Ýzmir’in yetiþtirdiði deðerli doktor ve ortopedi uzmaný olan Prof. Dr. Veli Lök 1932 yýlýnda Ýzmir’de doðmuþtur. Prof. Dr. Veli Lök, Ýzmir Atatürk Lisesini ve Ýstanbul Týp Fakültesini bitirdikten sonra; 1958 yýlýnda Ege Üniversitesi Týp Fakültesi Cerrahi Kliniðine asistan olarak girmiþ, 1959 yýlýnda Ortopedi Çocuk Cerrahisi Kliniði asistanlýðýna geçmiþtir. Ardýndan 1963 yýlýnda Uzman, 1969’da Doçent, 1975’de Profesör olmuþtur.
Prof. Dr. Veli Lök, Türkiye’de artroskopinin (tanýsal ve cerrahi) kurucusu olup, ayrýca geç fiziksel “iþkence izlerini” saptayan bilimsel metodlarý bulmuþtur. Ege Üniversitesi Týp Fakültesinde 40 yýl hizmet ettikten sora 1999’da emekli olmuþtur. Prof. Dr. Veli Lök, artroskopi ve bilimsel olarak “iþkencenin geç fiziksel izlerinin saptanmasý” konusundaki çalýþmalarýnýn yaný sýra; ayný zamanda ortopedi alanýndaki “sklerozan osteomiyelitin kesin iyileþmesini saðlayan ameliyat tekniði olan “oluklaþtýrma yöntemi”ni, “Forrester- Brown” atelinin “fleksibl” modelini (Fleksibl Forrester- Brown Ateli), “diz instabilitesinde tibial rekurvasyon ameliyatý / genurekurvatum osteotomi ile dizde stabilite saðlayan tekniði geliþtirmiþtir. Tüm bunlarýn yaný sýra Prof. Dr. Veli Lök, «þok dalgalarýnýn kaynamamýþ kýrýklarýn iyileþmesinde
kullanýlmasý” konularýnda yaptýðý öncü çalýþmalarla tanýnmaktadýr. Prof. Dr. Veli Lök’ün “iþkencenin önlenmesi”, “adaletin saðlanmasý” ve “insan haklarýnýn korunmasý” amacý ile bilimsel yöntemlerle iþkence izlerini ortaya çýkaran buluþlarý “Nobel Týp ve Barýþ Ödülü” alacak ölçüde önemli ve deðerlidir.

One of the valuable doctors and orthopedic specialists trained in Ýzmir, Prof. Dr. Veli Lok was born in 1932 in Izmir. After graduating from Izmir Atatürk High School and Istanbul Faculty of Medicine, Prof. Dr. Veli Lök started working at Ege University as an assistant in 1958. He joined EUMF Orthopedic and Pediatric Surgery Clinic as an assistant in 1959, became a Specialist in 1963, Associate Professor in 1969, and Professor in 1975.
Prof. Dr. Veli Lök is the founder of (diagnostic and surgical) arthroscopy in Turkey. Also, Prof. Dr. Veli Lök discovered the late physical traces of torture by scientific methods. He retired in 1999 after serving 40 years at Ege University Faculty of Medicine. In addition to these studies, Prof. Dr. Veli Lök also works in the field of orthopedics. He is known for his pioneering studies on developing the surgical technique that provides the definitive healing of sclerosing osteomyelitis grooving procedure, the technique that provides stability in the knee with tibial recurvation surgery-genu recurvatum osteotomy in knee instability, the flexible model instead of the rigid “Forrester-Brown” splint (Flexible Forrester-Brown splint), and the usage of shock waves in nonunion bone fractures healing.
Prof. Dr. Veli Lök’s inventions that reveal traces of torture with scientific methods for preventing torture, providing justice, and protecting human rights are so important and valuable that he is nominated for the “Nobel Medicine and Peace Prize”.

Abstract | Full Text PDF

Prof. Dr. Freddie H. Fu, Pittsburgh Üniversitesi Ortopedi ve Spor Hekimliði öðretim üyesi olup, Türkiye’de artroskopinin geliþmesine ve yaklaþýk 50 Türk meslektaþýnýn (Ortopedist) yanýnda eðitim almasýna önemli katkýda bulunmuþtur.
Prof. Dr. Freddie H. Fu, Türkiye Spor Yaralanmalarý, Artroskopi ve Diz Cerrahisi (TUSYAD) Kongrelerine ve Kurslarýna birçok kez katýlmýþ, bilgisini paylaþmýþtýr.
Dünya çapýnda tanýnan bir bilim insaný olan Prof. Dr. Freddie H. Fu’nun en verimli çaðýnda vefatý nedeniyle kendisini anmak, çalýþmalarýný ve bilimsel yönlerini genç kuþaklara tanýtmak amacý ile bu makale yazýlmýþtýr.

