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Bilateral Spontaneous Achilles Tendon Rupture without Any Predisposing Factors

Open Journal of Orthopedics 2012年第3期2卷 117-120页

作者： Esat Uygur Samet Erinc Hakan Turan Cift Feyza Unlü Ozkan salih soylemez Trauma and Orthopaedic Surgery Department Istanbul Medeniyet University Goztepe Research and Training HospitalIstanbulTurkey Department of Physical Therapy and Rehabilitation Istanbul Fatih Sultan Mehmet Research and Training HospitalIstanbulTurkey

Besides spontaneous rupture of achilles tendon is a rare condition which is usually associated with corticosteroid or fluoroquinolon usage, spontaneous rupture of Achilles tendon without any risk factors is extremely rare. In this report we aimed to present clinical features of a case of bilateral spontaneous achilles tendon rupture and tried to investigate potential etiologic factors. A 54 year old man was admitted to our emergency department as complaining bilateral ankle pain at the retrocalcaneal region. He had no trauma, any comorbidities or any drug consumption history. Painful achilles tendon gaps proximal to his ankles had been palpated and bilateral Thompson’s test positivity had been noted (Figures 1 and 2). He was unable to rise upon his toes however he was able to walk. American Orthopedic Foot and Ankle Society Hindfoot Scoring was calculated as 78 points. The rupture had been verified with a magnetic resonance imaging and his laboratory findings were all within normal limits (Figures 3 and 4).The patient did not approve an operation so conservative treatment with dorsiflexion limiting brace was applied and strengthening and stretching exercises of gastrosoleus was suggested. Atraumatic and bilateral cases with achilles rupture should be well investigated whether any systemic factors are coexistent. Besides well known corticosteroids or fluoroquinolone exposure, endocrinologic and rheumatological diseases, hypercholesterolaemia should be evaluated in terms of predisposing causes. Patients who have to use corticosteroids or fluoroquinolone, should be informed about achilles tendon rupture and be suggested do regular physical exercises in order to reduce the rupture risk. Despite predisposing factors, sometimes nothing can be associated with achilles tendon rupture as in our case. Genetic predisposition or a degenerative process of a tendon due to age may be underlying cause like in rotator cuff tears.

关键词： Spontaneous Achilles Tendon Rupture Achilles Tendon

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Synovial Chondromatosis of the Elbow Joint in a 27-Year-Old Man:A Case Report

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Open Journal of Orthopedics 2013年第2期3卷 164-166页

作者： Fatih Turkmensoy Ismail Türkmen Mehmet salih soylemez Yalcin Turhan Birol Aktas Feyza Unlu Ozkan Department of Orthopaedics and Traumatology Goztepe Training and Research HospitalIstanbul Medeniyet UniversityIstanbulTurkey Department of Orthopaedics and Traumatology Düzce State HospitalDüzceTurkey Department of Physical Therapy and Rehabilitation Fatih Sultan Mehmet Training and Research HospitalIstanbulTurkey

Introduction: Multiple intraarticular loose bodies are pathognomonic for the Synovial chondromatosis. This disorder affects a wide age range from adults to childhood with no sex dominance. Malignant transformation is rare to date, and there are approximately 34 cases in literature about the transformation of synovial chondromatosis to chondrosarcoma. Case: We present case of a 27-year-old patient who had synovial chondromatosis in his elbow. Discussion: Radiographic findings are usually pathognomonic for the diagnosis. Multiple calcified loose bodies can be seen in the joint in radiographs. Computed tomography (CT) optimally depicts the calcified intraarticular fragments and extrinsic bone erosion. However, because the radioopacity cannot be detected in 1/3 of the cases, diagnosis becomes difficult. Treatment modalities include arthroscopic or open extraction of the loose bodies and arthropasty in the presence of severe osteoarthritis. Conclusion: Synovial chondromatosis should be kept in the differential dignosis of the chronic monoarticular pain and painful limitations of the range of motions of the joints.

