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Öğe Comparison of stiffness, elasticity and resilience values of ACL with autografts used instead of ACL in terms of texture analysis(Cell Press, 2024) Mert, Ahmet; Cinaroglu, Selim; Aydin, Murat; Cicek, Fatih; Ceranoglu, Faruk GaziBackground: Anterior cruciate ligament (ACL) ruptures are one of the most extensively studied injuries in the field of orthopedics, but despite the extensive research, graft selection for ACL reconstruction remains a matter of debate. The present study aims to evaluate the stiffness and elasticity of native ACLs using texture profile analysis and compare results with those of autografts used in ACL reconstruction. Methods: Included in the study were dissected 12 cadavers from which grafts were recovered. The graft characteristics, such as stiffness, elasticity and resilience, were measured using a TA.XT Plus Texture Analyzer. Findings: Among the grafts studied, Achilles' tendon graft (0.70; 0.64) had the highest resilience in both males and females, while the greatest elasticity was identified in the patellar tendon graft (Male: 93 %; Female: 94 %) in all subjects. The highest stiffness value in males was recorded for the quadriceps tendon graft (2928.76 N), while the highest stiffness value in females was recorded for Achilles' tendon graft (2204.61 N). Interpretation: According to the study data, the autografts that may be considered as an alternative to ACL were, listed in order of strength from high to low, the quadriceps, Achilles', patella and hamstring tendons in men, and the Achilles', quadriceps, patellar and hamstring tendons in women. It is worthy of note that the hamstring tendon graft, which is the most frequently preferred autograft in ACL reconstruction, was found to be the lowest in all parameters in both groups.Öğe Connection between medial dorsal cutaneous nerve and saphenous nerve: case report(Springer France, 2023) Cicek, Fatih; Koc, Turan; Olgunus, Zeliha KurtogluPurposeThere are no data on the connection of the saphenous nerve (SN), located on the medial side of the foot, with the terminal branches of the superficial fibular nerve. The aim of this study is to reveal the variation that surgeons should pay attention to for anesthesia applied in foot surgeries.MethodsIn this study, the left foot of a 70-year-old female cadaver fixed with formalin was dissected. The distance to the medial malleolus and the incision line was recorded using digital caliper to determine the reference points in the resulting variation.ResultsIt was observed that a branch from the SN, which arose from the SN and proceeded anteriorly to the upper part of the medial malleolus and continued towards the dorsum of the foot, hooked with a branch from the medial dorsal cutaneous nerve (MDCN). The branches arising from this hook were distributed on the medial edge of the foot up to the proximal metatarsophalangeal joint I. The distance of this nerve connection to the medial malleolus is 91.14 mm, and the distance to the incision line is 15.76 mm.ConclusionsIt is suggested that the case presented as an unusual SN variation, which may affect the success of local anesthesia in invasive procedures to the medial part of the foot and could be considered in the evaluation of sensory loss after anteromedial surgical approach to the ankle, should be included in the classification of the cutaneous innervation pattern of the foot.Öğe Evaluation of nerve innervation distribution of orbicularis oculi muscle for botulinum neurotoxin application using Sihler's method(Elsevier Gmbh, 2024) Cicek, Fatih; Cinaroglu, Selim; Ceranoglu, Faruk Gazi; Kucuk, Erkut; Zor, Kursad RamazanBackground: Blepharospasm is the involuntary and forced closure of the eyelids due to spasm-like contraction of the orbicularis oculi muscle around the eye. The study aimed to reveal the nerve innervation of the orbicularis oculi muscle for Botulinum neurotoxin (BoNT) treatment of blepharospasm by Sihler's staining technique.Methods: This study used six cephalus (12 orbicularis oculi muscles) with an average age of 69,6 (62-88) years. Then, the orbicularis oculi muscles were removed by dissection, and Sihler's staining technique was applied to the muscles. The limit for dissection of the muscle is the orbital opening level, where the nerves enter the muscle, and the muscle attaches to the bone. Results: In the region above the palpebral fissure, the nerves entering the muscle were densely located in the superolateral