SUMMARY
Prof. Dr. Freddie H. Fu is a faculty member of Orthopedics and Sports Medicine at Pittsburgh University and has contributed significantly to the development of arthroscopy in Turkey and the training of nearly 50 Turkish colleagues.
Prof. Dr. Freddie H. Fu has participated many times in Turkey Sports Injuries, Arthroscopy, and Knee Surgery (TUSYAD) Congresses and Courses and shared his knowledge.
Due to the death of Prof. Dr. Freddie H. Fu in his most productive age, who was a world-renowned scientist and a friend, this article has been written to commemorate him and introduce his work and scientific aspects to younger generations.

Abstract | Full Text PDF

Amaç: Asetabular versiyon, hem kalça patolojilerinin tanýsýnda hem de kalça protez cerrahisinde doðru komponent oryantasyonu için önemlidir. Çalýþmamýzda hem Türk toplumunun asetabular versiyonunun sunulmasý hem de pelvik ve lomber deðiþkenler karþýsýnda asetabular versiyonun deðiþiminin belirlenmesi amaçlanmýþtýr.

Gereç ve yöntem: Hastanemizde Ocak 2020-Ocak 2021 tarihleri arasýnda travma nedeniyle çekilen pelvik ve spinal BT’ler incelendi. Lomber, pelvik ve kalça patolojisi olmayan 20-80 yaþ aralýðýndaki 300 hasta çalýþmaya dahil edildi. Hastalarýn aksiyel pelvis BT kesitleri üzerinden bilateral asetabular versiyonu, anterior asetabular kýsým açýsý (AASA) ve posterior asetabular kýsým açýsý (PASA) ölçüldü. Hastalarýn spinal BT sagital kesitlerinden; pelvis tilt, sakral slop ve pelvik insidans ölçüldü. Omurga deðerlendirmesi için Roussouly sýnýflandýrmasýna göre tiplendirme yapýldý ve lomber lordoz ölçüldü. Asetabular versiyonun demografik verilere, pelvik ve lomber deðiþkenlere göre deðiþimi belirlendi.

Bulgular: Asetabular ölçümler; ortalama asetabular versiyon: 18.8±5.9, AASA: 65±8.9, PASA: 99.4±9.9 olarak bulundu. Asetabular versiyon ölçümlerinde; yaþ ve cinsiyet deðiþkenine göre istatistiksel olarak fark gözlenmezken (p=0.766, p=0.087), taraf ölçümlerinde sað: 18.8±5, sol: 18.8±6.7 anteversiyon olmak üzere ayný bulundu (p=0.841). Hastalarýn lomber lordozu 31.7±11.3 olup anteversiyon ile korelasyonu anlamlý bulundu (p=0.001). Pelvik tilt: 10.9±5.3, sakral slop: 41.1± 7.5 ve pelvik insidans: 52±9.5 olup anteversion ile korelasyonu anlamlý bulundu (sýrasýyla: p<0.001, p=0.017, p<0.001). Roussouly sýnýflandýrmasýna göre tip arttýkça anteversiyonda artýþ gözlendi ve bu artýþ da istatistiksel olarak anlamlý idi (Tip 1: 14.9±5.1, Tip2: 18.3±5, Tip 3: 18.7±4.7, Tip4: 20.1±5.2, p=0.05).

Sonuç: Asetabular anteversiyon deðeri beklenenden daha geniþ bir aralýkta olup karþý kalça ile benzerdir. Lomber ve pelvik deðiþkenler asetabular anteversiyona doðrudan etkili olup pozitif korelasyon göstermektedir.

ABSTRACT

Objective: The acetabular version is important both for the diagnosis of hip pathologies and in hip replacement surgery. This study aimed to present the acetabular version of the Turkish population and to determine the variation of the acetabular version according to pelvic and lumbar parameters.

Methods: A total of 300 patients with pelvic and spinal CT scans aged 20-80 years without lumbar, pelvic, and hip pathology or fractures were included. Bilateral acetabular version, anterior acetabular sector angle (AASA), and posterior acetabular sector angle (PASA) were measured on axial pelvic CT scans. The pelvic tilt, sacral slope, pelvic incidence, and lumbar lordosis were measured in spinal CT sagittal sections. Sagittal spinal alignment was typed according to Roussouly classification. The variation of the acetabular version according to demographic, pelvic, and lumbar parameters was determined.

