (SPRINGER HEIDELBERG, 2014-06) EROL, BÜLENT; Basar, Hakan; Basar, Betul; Erol, Bulent; Tetik, Cihangir
    Background: Volar and/or dorsal surgical approaches are used for surgical treatment of perilunate and lunate dislocations. There are no accepted approaches for treatment in the literature. We evaluated the functional results of isolated volar surgical approach for the treatment of perilunate and lunate dislocation injuries. Materials and Methods: 9 patients (6 male and 3 female patients average age 34.5 +/- 3.6 years) diagnosed with perilunate or lunate dislocations between January 2000 and January 2009 were involved in the study. The reduction was performed through isolated volar surgical approach and K-wire fixation, fracture stabilization with volar ligament repair was performed. Range of wrist joint motion, fracture healing, carpal stability, grip strength, return to work were evaluated and also direct radiographs were taken routinely at each control. The scapholunate interval and the scapholunate angle were evaluated radiographically. Evaluations of the clinical results were done using the DASH, VAS and Modified Mayo Wrist Scores. Results: The physical rehabilitation was started at 6th week, after the K-wires were removed. The average followup was 18.2 months (range 12-28 months). At the final followup, the average flexion extension arc was 105.0 +/- 9.6 degrees (74.6% of the other side), the average rotation arc was 138.8 +/- 7.8 degrees (81.5% of the other side) and the average radioulnar arc was 56.1 +/- 9.9 degrees (86.4% of the other side). The grip strength was 0.55 bar; 83.2% that the uninjured arm. According to the Mayo Modified Wrist score, the functional result was excellent in five patients and good in four and the average DASH score was 22.8. The scapholunate interval was 2.1 mm and scapholunate angle was 51 degrees. Conclusion: The clinical and radiological results of the isolated volar surgical approach were satisfactory. The dorsal approach was not needed for reduction of dislocations during operations. Our results showed that an isolated volar approach was adequate.
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    PublicationOpen 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.
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    PublicationOpen 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.
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    PublicationOpen Access
    Tricks and pitfalls in the surgical treatment of malignant bone tumours of the forearm in children and adolescents
    (BRITISH EDITORIAL SOC BONE & JOINT SURGERY, 2021-08) EROL, BÜLENT; Erol, Bulent; Sofulu, Omer
    Malignant bone tumours around the forearm are rare. Nowadays, oncological and surgical management of bone sarcomas of this region has improved significantly. Although the anatomical features are complex, limb-sparing surgery is possible with wide surgical resection. Biological reconstruction methods are promising in this anatomically unique region. In addition, meticulous soft-tissue reconstruction yields good functional results in the hand and wrist. This study reviews malignant bone tumours of the forearm and their oncological and surgical management. Malignant bone tumours should be treated with a multidisciplinary approach based on chemotherapy, radiotherapy and limb salvage procedures.
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    PublicationOpen 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.
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    PublicationOpen Access
    Does re-amputation following lower extremity amputation in diabetic or dysvascular patients negatively affect survival
    (2022-01-01) EROL, BÜLENT; Baysal O., Msangi W. J., Gunar B., EROL B.
    Objective: We aimed to investigate the characteristics of patients who underwent unilateral amputation due to diabetes and peripheral artery disease, as well as the risk factors that cause re-amputation, and to determine these patients’ survival status and the risk factors for mortality. Patients and Methods: This retrospective study included 133 patients who underwent amputation due to diabetes and peripheral arterial disease between 2012 and 2018. The etiology of amputation, the re-operation rate and time to re-operation following initial amputation, survival status and follow up results were accessed from hospital records. Results: Twenty-eight patients underwent amputation due to peripheral arterial disease, whereas 105 patients had peripheral vasculopathy due to diabetes mellitus. The re-operation rate was 33.8%, and the median period from initial surgery to the second surgery was six-weeks. Sixty-six deceased patients survived with a median of 6 months following initial operation. Conclusion: The most crucial factor causing re-amputation was the non-healing wound problems. Patients with amputation should be followed up carefully for wound problems in the six weeks after surgery. Advanced age, American Society of Anesthesiologist grade 4 patients, associating neurological disease, low albumin level, low lymphocyte count and postoperative intensive care unit requirement were all poor prognostic factors for survival. Re-amputation had no negative effect on survival..