AMAÇ: Bu çalýþma, kalp ve akciðer dokularýnda yanýkla uyarýlan oksidatif hasara karþý kaptopril tedavisinin olasý koruyucu etkisini saptamak için tasarlandý.
GEREÇ VE YÖNTEM: Eter anestezisi altýnda sýrt derileri traþ edilen Wistar albino türü sýçanlar 10 saniye süreyle 90°C suya tutuldu. Yanýk hasarýndan sonra ve 12 saat sonra olmak üzere 10 mg/kg intraperitoneal kaptopril uygulandý. Kontrol grubunda ise sýçanlarýn sýrtý 10 saniye süreyle 25°C suya tutuldu. Yanýk hasarýndan 24 saat sonra ekokardiyografik kayýtlarý alýnan sýçanlar dekapite edildi ve kalp ve akciðer doku örnekleri çýkartýlarak tümör nekroz faktör-α (TNF-α), malondialdehit ve glutatyon düzeyleri, miyeloperoksidaz, kaspaz-3 ve Na+, K+-ATPaz aktiviteleri tayini ile histolojik analizler yapýldý.
BULGULAR: Yanýk sol ventrikül fonksiyonlarýnda önemli deðiþikliklere neden oldu. Kalp ve akciðer dokularýnda yanýk hasarýna baðlý olarak glutatyon düzeyleri ve Na+, K+-ATPaz aktivitelerinin azaldýðý ve TNF-α ve malondialdehit düzeyleri ile miyeloperoksidaz ve kaspaz-3 aktivitelerinin arttýðý bulundu. Kaptopril tedavisinin, azalmýþ glutatyon düzeyi ve Na+, K+-ATPaz aktivitesini anlamlý düzeyde yükselttiði ve sitokin ve malondialdehit düzeyleri ve miyeloperoksidaz ve kaspaz-3 aktivitelerini ise anlamlý düzeyde azalttýðý bulundu.
TARTIÞMA: Kaptopril kalp ve akciðer dokularýnda yanýkla uyarýlan hasarý önler ve oksidatif organ hasarýna karþý korur.

BACKGROUND: This study was designed to determine the possible protective effect of captopril treatment against oxidative damage in heart and lung tissues induced by burn injury.
METHODS: Under ether anesthesia, the shaved dorsum of Wistar albino rats was exposed to 90°C water bath for 10 seconds. Captopril was administered intraperitoneally (10 mg/kg) after the burn injury and repeated twice daily. In the sham group, the dorsum was dipped in a 25°C water bath for 10 seconds. At the end of the 24 hours, echocardiographic recordings were performed, then animals were decapitated and heart and lung tissue samples were taken for the determination of tumor necrosis factor-α (TNF-α) as a pro-inflammatory cytokine, malondialdehyde and glutathione levels and myeloperoxidase, caspase-3, and Na+,K+-ATPase activity in addition to the histological analysis.
RESULTS: Burn injury caused significant alterations in left ventricular function. In heart and lung tissues, TNF-α and malondialdehyde levels and myeloperoxidase and caspase-3 activities were found to be increased, while glutathione levels and Na+, K+-ATPase activity were decreased due to burn injury. Captopril treatment significantly elevated the reduced glutathione level and Na+, K+-ATPase activity, and decreased cytokine and malondialdehyde levels and myeloperoxidase and caspase-3 activities.
CONCLUSION: Captopril prevents burn-induced damage in heart and lung tissues and protects against oxidative organ damage.

AMAÇ: Bu çalýþmanýn amacý, nikotinize sýçanlarda hiperbarik oksijen tedavisinin kýrýk iyileþmesi üzerine etkisini incelemektir.
GEREÇ VE YÖNTEM: Otuz iki adet sýçan dört gruba ayrýldý: nikotinize grup (1), hiperbarik oksijen grubu (2), nikotinize + hiperbarik oksijen grubu (3) ve kontrol grubu (4). Yirmi sekiz gün boyunca grup 1 ve grup 3’e nikotin uygulandý. Daha sonra, sýçanlarýn sol femurlarýnda standart cisim kýrýðý oluþturuldu. Yirmi bir gün boyunca grup 2 ve grup 3’e hiperbarik oksijen tedavisi uygulandý. Deneyin sonunda kýrýk alaný, sol femur ve tüm vücut kemik mineral içeriði ve dansitesi ölçüldü.
BULGULAR: Radyolojik ve histopatolojik skorlar grup 1’de, grup 2, 3 ve 4’e göre anlamlý düzeyde düþük bulundu. Grup 2, 3 ve 4 arasýnda radyolojik ve histopatolojik skorlar açýsýndan istatistiksel olarak anlamlý fark saptanmadý. Gruplar arasý karþýlaþtýrmada kýrýk alaný, total sol femur ve tüm vücutta ölçülen kemik mineral içeriði ve dansitesi deðerleri bakýmýndan istatistiksel olarak anlamlý fark bulunmadý.
TARTIÞMA: Nikotinin kýrýk iyileþmesi üzerindeki olumsuz etkileri hiperbarik oksijen tedavisi ile giderilmekte, ancak hiperbarik oksijen tek baþýna radyolojik ve histopatolojik olarak iyileþme üzerinde anlamlý deðiþikliðe sebep olmamaktadýr.