Results: Acetabular measurements; mean acetabular version: 18.8±5.9, AASA: 65±8.9, PASA: 99.4±9.9. While there was no statistically significant difference in acetabular version measurements according to age and gender (p=0.766, p=0.087), anteversion was the same on both sides: 18.8±5 on the right and 18.8±6.7 on the left (p=0.841). Mean pelvic tilt was 10.9±5.3, mean sacral slope was 41.1±7.5, mean pelvic incidence was 52±9.5 and all three measurements were significantly correlated with anteversion (respectively: p<0.001, p=0.017, p<0.001). Mean lumbar lordosis was 31.7±11.3 and it was significantly correlated with anteversion (p=0.001). An increase in anteversion was statistically significant according to the Roussouly classification (p=0.05).

Conclusion: The acetabular version is in a wide range, similar to that of the contralateral hip. Lumbar and pelvic parameters have positive correlations with acetabular anteversion.

Abstract | Full Text PDF

Trafik kazalarýnýn neden olduðu travmaya baðlý jinekolojik yaralanmalar nadirdir çünkü kadýn üreme organlarý yumuþak doku ile sýnýrlandýrýlmýþ olarak pelvisin koruyucu kemik yapýsýnýn derinliklerinde yer almaktadýr. Trafik kazalarýnda jinekolojik yaralanmalarýn riski düþük olsa da kanamaya neden olabilecek organlar olan; vulva, vajen, serviks, uterus, adneksler için kapsamlý bir jinekolojik deðerlendirme mutlaka gereklidir. Trafik kazasý nedeni ile meydana gelen jinekolojik yaralanmalar konusunda literatürde oldukça az veri bulunmaktadýr. Üçüncü basamak bir merkezde son on bir yýl içinde trafik kazasý nedeni ile meydana gelen jinekolojik yaralanmalar deðerlendirmiþ ve çalýþmamýzda bu hususta literatüre katký saðlamayý amaçlamaktayýz.

Gynecological injuries due to trauma caused by traffic accidents are rare because the female reproductive organs are located deep within the protective bone structure of the pelvis, limited by soft tissue. Although the risk of gynecological injuries in traffic accidents is low, there are organs that can cause bleeding; A comprehensive gynecological evaluation of the vulva, vagina, cervix, uterus and adnexa is absolutely necessary. There is very little data in the literature on gynecological injuries caused by traffic accidents. We evaluated gynecological injuries caused by traffic accidents in a tertiary center in the last eleven years, and we aim to contribute to the literature in this regard in our study.

Abstract | Full Text PDF

Arkaplan: Adjuvan tedavideki geliþmeler sonucu, malign kemik tümörlerinin 5 yýllýk sað kalým oranlarý %20’den %70’e kadar çýkmýþtýr. Buna ek olarak metastatik kanser hastalarýnýn týbbi tedavisindeki geliþmeler sonucunda sað kalým sürelerinde artýþ görülmüþtür. Akciðer ve karaciðerden sonra kemik kanseri hastalarýnda üçüncü en yaygýn metastaz yeridir. Dolayýsýyla modüler tümör rezeksiyon protezleri ile rekonstrüksiyon giderek artan oranda kullanýlmaktadýr. Bununla birlikte bildirilen komplikasyon oranlarý normal eklem artroplastilerinde görülen oranlardan beþ ila on kat daha fazladýr (5,10). Bu yazýda modüler yapýda bir tümör rezeksiyon protezinin (ESTAS Medical, Sivas, Türkiye) intramedüller çivi ile protez ara baðlantýsý birleþim yerinden travma dýþý geliþen kýrýðýný sunuyoruz. Literatürde bu tip proteze ait benzer bir mekanik komplikasyon vakasý bildirilmemiþtir.

Olgu: 73 yaþýnda (82 kg, 163 cm, Vücut kitle indeksi: 30,86) kadýn hasta acil servise kalça aðrýsý ve yürüyememe þikayetiyle baþvurdu. Subtrokanterik bölgede patolojik kýrýk nedeniyle proksimal femur rezeksiyonu ve tümör protezi ile rekontrüksiyon yapýldý. Parsiyel çimentosuz modüler tümör protezi (ESTAS Medical, Sivas, Türkiye) ile rekonstrüksiyon yapýldý. Takiplerinde tek baston ile mobilize olan ve aðrýsý olmayan hastanýn, postoperatif 2. yýlýnda femoral intramedüller çivi ile protez ara baðlantý bölgesi arasýnda travma dýþý geliþen kýrýk görüldü. Kýrýk bölgesine uygun seviyeden ve eski insizyon bölgesi üzerinden yaklaþýlarak kýrýk protez bölgesine ulaþýlmasýyla, kanal içi femoral çivi ve ara baðlantý segment parçasý deðiþtirilerek revizyon ameliyatý yapýldý. Hastada yara yeri sorunu görülmedi ve destekli olarak mobilize edildi.