quadrant between 9 and 12 o ' clock in the right eye and between 12 and 3 o ' clock in the left eye. In the region under the palpebral fissure, the nerves' density in the orbicularis oculi muscle was higher between 4 and 7 o ' clock in the right eye and between 5 and 8 o ' clock in the left eye.Conclusion: This study unveiled the nerve branches associated with the orbicularis oculi muscle. It pinpointed precise crossing points of these nerve branches, which can be targeted for applying BoNT in treating blepharospasm. Consequently, by utilizing minimal BoNT, it is anticipated that the quantity of toxin administered will decrease, leading to more efficient outcomes and reduced expenses. Furthermore, this approach can aid in averting potential undesired complications during BoNT administration.Öğe Examination of the Tensile Strength of the Peroneus Longus Muscle(Springernature, 2024) Yagar, Hilal; Cinaroglu, Selim; Cicek, Fatih; Ceranoglu, Faruk; Karadag, HueseyinIntroduction: The peroneus longus tendon (PLT) is increasingly used as a tendon autograft in ligament and tendon reconstructions. The aim of this study is to evaluate the biomechanical properties of the PLT to assess its usability in frequently performed reconstructions. Methods: Six fresh-frozen, below-knee cadavers with a mean age of 65 years, no previous surgical operation, and no history of chronic disease were used. PLTs were harvested, freed from muscle tissue, and prepared for tensile strength testing at a tensile force rate of 2 mm/min using a Shimadzu Autograph AG-IS 100 kN instrument (Shimadzu Corporation, Kyoto, Japan). Results: The maximum tensile force varied between 600.7 N and 1131.313 N, with a median of 758.185 N. All tendons had diameters of 8 mm or more. The elongation at maximum force ranged from 9.0 mm to 16.0 mm, with a median of 14.0 mm. Conclusion: According to this study, PLT is a viable choice for surgeries involving autograft reconstruction. However, further clinical studies are needed to confirm its efficacy in reconstructive surgeries.Öğe Gender and Height Estimation from Hand and Handprint Sizes in the Turkish Population(Wolters Kluwer Medknow Publications, 2023) Keles, Haci; Cinaroglu, Selim; Cicek, Fatih; Ceranoglu, Faruk Gazi; Tekeli, MustafaIntroduction: In forensic medicine, it becomes impossible to identify corpses in events that affect a large part of the population, such as natural disasters, accidents, and wars. The aim of this study is to determine the height and gender of the Turkish population with hand and handprint morphometric measurements. Materials and Methods: The sample size of the study consists of 600 Turkish population aged between 18 and 58 years (mean +/- standard deviation: 22.18 +/- 5.43) living in Middle Anatolia. In the morphometric measurements of the hand, 21 anthropometric measurements were taken from each volunteer. Results: It was determined that men had higher values than women in all hand and handprint measurements and were statistically significant. When the correlation between hand and handprint measurements and statue was examined, it was determined that hand length and handprint length had the highest correlation with height in both genders (male: r: 0.57, r: 0.62; female: r: 0.49, r: 0.50). When comparing the bilateral asymmetry of the right and left hands of both sexes, it was observed that there was a statistically significant difference between the lengths of the thumb distal phalanx, little finger proximal, and middle phalanx in men and between the lengths of the index finger distal phalanx, middle finger middle and distal phalanx, and ring finger distal phalanx in women (P < 0.05). Conclusion: As a result, it was seen that the use of hand and handprint measurements to determine height and gender in the Turkish population gave high results.Öğe Investigation of Morphometric Characteristics of the Mesencephalon in a Healthy Turkish Population: An MRI-Based Morphometric Study(Springernature, 2023) Demir, Mehmet; Cinaroglu, Selim; Ceranoglu, Faruk G.; Cicek, Fatih; Koc, TuranIntroduction: Due to the important functions of the mesencephalon, knowledge of its morphometric characteristics in a healthy population is important for any pathological diagnosis. The aim of this study was to determine the specific morphometric values of the mesencephalon in a healthy Turkish population.Methods: Magnetic resonance (MR) images of 184 subjects (98 females, 86 males) with a mean age of 47.33 years (range 18 to 85 years) were included