BACKGROUND: The aim of the present study was to investigate the effect of hyperbaric oxygen therapy on fracture healing in nicotinized rats.
METHODS: Thirty-two rats were divided as follows: nicotinized group (1), hyperbaric oxygen group (2), nicotinized + hyperbaric oxygen group (3), and control group (4). For 28 days, nicotine was administered in Groups 1 and 3. Then, a standard shaft fracture was induced in the left femur of rats. Groups 2 and 3 underwent hyperbaric oxygen therapy for 21 days. At the end of the experiment, fracture site, left femur and whole body bone mineral content and density were measured.
RESULTS: The radiological and histopathological scores of Group 1 were statistically significantly lower compared to Groups 2, 3 and 4, and there was no statistically significant difference between the Groups 2, 3 and 4. In a comparison between the groups, no statistically significant difference was found in terms of bone mineral content and density values measured at the fracture site, left femur and whole body.
CONCLUSION: The negative effects of nicotine on fracture healing are eliminated with hyperbaric oxygen therapy, but hyperbaric oxygen alone does not cause significant changes in healing (radiologically and histopathologically).

AMAÇ: Yumuþak doku travmalarý bir çeþit akut travmatik iskemidir. Travmayla ortaya çýkan ödem, enflamasyon ve iskemiye, HBO ve ozonun olumlu etkileri olacaðý düþünüldü.
GEREÇ VE YÖNTEM: Toplam 63 yetiþkin erkek Sprague-Dawley türü sýçanýn her birine baþlangýçta yumuþak doku travmasý (YDT) uygulanmýþ sonrasýnda bir kýsmýna ozon, bir kýsmýna HBO tedavi prosedürü uygulandý. Prosedürler bitiminde doku ve kan örnekleri alýnan hayvanlarda, doku oksidatif stres düzeyini tespitte doku LPO düzeyleri, antioksidan sistemin iþlerliðini tespitte doku SOD ve GSH-Px enzim düzeyleri, histopatolojik olarak, enflamasyon ve ödemin tespitinde rutin hematoksilen-eozin boyamasý kullanýldý.
BULGULAR: Oksijen konsantrasyonu arttýðýnda azalan HIF1 aktivitesine, antienflamatuvar etkilerinin olduðu gösterilen HO-1 aktivitesine, her türlü akut olayda salýnan iNOS aktiviteleri de çalýþmamýzda tespit edildi. Sonuç olarak, HBO ve ozon gruplarýnda LPO, iNOS düzeylerinde istatiksel olarak anlamlý azalma tespit ettik. Bu sonuçlarla uyumlu olarak histopatolojik incelemede de kontrol grubuna kýyasla HBO ve ozon gruplarýnda enflamasyonda anlamlý bir azalma ve her üç grupta ödemde anlamlý düþme mevcuttu.
TARTIÞMA: YDT’lerinde, HBO ve ozon tedavisinin çalýþmamýzdaki biyokimyasal ve histopatolojik bulgulara göre faydalý etkilerinin olduðu deðerlendirilmektedir. Konuyla ilgili klinik çalýþmalarýn yapýlmasý etkilerinin daha iyi irdelenmesi adýna faydalý olacaðý söylenebilir.

