Person: AKGÜLLE, AHMET HAMDİ
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AKGÜLLE
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AHMET HAMDİ
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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 Supracondylar humerus fractures in ınfants and early toddlers; characteristics, clinical and radiological outcomes compared with older children(2022-09-01) AKGÜLLE, AHMET HAMDİ; ŞAHBAT, YAVUZ; EROL, BÜLENT; AKGÜLLE A. H. , Sahbat Y., Baysal O., Kart H., EROL B.Background Supracondylar humerus fractures (SCHF) are rarely seen in the youngest age groups (1-3 years). Although there is no difference in the context of treatment options, it has been shown that younger age groups have different characteristics. Few studies have examined toddlers, which have notably different characteristics. This study is the first to report the characteristics, diagnosis, treatment and functional results of SCHF in infants and early toddlers. Methods A retrospective analysis was made of the data of patients younger than 30 months old, who were operated on in our clinic for SCHF between 2012 and 2020 with at least 2 years of follow-up. Patient demographic and surgical data, and the functional and radiological results were documented. Results Evaluation was made of a total of 52 patients comprising 30 females (58%) and 22 males (42%), with a mean age of 20.75 +/- 5.4 months (range, 6-30 months). The injury was in the right elbow in 24 (46%) patients. The mechanism of injury was a fall from an object at home (table, chair, bed, etc.) in 41 (79%) patients. Patients who fell from a height of more than 4 meters had additional injuries (liver laceration, vertebral fracture, etc.). Only 1 patient had anterior interosseous nerve (AIN) damage before the operation, but the final follow-up neurovascular examinations for all patients were normal. The median follow-up period was 4 years (range, 2-7 years). Flynn outcome scores were (88.5%) excellent and variant Hospital for Special Surgery scores were (82.7%) excellent. Conclusions With appropriate treatment of SCHF, the clinical outcomes in infants and early toddlers are excellent. Using a medial pin to achieve and protect stability in this age group does not increase the risk of iatrogenic ulnar nerve damage. Patients younger than 20 months tend to have more varus malalignment but similar functional results.Publication Open Access Mid-term results of intralesional extended curettage, cauterization, and polymethylmethacrylate cementation in the treatment of giant cell tumor of bone: A retrospective case series(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2020-10-30) AKGÜLLE, AHMET HAMDİ; Sirin, Evrim; Akgulle, Ahmet Hamdi; Topkar, Osman Mert; Sofulu, Omer; Baykan, Said Erkam; Erol, BulentObjective: The aim of this study was to present the mid-term functional outcomes and recurrence rate in patients with giant cell tumor of bone (GCTB) treated by intralesional extended curettage, electrocauterization, and polymethylmethacrylate (PMMA) cementation. Methods: In this retrospective observational study, 79 consecutive patients (41 females, 38 males; mean age=39 years; age range=19-62 years) who were diagnosed and treated for GCTB between 2005 and 2017 were identified from hospital medical records. All patients were treated by intralesional extended curettage using high-speed burr, electrocauterization of the cavity, and filling the defect with PMMA. No additional local adjuvants were used. The mean follow-up period was 47 months (range=24-96). The tumors were graded according to the radiological classification system described by Campanacci. Functional outcomes were evaluated using the Musculoskeletal Tumor Society Score (MSTS) preoperatively, one year postoperatively, and at the final follow-up. Postoperative complications and recurrence rates were recorded. Results: Twenty-nine tumors were located in the distal femur, 23 in the proximal tibia, nine in the distal radius, five in the proximal humerus, five in the pelvis, three in the proximal fibula, two in the distal ulna, two in the distal tibia, and one in the second metatarsal. According to Campanacci classification, 37 tumors were grade III, 32 grade II, and 10 grade I. The mean MSTS score was 46.1% (range 40.2 to 71.4%) preoperatively, 91.7% (range 73.3% to 100%) one year postoperatively, and 86.3 % (range 66.2% to 96,1%) at the final follow-up. The overall complication rate was 7.6%; which included local tumor recurrence in four patients, superficial wound infection in one, and deep wound infection in another. The recurrence rate was 5.1% (4 patients). Recurrent tumors were located at the distal femur in three patients and proximal tibia in one. Conclusion: With satisfactory functional results and low recurrence rates at the mid-term follow-up, GCTB can be treated effectively with intralesional extended curettage, electrocauterization, and PMMA cementation.Publication Open Access Factors affecting postmusculoskeletal tumour surgery wound problem treatment with negative pressure wound therapy(WILEY, 2020-06) AKGÜLLE, AHMET HAMDİ; Baysal, Ozgur; Saglam, Fevzi; Akgulle, Ahmet Hamdi; Sofulu, Omer; Yigit, Okan; Sirin, Evrim; Erol, BulentThe aim of the study is to investigate the risk factors identified in literature that have been associated with prolonged Negative Pressure Wound Therapy (NPWT). Our study included patients who developed local wound problems after bone or soft tissue sarcoma surgery with negative margin at our clinic between 2012 and 2018 and treated with NPWT. All patients were followed up of at least 6 months. Sex, albumin level, skin infiltration, type of wound problem, postoperative intensive care unit (ICU) requirement, and intraoperative blood loss were found to be influential factors on NPWT > 10 sessions. We conclude that treatment may be prolonged and the necessary precautions need to be taken in patients with an impaired preoperative nutritional condition, with intraoperative high amount of blood loss, and with long postoperative stays in the ICU as well as if the underlying cause for wound problem is an infection.