in the study. Then, parameter measurements were performed on 1.5 T MR images, and MicroDicom Digital Imaging and Communications in Medicine (DICOM) viewer 2022.1 (MicroDicom Ltd., Sofia, Bulgaria) software program was used for the measurements.Results: The mean sagittal diameter of the right cerebral peduncle was 17.17 +/- 2.03 mm, the mean crosssectional area of the right cerebral peduncle was 171.75 +/- 32.81 mm(2), the mean transverse diameter of the left cerebral peduncle was 16.60 +/- 2.32 mm, sagittal diameter of tectum and tegmentum 17.01 +/- 1.57 mm, the cross-sectional area of tectum and tegmentum 223.40 +/- 27.37 mm(2) and pontomesencephalic angle 52.03(degrees)+/- 10.61(degrees), while in males these values were 18.26 +/- 2.38 mm, 182.61 +/- 38.57 mm(2), 17.39 +/- 2.57 mm, 17.76 +/- 1.90 mm, 237.20 +/- 35.94 mm(2) and 56.77(degrees)+/- 9.78(degrees), respectively. Except for the mamillopontine distance, there was a statistically significant difference between genders in the other parameters (p<0.05).Conclusion: In conclusion, the findings related to the mesencephalon obtained in this study are presented for the first time in a healthy Turkish population. Especially, the cerebral peduncle cross-sectional area, tectum and tegmentum cross-sectional area, and cerebral peduncle transverse diameter can be evaluated clinically. We believe that knowledge of these values will guide specialists and radiologists in the diagnosis of any pathologic condition. Furthermore, the pontomesencephalic angle and mamillopontine distance have been identified as potentially useful landmarks in the diagnosis of intracranial hypotension and hydrocephalus. In particular, these angles can be measured in patient groups and may be a potential landmark in making an alternative diagnosis.Öğe Positional and dimensional relation of tendons around the first metatarsal bone with hallux valgus(Springer France, 2023) Olgunus, Zeliha Kurtoglu; Cicek, Fatih; Koc, Turan1. Coughlin MJ, Jones JP (2007) Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ankle Int 28:759-777. https://doi.org/10.3113/FAI.2007.0759 2. Perera A, Mason L, Stephens M (2011) The pathogenesis of hallux valgus. J Bone Joint Surg Am 93:1650-1661. https://doi.org/10. 2106/JBJS.H. 01630 3. Cavalheiro CS, Arcuri MH, Guil VR, Gali JC (2020) Hallux valgus anatomical alterations and its correlation with the radiographic findings. Acta Ortop Bras 28:12-15. https://doi.org/10. 1590/1413-785220202801226897 4. Chhaya SA, Brawner M, Hobbs P, Chhaya N, Garcia G, Loredo R (2008) Understanding hallux valgus deformity: what the surgeon wants to know from the conventional radiograph. Curr Probl Diagn Radiol 37:127-137. https://doi.org/10.1067/j.cpradiol. 2007.11.004 5. Coughlin MJ, Shurnas PS (2003) Hallux valgus in men part II: first ray mobility after bunionectomy and factors associated with hallux valgus deformity. Foot Ankle Int 24:73-78. https://doi.org/ 10.1177/107110070302400112 6. Mickle KJ, Nester CJ (2018) Morphology of the toe flexor muscles in older people with toe deformities. Arthritis Care Res (Hoboken) 70:902-907. https://doi.org/10.1002/acr.23348Öğe The effect of hallux valgus on the anatomy of the nerves around the first metatarsal bone(Springer France, 2024) Cicek, Fatih; Olgunus, Zeliha Kurtoglu; Koc, TuranObjective To identify the variations in the location of the nerves that may be at risk in hallux valgus (HV) surgery, and to reveal whether these nerves are affected by the anatomical changes associated with HV. Method In the formalin fixed, 46 lower extremities (19 female, 27 male) (9 normal, 14 mild HV, 21 moderate/severe HV), extensor hallucis longus tendon (EHL), deep plantar artery, medial dorsal cutaneous (MDCN), deep fibular (DFN), common plantar digital (CPDN) and proper plantar digital (PPDN) nerves were examined. The branches of MDCN extending to the medial side of foot were recorded in three segments. The positional topography of nerves according to EHL were analyzed on 360(degrees) circle and clock models. Results Sex-related differences observed in some parameters in direct measurements were not found in the clock model comparisons. In advanced HV angles (> 20(degrees)), DFN was closer to EHL in the distal part of the metatarsal bone, while there was no difference in the proximal. The intersection of the medial branch of the MDCN with the EHL was more proximal in HV cases than in normal feet. The location of the nerves in the clock pattern did not change in HV. Of the nerve branches