BACKGROUND: Soft tissue trauma is a type of acute traumatic ischemia. We investigated in this study whether the edema, inflammation and ischemia caused by the trauma could be affected positively by hyperbaric oxygen (HBO) and ozone therapy.
METHODS: Soft tissue trauma was generated in a total of 63 adult male Sprague-Dawley rats. Subsequently, rats were divided into three groups. The first group was treated with ozone, the second group with HBO, and the third group served as controls. Tissue and blood samples were taken at the end of the procedures. Tissue lipid peroxidation (LPO), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), inducible nitric oxide synthase (iNOS), heme oxygenase (HO)-1, and hypoxia-inducible factor (HIF)-1 levels were detected. Hematoxylin-eosin staining was used to determine the inflammation and edema histopathologically.
RESULTS: We also detected HIF-1 activity, which decreases when the oxygen concentration increases, HO-1 activity, which has anti-inflammatory effects, and iNOS activity, which releases in any type of acute case. We determined a statistically significant reduction in iNOS and LPO levels in both the HBO and Ozone groups. A significant decrease in inflammation was detected in both the Ozone and HBO groups compared with the Control group, and a significant decrease in edema was detected in all three groups.
CONCLUSION: We think that HBO and Ozone therapy have beneficial effects on biochemical and histopathological findings. Related clinical trials will be helpful in clarifying the effects.

AMAÇ: Bu çalýþmada, yanýk yaralanmasý olan Türk çocuklarda psikiyatrik bozukluklarýn ve bu bozukluklarýn yanýk-iliþkili faktörlerle baðlantýsý deðerlendirildi.
GEREÇ VE YÖNTEM: Ocak 2013 ile Aðustos 2013 tarihleri arasýnda Cerrahpaþa Týp Fakültesi Yanýk Ünitesi’nde yatmakta olan 31 hasta öncelikle plastik cerrah tarafýndan deðerlendirildi, psikolojik semptomlarý olan hastalar çocuk psikiyatristine yönlendirildi, daha sonra veriler geriye dönük olarak analiz edildi.
BULGULAR: Hastalarýn yanýk yüzdesi %2 ile %60 arasýnda deðiþmekteydi (ortalama yanýk yüzdesi= %17.32). On dokuz hastada (%61.3) psikiyatrik bozukluk saptandý. Psikiyatrik bozukluklar arasýnda, akut stres bozukluðu (ASB) (n=15), depresyon (n=3), travma sonrasý stres bozukluðu (n=2, depresyona eþlik etmektedir) ve delirium (n=1) bulundu. Yanýk yüzdesi psikopatoloji varlýðýyla ve ASB ile iliþkili bulundu. Ayrýca, psikopatoloji yanan vücut bölgesi sayýsýyla iliþkili bulundu.
TARTIÞMA: Pediatrik yanýk hastalarý psikopatoloji açýsýndan risk altýndadýrlar. Yanýk yüzdesi ve yanan vücut bölgesi fazla olan çocuklar psikopatoloji açýsýndan en fazla risk taþýyan gruptur. Hastalarýn psikiyatrik deðerlendirilme için yönlendirilmesi ve böylece psikiyatrik bozukluklarýn geliþmesini önlemek açýsýndan cerrahlar önemli role sahiptir.

BACKGROUND: The aim of this study was to assess psychiatric disorders and their association with burn-related factors in a population of Turkish children with burns.
METHODS: Thirty-one children admitted to the Cerrahpasa Medical Faculty Burn Unit between January 2013 and August 2013 were first assessed by the plastic surgeon, and then those with psychological symptoms were referred to a child psychiatrist, and the records were analyzed retrospectively.
RESULTS: The percentage of burned area to Total Body Surface Area (TBSA) ranged between 2-60% (mean, 17.3%). Nineteen patients (61.3%) had a psychiatric diagnosis, which included acute stress disorder (ASD) (n=15), depression (n=3), posttraumatic stress disorder (n=2, comorbid with depression), and delirium (n=1). The percentage of burned area to TBSA was associated with the presence of psychopathology and ASD. Further, psychopathology was associated with the number of burned major body regions.
CONCLUSION: Pediatric burn patients are at risk of developing psychopathology. The children with a greater percentage of burned area to TBSA and more burned body regions have the greatest risk of psychopathology. Surgeons have an important role in patient referral for psychiatric interventions, so that psychiatric disorders can be prevented as early as possible.

