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Biomedical subjects

E Atasoy

Publications and source records attributed to E Atasoy.

At least 19 recordsLinked to original sources
PubMed2006

Combined surgical treatment of thoracic outlet syndrome: transaxillary first rib resection and transcervical scalenectomy.

Many different procedures have been developed to treat thoracic outlet compression syndrome (TOCS), a condition in which neurovascular structures in the thoracic outlet region are compressed. Currently, transaxillary first rib resection and transcervical anterior and middle scalenectomy are the most popular and standard procedures. In the early 1980s, some surgeons started to perform both procedures, starting with the scalenectomy and following with a transaxillary first rib resection. We have found that performing these procedures in the reverse order, starting with the first rib resection and following immediately with a transcervical anterior and middle scalenectomy accomplishes total decompression of the thoracic outlet area with much better improvement of symptoms and much lower recurrence rate.

Adolescent↗
PubMed2000

Scapulothoracic stabilisation for winging of the scapula using strips of autogenous fascia lata.

We have used a modified technique in five patients to correct winging of the scapula caused by injury to the brachial plexus or the long thoracic nerve during transaxillary resection of the first rib. The procedure stabilises the scapulothoracic articulation by using strips of autogenous fascia lata wrapped around the 4th, 6th and 7th ribs at least two, and preferably three, times. The mean age of the patients at the time of operation was 38 years (26 to 47) and the mean follow-up six years and four months (three years and three months to 11 years). Satisfactory stability was achieved in all patients with considerable improvement in shoulder function. There were no complications.

Adult↗
PubMed1997

Thoracic outlet compression syndrome caused by a schwannoma of the C7 nerve root.

This is the first report of a schwannoma originating from the C7 nerve root causing thoracic outlet compression syndrome. The patient was a 30-year-old woman with a 3-year history of numbness on the radial side of the left hand, left arm tiredness, nocturnal pain in the left forearm and pain in the left elbow, shoulder and neck. Conservative treatment and previous operations, including carpal tunnel release and first rib resection, provided no relief. A left scalenectomy was performed. During the removal of the anterior scalene muscle, a mass approximately 3 cm long and 1.5 cm in diameter was noted under the anterior scalene muscle involving the C7 nerve root. The tumour was encapsulated and covered with attenuated and stretched nerve fascicles. It was completely excised without disturbing the nerve fascicles. The clinical impression was schwannoma, which was confirmed on pathological examination.

Adult↗
PubMed1996

Thoracic outlet compression syndrome.

This article is concerned with thoracic outlet compression syndrome (TOCS), one of the most controversial subjects in medicine. It may also be the most underrated, overlooked, misdiagnosed, and probably the most important and difficult to manage peripheral nerve compression in the upper extremity. Contents of the chapter include the historical aspect, anatomy, etiology and incidence, pathophysiology, symptomatology, diagnosis, conservative and surgical treatment, other conditions associated with TOCS, and results of TOCS surgical treatment.

Diagnosis, Differential↗
PubMed1993

Long-term results of denervation of the wrist joint for chronic wrist pain.

The results have been evaluated of 29 patients who had wrist denervation for chronic wrist pain between 1979 and 1987. Follow-up ranged from 22 to 86 months (mean 51 months). 17 patients had denervation without a concurrent procedure. Of these, 12% became pain-free and 71% had pain with all activities or had additional surgery; 24% said they were satisfied with their treatment. The results were worse in those who had partial denervation than those who had total denervation. 12 patients had denervation performed concurrently with another pain-relieving procedure. Denervation alone was not reliable in resolving chronic wrist pain.

Adult↗
PubMed1984

Perichondrial resurfacing arthroplasty in the hand.

A retrospective study of 36 perichondrial resurfacing arthroplasties, 16 metacarpophalangeal (MP) joints, and 20 proximal interphalangeal (PIP) joints with a minimum follow-up of 3 years was conducted to further define indication and contraindication of this procedure. The overall results for MP joints were 56% good, 25% fair, and 19% revision, and for PIP joints, 55% good, 15% fair, and 30% revision. All arthroplasties for healed pyarthrosis failed. Concomitant tendon repair was a cofactor in the high failure rate. Patient age had a direct influence on the outcome of the arthroplasty. In MP joint arthroplasties, 100% of patients in their 20s had good results and 75% in their 30s had good results. In PIP joint arthroplasties, 75% of patients in their teens and 66% in their 20s had good results. Good results were not recorded in MP or PIP joints for patients older than 40 years of age. Perichondrial resurfacing arthroplasty should be considered contraindicated in the treatment of arthropathies resulting from healed pyarthrosis, systemic diseases with joint involvement, concomitant tendon reconstruction, and age over 40 years. The procedure is indicated and can be utilized in the treatment of traumatic arthritis of the MP and PIP joints of the hand in young individuals.

Adolescent↗
PubMed1983

The "antenna" procedure for the "hook-nail" deformity.