reaching the medial side of the foot, 65.2% were in Part I, 71.7% in Part II, and 4.3% in Part III. Conclusion Sex differences in the distance of the nerves to the EHL disappeared when the size effect of the cross-section of the first metatarsal bone region was eliminated with the clock model. Only in advanced HVA (>20(degrees)) (not in mild HV), the DFN being closer to the EHL distally and the intersection of the medial branch of the MDCN with the EHL in HV being more proximal than in normal can be interpreted as specific reflections of HV progress. The variations we revealed in the number of branches reaching the inside of the foot may explain the diversity of neuromas or nerve injuries associated with HV surgery.Öğe The relationship between sphenoidal sinus and sella turcica morphometry in the Turkish population: a retrospective study(Springer France, 2024) Keles, Haci; Yakar, Huseyin; Kaya, Ismail; Cicek, Fatih; Ceranoglu, Faruk Gazi; Ciftci, Ali Turker; Karadag, HuseyinPurpose The anatomical position of the sphenoidal sinus (SS) is very important for neurosurgeons because of the trans-sphenoidal approach to the pituitary gland. Therefore, the aim of this study was to determine the volume and shape of the SS and its relationship with the morphometry of the sella turcica. Methods This study included CT images of 282 males and 258 females with a mean age of 50.52 years (range 18-75) who underwent head CT. The morphometric values of the sella turcica and the volume of the SS were measured on the included radiologic images. Measurements were made on the sagittal slice closest to the midline in T1 sequence. Morphometric measurements were made with Micro Dicom Viewers software program and volume measurements were made with ITK SNAP software program. Results In this study, 4 types of SS shapes were obtained in the whole population: amorphous, pentagonal, triangular and quadrilateral. The mean SS volume was 7055.88 mm3 in males and 5694.48 mm3 in females and a statistically significant difference was observed (p < 0.001). In addition, a statistically significant difference was found between the sexes in the width and surface area parameters of the sella turcica (p < 0.05). Conclusion In this study, the morphometric relationship between the shape of the sinus sphenoidale and sella turcica was demonstrated between men and women. In particular, the shape of the sinus sphenoidale was found to be anthropometrically different between men and women in the Turkish population. It is hypothesised that the data obtained in our study will guide surgeons performing transsphenoidal approach.Öğe Tractography analysis results of the trigeminus nerve, which contains fibers responsible for proprioception sensation and motor control in Adolescent Idiopathic Scoliosis(Springer, 2024) Payas, Ahmet; Cicek, Fatih; Ekinci, Yakup; Batin, Sabri; Gokturk, Sule; Gokturk, Yasin; Kararti, CanerStudy Design Cross-sectional Study. Background It is not yet clear whether the loss of proprioceptive sensation and muscle weakness seen in adolescent idiopathic scoliosis (AIS) is the result of central nervous system dysfunction or secondary to spinal deformity. In our study, in order to find an answer to this question, we examined the microarchitecture of the nervus trigeminus, which is least affected by spinal deformity and contains both proprioceptive sensory and motor fibers. Methods In this single-center, cross-sectional cohort study, 40 Lenke Type 3 (27 female, 13 male) AIS patients and 40 (25 female, 15 male) healthy individuals between the ages of 10-18 years. Tractography of the nervus trigenimus was performed using the DSI Studio program. The volumes of the targeted musculus pterygoideus lateralis and musculus pterygoideus medialis were measured using the Insight Segmentation and Registration Tool Kit (ITK -SNAP) program. The data were evaluated using the Statistical Package for the Social Sciences 22.0 program for Windows. Results There was no significant difference between the two groups in terms of baseline characteristics (p >0.05). Left nervus trigeminus fiber number and fiber ratio were significantly higher in the control group compared to the scoliosis group p < 0.05. Right and left lateral pterygoid muscle showed lower volume and volume percentage in the scoliosis group compared to the control group (p < 0.05). Conclusion According to the study data, proprioceptive sensory and motor control dysfunction in AIS is predicted to develop independently of spinal deformity.