AMAÇ: Penetran keratoplasti (PK) sonrasý travmatik yara ayrýþmasý için risk faktörleri, klinik özellikler ve cerrahi sonuçlarý deðerlendirmek.
GEREÇ VE YÖNTEM: Penetran keratoplasti sonrasý travmatik yara ayrýþmasý geliþen 26 hasta travma ile iliþki faktörler, rekonstriktif cerrahi iþlemler ile sonuç greft saðkalýmý ve görme keskinliði açýsýndan geriye dönük olarak deðerlendirildi.
BULGULAR: Yaþ ortalamasý 40.7±19.6 yaþ olan 26 hastanýn 12’sinde (%46.1) travmadan daha iyi gören göz etkilenmiþti. En sýk travma tipinin dokuz olguda (%34.6) olmak üzere çeþitli objelerle geliþen künt travma olduðu görüldü. Ayrýþma bütün olgularda greft ile alýcý bileþkesinde geliþmiþti. Ayrýþma geniþliði ortalama 135.4°±57.6° idi. Kristalin lens veya göz içi lens hasar oraný %42.3 olarak bulundu. Cerrahi sonrasý medyan takip süresi 36 aydý. On üç (%50) hastada greft saydam kalýrken, 13 hastada (%50) greft yetmezliði/greft reddi geliþmiþti. Sonuç görme keskinliði 20/200 üzerinde olan hasta sayýsý 13 (%50) idi.
TARTIÞMA: Travmatik yara ayrýþmasý PK sonrasý en sýk birinci yýlda olmak üzere herhangi bir zamanda geliþebilir. Diðer gözde görme azlýðý önemli bir risk faktörü olarak gözükmektedir. Arka segmenti hasarý gibi önemli komplikasyonu olmayan hastalarda görsel sonuçlar ve greft saðkalýmý olumludur.

BACKGROUND: We aimed to evaluate the risk factors, clinical features and outcomes of surgery for traumatic wound dehiscence (TWD) following penetrating keratoplasty (PK).
METHODS: Twenty-six patients with TWD following PK were evaluated retrospectively in terms of factors related to the trauma, types of reconstructive surgery, final graft clarity, and visual acuity.
RESULTS: There were 26 patients with a mean age of 40.7±19.6 years. In 12 (46.1%) patients, the better eye was affected by the trauma. The most frequent type of trauma was blunt trauma by various objects (9). In all cases, the dehiscence was at the graft host junction. The mean extent of detachment was 135.4°±57.6°. Crystalline or intraocular lens damage was present in 42.3% of cases. Median follow-up time after the reconstructive surgery was 36 months. The graft remained clear in 13 (50%) patients, whereas graft insufficiency/graft rejection developed in 13 (50%) patients. Final visual acuity was over 20/200 in 13 (50%) patients.
CONCLUSION: TWD may occur at any time after PK, most frequently within the first postoperative year. Low visual acuity in the other eye seems to be a major risk factor. In patients without major complications such as posterior segment damage, visual outcomes and graft survival can be favorable.

AMAÇ: Bu çalýþmada ayak bileði eklemine (mortis) yakýn distal tibia diafiz kýrýklarýnýn tedavisinde intramedüller çivi veya plak tedavisinin fonksiyonel ve radyolojik sonuçlarýný karþýlaþtýrmayý amaçladýk.
GEREÇ VE YÖNTEM: 2005-2011 yýllarý arasýnda intramedüller çivi (21 hasta) veya plak (34 hasta) ile tedavi edilen 55 hasta (32 erkek, 23 kadýn; ortalama yaþ 42; daðýlým 15-72 yýl) çalýþmaya alýndý. Ortalama takip süresi 27.6 ay (daðýlým 12-82 ay) idi. Hastalar kaynamama (nonunion), yanlýþ kaynama (malunion), enfeksiyon, implant irrtasyonu ve klinik açýdan AOFAS (American Orthopaedic Foot and Ankle Society) skoru ile deðerlendirildi.
BULGULAR: Kýrýðýn ekleme uzaklýðý, kaynama zamaný, AOFAS skoru, ilave fibula kýrýðý, malunion, materyal irritasyonu açýsýndan istatistiksel fark gözlenmedi. Hastalarýn dokuz tanesinde açýk kýrýk mevcuttu ve bu hastalar plak ile tedavi edilmiþti (p=0.100). Plak ile tedavi edilen üç hastada kaynamama geliþti. Bir hastada enfeksiyon geliþti. Diz önü aðrýsý çivi yapýlan hastalarda istatistiksel olarak fazla idi. <10° malunion geliþen hastamýz yoktu. Çivi veya plak uygulanan hastalar arasýnda minimal malunion (13 hasta) açýsýndan karþýlaþtýrýldýðýnda fark yoktu.
TARTIÞMA: Distal tibia diafiz kýrýklarýnýn tedavisinde distal parça kýsa olduðu için genellikle plak tercih edilmektedir. Çalýþmamýzda cerrahi kurallara dikkat edildiðinde çivi tedavisinin malunionu artýrmadýðý bununla birlikte kapalý cerrahi ve daha az yara yeri problemi nedeniyle avantajlarý olduðunu gördük.