The hook-nail deformity is a relatively common problem after fingertip amputations. It is usually ignored but can be quite disabling. This deformity can be corrected by a carefully planned operation. Most of the curved nail plate is removed, the pulp is reflected from the distal phalanx out to a normal contour, and then the full thickness of the nail bed is elevated off the distal phalanx and splinted by multiple small Kirschner pins in a straight position. The defect created is covered with a cross finger flap.

Adolescent↗
PubMed1981

Reconstruction of severe transmetacarpal mutilating hand injuries by combined second and third toe transfer.

This paper reports on nine instances of combined second and third toe-to-hand transfers in eight patients for severe transmetacarpal mutilating hand injuries. In four cases, the transfer included an innervated flap from the fibular side of the great toe to provide sensibility to a previously constructed osteoplastic thumb. Prehensile function was significantly improved by providing chuck or tripod pinch as well as improved pulp-to-pulp and lateral pinch. At a mean follow-up of 20.3 months, there was only one failure.

Adult↗
PubMed1980

The abdominohypogastric flap--an axial pattern flap for forearm coverage.

The abdominohypogastric flap, an axial pattern flap supplied by the anterior perforating branches of the deep inferior epigastric artery and the branches of the superficial inferior epigastric artery, has been used successfully to resurface defects on the forearm in two patients. The Doppler is employed to determine the presence and the course of the superficial inferior epigastric artery in order to include branches of this artery within the base of the flap.

Abdomen↗
PubMed1980

The cross thumb to index finger pedicle.

By careful technique the dorsum of the thumb can be used as a donor area to cover exposed bone of index fingertip amputations and, in certain cases, avulsions of the nailbed. In this procedure an oblique, radially based flap from the dorsum of the proximal phalanx is used.

Adolescent↗
PubMed1977

Arthritis of the trapezial articulations treated by prosthetic replacement.

This paper reviews experience with thirty-six trapezial replacements over a period of six years. The indications for replacement are given, the group of patients analysed and the technique outlined, with particular attention given to tendinous reinforcement of the capsular repair. The results with regard to pain, dislocation and other complications are recorded. The causes of dislocation and its prevention are discussed.

Arthritis, Rheumatoid↗
PubMed1977

Replantation of digits and hands: analysis of surgical techniques and functional results in 71 patients with 86 replantations.

Defining replantation as the restoration of a completely amputated part as opposed to simply restoring circulation to an incompletely severed part, the results of replantation of 86 completely amputated parts in 71 patients performed from January, 1970, to December, 1975, were studied. Twenty-eight, or 32.5 percent, were the result of sharp severances of the part; localized crushing accounted for 56, or 65.1 percent. Two were classified as degloving injuries. Twelve amputations were transmetacarpal, six were at the metacarpophalangeal joints, 14 through the proximal phalanx, 15 at the proximal interphalangeal joint, 21 in the middle phalanx, 13 at the distal interphalangeal joint, and five through the distal phalanx. The technique consisted of bone shortening and fixation and repair of all tendons and nerves if possible. Veins are repaired first, at least two for each artery, and heparinized saline and lidocaine are used locally. Irrigation of the vessels is not done, but an intravenous bolus of 3,000 U. of heparin is given when the anastomoses are completed. Aspirin and low molecular weight dextran are given for 3 to 7 days. For the more distal replantation, heparin may be used. Antibiotics are given. In the total series of 86 completely amputated hand units, 52 were unsuccessful, primarly due to vascular thrombosis and usually on the venous side. In the year 1975 a success rate of 69.2 percent was achieved, whereas in the last 50 replantations, done between Jan. 1, 1976, and Oct. 15, 1976, the success rate was 90 percent. Results improved with more experience in the technique and with more careful selection of patients.

Adolescent↗
PubMed1977

Primary flexor tendon repair followed by immediate controlled mobilization.

A study was made of the results of immediate repair and controlled mobilization in 156 severed flexor tendons in 68 patients occuring over an 18-month period. Eight patients with 16 tendon injuries could not be followed. Results were obtained from examinations done 6 weeks to 18 months (mean, 5.3 months) after repair. Thirty-one of the 60 patients were less than 20 years old, and 44 of the 60 were less than 30 years old. Seventy-nine (56%) of the injuries occurred in the area known as "no man's land"; 28 patients with repair of tendons in this area were rated by our standards as "excellent" or "good"--75% of patients as compared to 84.4% for the results of repair in other areas. In one fourth of the cases of severance of both tendons, because of local conditions in the wound, the superficialis was excised, but in all others it was repaired.

Adolescent↗
PubMed1976

Microvascular procedures in reconstructive surgery.

The application of microvascular technics to problems in reconstructive surgery has enabled the surgeon to revascularize ischemic digits, replant amputated digits, and to transfer directly composite tissue from one area of the body to another for reconstructive purposes. The success of these procedures is directly dependent upon the ability to perform and maintain patent microvascular anastomoses. Representative cases are reported including the revascularization of an incompletely amputated digit, the replantation of an amputated thumb, the direct transfer of a toe to replace a missing thumb, and the transfer of a groin flap to cover a lower extremity defect. The principles of preoperative management, operative technics, and postoperative care are reviewed.

Adult↗