关键词： Elbow Loose Body Malignant Transformation Synovial Chondromatosis Treatment

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Periacetabular Brucella Osteomyelitis

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Open Journal of Orthopedics 2013年第1期3卷 20-22页

作者： Hakan Cift Krishna Reddy Esat Uygur salih soylemez Senol Korhan Ozkan Maria Silvia Spinelli Abdullah Eren Orthopaedics and Traumatology Department Medipol University Istanbul Turkey Orthopaedics and Traumatology Department Royal Orthopaedic Hospital Birmingham United Kingdom Orthopaedics and Traumatology Department Medeniyet University Goztepe Research and Training Hospital Istanbul Turkey Department of Pathology Medeniyet University Goztepe Research and Training Hospital Istanbul Turkey Orthopaedics and Traumatology Department University Hospital Agostino Gemelli Catholic University of the Sacred Heart School of Medicine Rome Italy Orthopaedics and Traumatology Department Florence Nightingale Hospital Istanbul Turkey.

Introduction: Although Brucellosis has a limited geographic distribution;it remains a challenge in certain parts of the world such as in Mediterranean, western Asian, Latin American and African regions. We present a unique case of periacetabular Brucella osteomyelitis and increase awareness of possible widespread distrubition of Brucella osteomyelitis and its ability to affect any region of the musculoskeletal system. Case Presentation: A 44-year-old male farmer presented with symptoms of pain radiating from his left hip to his thigh of five years duration. There was a history of night sweats and fever for the past two months. A lytic area with smooth borders in left periacetabular region was detected on pelvic roentgenography of the patient. Magnetic resonance imaging revealed a cavitatory lesion in relation to hip joint. Open biopsy was undertaken with the differential diagnosis of an infectious (Brucella or Tuberculous) or tumoral lesion. Intraoperative frozen sections showed granulomatous inflammatory tissue. Post debridement, the cavity was filled with autograft taken from the patient’s right iliac wing. Postoperative immunohistochemistry confirmed diagnosis of Brucella osteomyelitis. Oral Doxycyline, Rifampicine and Ciprofloxacin were administered for 3 months. At one-year postoperatively, the patient had a painless, unrestricted range of motion and function in relation to the affected hip. Conclusion: In endemic regions, Brucella osteomyelitis should be considered in differential diagnosis in patients with arthralgia and/or spondylodiscitis in the presence of radiologically suspected osseous lesions.

关键词： Brucella Acetabulum Osteomyelitis

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Intramedullary Nailing of Femoral Shaft Fractures with Compressive Nailing Using Only Distal Dynamic Hole and Proximal Static Hole

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Open Journal of Orthopedics 2014年第2期4卷 27-30页

作者： Hakan Cift Engin Eceviz Necdet Saglam Cem Coskun Avci salih soylemez Esat Uygur Yalcin Turhan Korhan Ozkan Department of Orthopaedics and Traumatology Medipol UniversityIstanbulTurkey Department of Orthopaedics and Traumatology Kartal Lutfi Kirdar Training and Research HospitalIstanbulTurkey Department of Orthopaedics and Traumatology Umraniye Training and Research HospitalIstanbulTurkey Department of Orthopaedics and Traumatology Medeniyet University Goztepe Training and Research HospitalIstanbulTurkey Department of Orthopaedics and Traumatology Atatürk Public HospitalDüzceTurkey.

Objectives: In this study we aimed to present our treatment results of intramedullary nailing of femoral shaft fractures with compressive nailing using proximal static hole and only distal dynamic hole with one screw. Methods: Forty-three patients who had a fracture of the femoral shaft were managed between 2005 and 2008 with intramedullary nailing and the use of only one screw for distal interlocking. Prospectively we evaluated the union time, possible reoperation, fixation and fracture alignment, range of knee motion and complications. Results: Union occurred within a mean duration of 18.7 weeks. No failures of the fixation and fracture alignment and no more than 1 cm shortness were detected. The knee range of motion was all more than 90 degree. Only one deep venous thrombosis was detected as complication. Conclusions: Compressive nailing using proximal hole and only distal dynamic hole with one screw is a convenient technique for femur fractures.

关键词： Femur Fracture Intramedullary Nailing Dynamic Locking

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