BACKGROUND: In this study, we aimed to compare the functional and radiological results of intramedullary nailing and plate fixation techniques in the surgical treatment of distal tibia diaphyseal fractures close to the ankle joint.
METHODS: Between 2005 and 2011, 55 patients (32 males, 23 females; mean age 42 years; range 15 to 72 years) who were treated with intramedullary nailing (21 patients) or plate fixation (34 patients) due to distal tibia diaphyseal fracture were included in the study. The average follow-up period was 27.6 months (range, 12-82 months). The patients were evaluated with regard to nonunion, malunion, infection, and implant irritation. The AOFAS (American Orthopaedic Foot and Ankle Society) scale was used for the clinical evaluation.
RESULTS: No statistically significant difference was found between the two surgical methods with respect to unification time, AOFAS score, accompanying fibula fracture, material irritation, and malunion. Nine patients had open fractures, and these patients were treated with plate fixation (p=0.100). Nonunion developed in three patients who were treated with plates. Infection occurred in one patient. Anterior knee pain was significantly higher in patients who were treated with intramedullary nails. There was no malunion in any patient.
CONCLUSION: As the distal fragment is not long enough, plate fixation technique is usually preferred in the treatment of distal tibia diaphyseal fractures. In this study, we observed that if the surgical guidelines are followed carefully, intramedullary nailing is an appropriate technique in this kind of fracture. The malunion rates are not significantly increased, and it also has the advantages of being a minimally invasive surgery with fewer wound problems.

AMAÇ: Bu çalýþmanýn amacý, kancalý (barbed) dikiþler kullanýlarak fasyotomi defektlerinin aþamalý olarak primer kapatýlmasýna olanak saðlayan ve literatürde daha önce tanýmlanmayan, yeni, basit ve güvenli bir tekniðin gösterilmesidir.
GEREÇ VE YÖNTEM: Teknik beþ farklý hastada, çeþitli etiyolojik nedenlere baðlý olarak geliþen kompartman sendromu sonrasý açýlan hem üst, hem de alt ekstremitelerdeki deðiþik boyutlardaki fasyotomi defektlerine uygulandý. Hastalarda yaklaþtýrýlarak primer kapatýlmasý planlanan ortalama defekt geniþliði 8.8 cm idi. Fasyotomi açýlmasýný takiben, eriyebilir kancalý dikiþ yara kenarlarýndaki dermal dokudan subkutiküler kapatmaya benzer þekilde geçirildi ancak gevþek býrakýldý ve kapalý pansumana alýndý.
BULGULAR: Klinik takipler sýrasýnda doku ödemi ve yara kenarlarýndaki gerginliðin azalmaya baþlamasýyla birlikte, kancalý dikiþ her 48-72 saatte bir yatakbaþý gerim yapýldý ve tüm olgularda aþamalý olarak ortalama 8.6 günde fasyotomi defektlerinin tamamý primer olarak kapatýldý. Yüksek gerilim elektrik yanýðý nedeniyle fasyotomi açýlan bir hastada defektin distal kýsmýnda meydana gelen ve sekonder iyileþmeyle tedavi edilen nekroz dýþýnda, tüm hastalarda komplikasyonsuz tam primer kapatým saðlandý.
TARTIÞMA: Sonuç olarak kancalý dikiþ ile aþamalý fasyotomi kapatma yöntemi teknik olarak oldukça basit, hýzlý ve etkili bir yöntem gibi görünmektedir. Çeþitli etiyolojilere baðlý olarak geliþen kompartman sendromu sonrasý açýlan fasyotomi defektlerine uygulanabilir.