Sonuç: Giderek artan sýklýkta kullanýlan tümör rezeksiyon protezlerinin modüler yapýsý saðladýðý birçok avantajýn yanýnda elde ettiðimiz izlenimler sonucunda potansiyel bir mekanik zayýflýk da taþýmaktadýr. Adjuvan tedavilerdeki geliþmelerle birlikte sað kalým sürelerinin uzamasý ile bu mekanik zayýflýk daha çok komplikasyona yol açabilir. Özellikle protezin birleþim yerlerindeki bu mekanik zayýflýðýn giderilebilmesi için yeni tasarýmlara ve çalýþmalara ihtiyaç vardýr.

Background: As a result of advances in adjuvant therapy, the 5-year survival rate of malignant bone tumors has increased from 20% to 70%. Similarly, longer survival times are observed as a result of advances in medical treatment of metastatic cancer patients. In addition, after lungs and livers, bones are the third most common site of metastasis in cancer patients. Therefore, reconstruction with modular tumor resection prostheses is increasingly used. In addition, the reported complication rates are five to ten times higher than those seen in normal joint arthroplasty. In this article, we present a non-traumatic fracture of a modular tumor resection prosthesis (ESTAS Medical, Sivas, Turkey) at the junction of the intramedullary nail and the prosthesis interconnection. No similar mechanical complication
cases of this prosthesis were reported in the literature we reviewed.

Case Description: A 73-year-old (82 kg, 163 cm, Body mass index: 30.86) female patient was admitted to the emergency department with complaints of hip pain and inability to walk. Due to the pathological fracture in the subtrochanteric region, proximal femur resection and reconstruction with tumor prosthesis were performed. The reconstruction was performed with a partial cementless modular tumor prosthesis (ESTAS Medical, Sivas, Turkey). During the follow-up, the patient was mobilized with a single cane and had no pain. In the 2nd year postoperatively, a non-traumatic fracture was observed between the femoral intramedullary nail and the prosthesis interconnection area. The fractured prosthesis area was reached by approaching the fracture site at the appropriate level over the old incision area, and revision surgery was performed by replacing the intracanal femoral nail and the interconnection segment piece. There was no wound site problem in
the patient and he was mobilized with support.

Conclusion: The modular structure of tumor resection prostheses, which are increasingly used, has many advantages, as well as a potential mechanical weakness as a result of the impressions we have obtained. With the advances in adjuvant treatments and the prolongation of survival, this mechanical weakness may lead to more complications. New designs and studies to eliminate this mechanical weakness, especially in the joints of the prosthesis, are highly needed.

Abstract | Full Text PDF

Aka Plan: Ateþli silah yaralanmasý sonucu genç eriþkin proksimal femurunda femur boynunun kaybýnýn da eþlik ettiði atipik kýrýðý vaka olarak sunuyoruz.

Vaka sunumu: Yüksek enerjili balistik yaralanma ile yaralanan ve ayrýca blastik etki nedeniyle sinir yaralanmasý geliþen 41 yaþýnda erkek hastayý sunuyoruz. Hastayý enfeksiyondan koruyarak ve hasar kontrollü cerrahi prensiplerine uyarak tedavi aþamalarýmýzý sunmaktayýz.

Tartýþma: Büyük eklemleri ilgilendiren ateþli silah yaralanmalarý özellikle kalça ekleminde ölümcül olabilir. Femoral boyun kemik dokusunda kayýp ve çevre yumuþak doku hasarý açýk redüksiyon ve internal fiksasyonu zorlaþtýrýr. Yüksek enerjili balistik yaralanmalarýn doðasý gereði ve enfeksiyon riski nedeniyle protez baþarýsýzlýðýna neden olur. Sonuç olarak hastayý üç aþamalý cerrahiyle tedavi edildi. Hastaya total kalça artroplastisi uygulandý ve hasta ameliyattan sonra fonksiyonel ve tatmin edici bir hayat yaþadý.

Background: We report an atypical case of a middle-aged adult male who wounds with gunshot injury of the proximal femur with femoral neck loss.

Case presentation: We present a 41-year-old male patient who wounds with a high-energy ballistic injury and had also nerve injury due to blastic effect. We present our treatment stages by protecting the patient from infection and by complying with the damage-controlled surgery principles.

Conclusion: Those gunshots involving major joints, especially the one on the hip, could be lethal. The comminuted femoral neck and periarticular soft tissue injuries made open reduction with internal fixation difficult. The nature of the high-energy ballistic injury increases the possibility of infection that may have contributed directly to prosthesis failure. As a result, we have treated the patient with three-stage surgery. The patient underwent total hip arthroplasty, and the patient lived a functional, satisfying life after surgery.

Abstract | Full Text PDF