BACKGROUND: The aim of this study was to demonstrate a new, easy and safe technique, which has not been defined in the literature previously, that enables the gradual primary closure of fasciotomy wounds using barbed sutures.
METHODS: The technique was performed on five patients who presented with fasciotomy wounds on both upper and lower extremities, varying in size, observed after compartment syndrome due to different causes. The average width of the defects for which primary closure was planned was 8.8 cm. Following the fasciotomy incision, absorbable barbed sutures were inserted through the dermal tissue around the wound similar to that of a subcuticular closure, but left loose, after which closed dressing was applied. During the clinical follow-up, with the decrease in tissue edema and tightness around the wound, the barbed suture was tightened at bedside every 48-72 hours.
RESULTS: At the end of this gradual closure, all the fasciotomy defects were primarily closed within an average of 8.6 days. All the patients had complete and uncomplicated primary closure with the exception of one with high-voltage electrical burn injury, who developed necrosis in the distal part of the defect, and was treated by secondary healing.
CONCLUSION: The gradual fasciotomy closure technique with barbed suture seems to be an easy, rapid and effective method.

AMAÇ: Bu çalýþmada skafoid psödoartroz tedavisinde uyguladýðýmýz debridman, otolog iliak kanat kemik grefti ile titanyum baþsýz kanüle kompresyon vidasý kombinasyonunun radyolojik ve klinik sonuçlarýný sunmaktýr.
GEREÇ VE YÖNTEM: 2009-2012 tarihleri arasýnda skafoid psödoartroz tanýsý ile iliak kanat kemik grefti ve baþsýz kanüle vida ile ameliyat edilen ve en az 12 aylýk takibi olan 24 hastanýn 24 el bileði geriye dönük olarak incelendi. Psödoartroz standart çekilen grafilerde kýrýk zamanýndan sekiz hafta geçmesine raðmen kaynama bulgusu olmamasý olarak belirlendi. Skafoid kýrýklarý Herbert sýnýflamasýna ve anatomik yerleþime göre sýnýflandý. Hastalarýnýn klinik deðerlendirilmesinde Mayo el bilek skorlamasý kullanýldý.
BULGULAR: Herbert sýnýflamasýna göre 20 hasta D1 ve dört hasta D2, anatomik sýnýflamaya göre bir hasta distal, altý hasta proksimal ve 17 hasta gövde kýrýðý olarak belirlendi. Ýki hasta haricinde tüm hastalarda tam kaynama ortalama 9.5 (6 ila 15 hafta) haftada saðlandý. Son kontrollerde skafolunat ve radiolunat açýlarý sýrasý ile ortalama 32° (39° ile 50°) ve 7° (4° ile 10°) idi. Ýstatistiksel olarak kaynama ve psödoartroz süreleri arasýnda baðlantý tespit edildi (p=0.003). Kýrýk hattý proksimal bölgeye yaklaþtýkça kaynama süresi uzamakta idi (p=0.004). Mayo el bilek skoru ortalama 86 (80-95) olarak belirlendi.
SONUÇ: Skafoid psödoartroz tedavisinde volar yaklaþýmla iliak kanattan alýnan trikortikal otogreft ve baþsýz kanüle kompresyon vidasý kombinasyonu, baþarýlý kaynama ve fonksiyonel sonuç veren bir yöntemdir.

BACKGROUND: We aimed to present the clinical and radiological results of patients treated with debridement, iliac bone graft and titanium headless compression screw for scaphoid nonunion.
METHODS: We retrospectively evaluated 24 patients (23 males, 1 female) who underwent this technique between 2009 and 2012, with a minimum of 12 months’ follow-up. Nonunion was determined as no union evidence within eight weeks on radiological view. Scaphoid fracture was classified according to Herbert classification and anatomical location. Functional evaluation was performed using the Mayo wrist scoring system.
RESULTS: According to the Herbert classification system, there were 20 D1 and 4 D2 fractures. Anatomical location included 1 distal, 6 proximal and 17 corpus. Fracture union was achieved in all but 2 patients, with a mean union time of 9.5 weeks (6-15). Scapholunate angle and radiolunate angle were measured as a mean 32° (39°-50°) and 7° (4°-10°) at the latest follow-up radiographic examination. There was a statistically significant correlation between the length of the pseudoarthrosis period and union time (p=0.003). Union time of proximal fractures was longer than of the others (p=0.004). Mayo wrist score was 86 (80-95).
DISCUSSION: Autologous iliac bone graft and titanium headless cannulated compression screw combination via volar approach is safe and effective for scaphoid nonunion.

AMAÇ: Triangular fibrokartilaj kompleks (TFKK) hasarlanmasý el bileðinin ulnar taraf aðrýlarýnýn baþlýca nedenidir. Bu çalýþmada, artroskopik olarak onarýlan TFKK periferik (Palmer tip 1B) yýrtýklarýnýn tedavi sonuçlarý geriye dönük olarak deðerlendirildi.
GEREÇ VE YÖNTEM: TFKK periferik (Palmer tip 1B) yýrtýðý nedeniyle Þubat 2007-Temmuz 2012 arasýnda artroskopik tamir uygulanan 38 hasta (30 erkek, 8 kadýn; ortalama yaþ 27.6; daðýlým: 19-42) deðerlendirildi. Deðerlendirme Mayo el bileði deðerlendirme formu ve ameliyat öncesi, ameliyat sonrasý VAS (Görsel analog skala) ile yapýldý.
BULGULAR: Hastalarýn Mayo el bileði deðerlendirme formu ile yapýlan deðerlendirme sonuçlarýna göre 30 hasta mükemmel, sekiz hasta iyi olarak deðerlendirildi. Ameliyat öncesi VAS 6.53 (daðýlým: 4.5-8.2) ameliyat sonrasý VAS 1.48 (daðýlým: 0.3-3.1) olarak saptandý.
SONUÇ: Artroskopik teknikle minimal hasarlanma ile TFKK tamiri yapýlabilmekte, eklemin tüm yapýlarýnýn daha iyi görüntülenmesi ve deðerlendirilmesi saðlanabilmektedir. 6R portalin 1 cm altýndan açýlan portalden uygulanan dýþarýdan içeriye dikiþ tekniði ulnar sinir yüzeyel dalýnýn etkilenme olasýlýðýnýn olmadýðý minimal travmatik yöntemdir. Bu yöntem ile ameliyat öncesi aðrý þikayetlerinin anlamlý olarak giderilmesi mümkündür.

BACKGROUND: Triangular fibrocartilage complex (TFCC) injury is the major cause of wrist pain on the ulnar side. In this study, treatment outcomes of arthroscopically repaired peripheral TFCC tears (Palmer type 1B) were evaluated retrospectively.
METHODS: Thirty-eight patients (30 males, 8 females; mean age 27.6; range 19 to 42 years) with TFCC tears (Palmer type 1B) who were treated arthroscopically between February 2007-July 2012 were evaluated retrospectively. The data were collected by Mayo wrist evaluation form and by preoperative and postoperative visual analogue scale (VAS).
RESULTS: The results of the data collected by the Mayo wrist evaluation forms were perfect in 30 patients and good in 8 patients. Preoperative VAS was 6.53 (range: 4.5-8.2) and postoperative VAS was 1.48 (range: 0.3-3.1).
DISCUSSION: With the arthroscopic technique, TFCC tears can be repaired with minimal harm and better visualization, and evaluation of all the structures of the wrist can be done. Outside-to-inside suturing technique, which is performed through the portal opened 1 cm inferior to the 6R portal, is the least traumatic technique and does not carry the risk of injury to the superficial branch of the ulnar nerve. With this technique, the complaints of preoperative pain can be eliminated significantly.

Künt göðüs travmasý ve bununla iliþkili komplikasyonlar çocukluk çaðýnda görülen kardiyak arrestin nadir nedenleridir. Ayrýca, bu olgular da giderek artan sayýda bildirilmektedir. Kurbanlar sýklýkla ventriküler fibrilasyon veya taþikardi ile teþhis edilmektedir. Bununla birlikte kardiyak ileti bozukluklarý da bildirilmektedir. Bu yazýda, futbol topu ile künt göðüs travmasýna baðlý supraventriküler taþikardi geliþen saðlýklý bir adolösan olgu sunuldu. Bu olgular içerisinde göðüs travmasýna baðlý atrial aritmi olmasý nedeniyle literatürdeki ilk bildiridir.

Blunt chest trauma and its associated complications represent a rare cause of cardiac arrest in a healthy child, although an increasing number of these events have been reported. Victims are most often diagnosed in ventricular fibrillation or tachycardia. However, cardiac conduction abnormalities are also reported. In this report, a healthy adolescent with supraventricular tachycardia associated with blunt chest trauma due to a football is presented. This is the first report in the literature of atrial arrhythmia in these cases with chest trauma.

Kuru sýký silahlar mermi çekirdeði fýrlatmaksýzýn ses ve gaz fiþekleri ateþleyen silahlardýr. Bu silahlarýn ateþleme sýrasýnda, dýþ görünümü ve sesi gerçeklerinden farksýzdýr. Toplulumuzda bu silahlarýn, zarasýz olduðuna dair inanýþ hakimken, literatürlerde bildirilen olgulara baktýðýmýzda sanýldýðý kadar masum olmadýklarýný görmekteyiz. Bu yazýda kuru sýký silah ile kafa travmasý geçiren 26 yaþýndaki hastayý sunarak kuru sýký silahlarýn zararlý silahlar olduklarýný göstermeyi amaçladýk.

Blank cartridge guns are devices that discharge sound and gas, but no bullet or shot. These devices are very similar to real guns in the form of their external design and the sound generated during their firing. Although it is widely held in society that these devices are harmless, reports from Turkey and the world have shown that these guns are not entirely innocent. Herein, we present a 26-year-old male with a head injury due to gunshot from a blank cartridge. The purpose of this presentation is to emphasize that these devices are not harmless, contrary to common public opinion.

Mortality following blunt chest injury and cardiac rupture remains high despite advances in the care of traumatic injuries. Indeed, most patients succumb to these injuries even prior to reaching a hospital. However, timely recognition and surgical intervention can save lives. We present the case of a 40-year-old woman who presented to our emergency department in cardiac arrest due to rupture of her left atrium following a major motor vehicle collision. The patient underwent emergency department thoracotomy with successful repair of the cardiac rupture. Emergency department thoracotomy, when indicated and performed by trained surgeons, can be the only life-saving procedure available. Rapid median sternotomy using a cost-effective fret sternum saw does not require significantly more time than a left lateral thoracotomy or clamshell incision in an emergency situation. It can be an effective and alternative method of thoracic entry in the emergency department. Prognosis of cardiac rupture depends largely on the mechanism of injury, location of injury, signs of life: vital signs, and availability of timely intervention. When indicated, hesitation should be avoided. Expedient cardiac exposure is essential and leads to better results with improved survival rates in patients with blunt cardiac rupture.

Burunda yabancý cisim özellikle çocuklarda sýkça karþýlaþýlan bir durumdur. Literatürde burunun deðiþik bölgelerinde çok çeþitli yabancý cisim vakasý bildirilmiþtir. Yabancý cisimin giriþ yolu sýklýkla burun delikleridir. Bu makalede ihmal edilmiþ bir travma olgusunda burunda yabancý cisim için sýradýþý bir giriþ yolu sunulmuþtur. Çocuklarda penetran yüz yaralanmasý sonrasýnda yabancý cisimden þüphelenilmeli ve detaylý aranmalýdýr.

Burunda yabancý cisim özellikle çocuklarda sýkça karþýlaþýlan bir durumdur. Literatürde burunun deðiþik bölgelerinde çok çeþitli yabancý cisim bildirilmiþtir. Yabancý cisimin giriþ yolu sýklýkla burun delikleridir. Bu yazýda, ihmal edilmiþ bir travma hastasýnda, burunda yabancý cisim için sýradýþý bir giriþ yolu sunuldu. Çocuklarda penetran yüz yaralanmasý sonrasýnda yabancý cisimden þüphelenilmeli ve detaylý aranmalýdýr.

Oksipital kondil kýrýklarý nadir olup, konservatif tedavi genellikle yeterlidir. Nadiren atlantooksipital dislokasyonun eþlik ettiði olgularda cerrahi tedavi gerekebilir. Acil servise travma nedeniyle baþvuran olgularda direkt grafilerde sýklýkla taný konulamayan kondil kýrýklarýna, son yýllarda bilgisayarlý tomografinin sýk olarak kullanýlmasý ile artan oranda taný konulabilmektedir. Bu çalýþmada, acil servisimize travma nedeniyle kabul edilen hastanýn, maksillofasiyal travmasý ön planda olup, boyun aðrýsýndan þikayet etmekteydi. Servikal direkt grafileri normal olan hastanýn, servikal bilgisayarlý tomografisinde tek taraflý oksipital kondil kýrýðý saptandý.

Occipital condyle fractures are rare, and conservative treatment is sufficient for many cases. Surgical treatment may be required if the condyle fracture is accompanied by atlantooccipital dislocation. Unfortunately, condyle fracture generally cannot be diagnosed with X-ray in the emergency department. Recently, computed tomography scans have been used more frequently, and enable easier diagnosis of these types of fractures. In this report, we describe a patient who admitted to our emergency department after a major trauma. She complained of neck pain, and maxillofacial trauma was more evident. Her cervical X-rays were normal, but cervical computed tomography revealed unilateral occipital condyle fracture.