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    How does tranexamic acid affect blood transfusion and bleeding amount in pelvis-acetabulum fractures treated with open reduction and internal fixation?
    (Turkish Assoc Trauma Emergency Surgery, 2022) Tekin, Sezgin Bahadir; Demir, Ibrahim Halil; Bozgeyik, Bahri; Mert, Ahmet
    BACKGROUND: This study aimed to investigate intravenous tranexamic acid's (TA) effect on blood loss and transfusion ratios in pelvis-acetabulum fractures treated with open reduction and internal fixation.METHODS: Patients who underwent open reduction and internal fixation due to pelvis-acetabulum fractures between January 2017 and January 2019 constituted this study's target population. After applying inclusion and exclusion criteria, patients were divided into two groups: Those who were perioperatively given 15 mg/kg TA (i.e., Group 1) and those who were not (i.e., Group 2). Data including age, gender, mechanism of injury, fracture type, presence or absence of additional injuries, the time interval between admission and surgery, incision site, pre-operative and post-operative hemoglobin levels, intraoperative estimated blood loss (EBL), number of blood units transfused, and complications were recorded. Two groups were compared regarding these parameters.RESULTS: The study cohort included 58 patients. There were 30 patients in Group 1 and 28 patients in Group 2. Our analysis revealed that the number of blood units transfused was significantly higher in Group 2 than Group 1 (p=0.016). However, there was no significant difference between the two groups regarding intraoperative EBL, pre-operative and post-operative hemoglobin levels, and the time interval between admission and surgery.CONCLUSION: Administration of intravenous TA reduces blood transfusion requirement in patients with pelvis-acetabulum fractures treated with open reduction and internal fixation. This approach can prevent potential blood transfusion-related complications.
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    Relationship between admission neutrophil/lymphocyte, thrombocyte/lymphocyte, and monocyte/lymphocyte ratios and 1-year mortality in geriatric hip fractures: Triple comparison
    (Turkish Assoc Trauma Emergency Surgery, 2022) Tekin, Sezgin Bahadir; Bozgeyik, Bahri; Mert, Ahmet
    BACKGROUND: Elderly patients with hip fractures have a high post-operative 1-year mortality rate. The aim of this study was to investigate the relationship of the neutrophil/lymphocyte ratio (NLR), thrombocyte/lymphocyte ratio (TLR), and monocyte/lymphocyte ratio (MLR) with mortality. METHODS: The data of 350 patients who suffered femoral intertrochanteric fractures between January 2015 and January 2020 were examined, and the demographic data of 124 patients who met the study criteria were evaluated. During the 1-year follow-up, 92 patients (74%) who continued their lives and 32 patients (25%) who died were divided into two groups: Group 1 (survivors) and Group 2 (non-survivors). NLR, TLO, MLO, presence of comorbidities, age, sex, American Society of Anesthesiologists Physical Status Classification, length of hospital stay, fracture type, and fracture pattern values were statistically compared between the two groups. RESULTS: NLR, TLR, and MLR are the laboratory parameters assessed within the scope of the study. Preoperatively, the mean NLR was 6.59 (1.61-26.29), mean TLR was 197.94 (86-516), and mean MLR was 0.73 (0.19-15.68). In this study, a significant relationship was found between NLR, TLR, and MLR values and the occurrence of post-operative 1-year mortality ( p=0.01). In addition, the result was significant in the correlation between these parameters. Cutoff values were found to be 7.53 for NLR, 192 for TLR, and 0.54 for MLR in receiver operator characteristic curve analysis (p<0.01). CONCLUSION: NLR, TLR, and PLR are significant predictors of 1-year mortality in patients aged over 60 years with hip fractures.
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    Which is superior in the treatment of AO Type 42A tibial shaft fracture? A comparison of talon intramedullary nailing and conventional locked intramedullary nailing
    (Turkish Assoc Trauma Emergency Surgery, 2022) Tekin, Sezgin Bahadir; Mert, Ahmet; Bozgeyik, Bahri
    BACKGROUND: This study aimed to compare the clinical and radiological outcomes of conventional locked intramedullary nailing (IMN) and talon IMN in AO Type 42A tibial fractures.METHODS: A total of 93 patients with AO Type 42A fracture were retrospectively analyzed. The patients were divided into two groups: Those treated with conventional IMN (Group 1), and those treated with talon distal locked nailing (Group 2). The patients were statistically compared in terms of age, sex, mechanism of injury, follow-up time, time to union, smoking status, presence of open fracture, presence of concomitant fibula fracture, development of malunion and nonunion, and the number of intraoperative fluoros -copy shots captured. All patients were evaluated with American Orthopaedic Foot and Ankle Society and Tegner Lysholm scores for clinical outcomes.RESULTS: A total of 93 patients (68 men and 35 women) participated in the study. Group 1 consisted of 35 (71.4%) men and 14 (28.6%) women, a total of 49 patients, while Group 2 consisted of 33 (75%) men and 11 (25%) women, a total of 44 patients. There were no significant differences between the two groups in terms of age, sex, mechanism of injury, follow-up times, smoking status, concomitant fibula fracture, presence of malunion, and presence of open fracture (p>0.05). However, there were significant differences between both groups in terms of time to union, nonunion rate, and the number of fluoroscopy shots captured (p<0.05). American Orthopaedic Foot and Ankle Society and Tegner Lysholm score were analyzed and compared, no statistically differences were found (p=0.786 and p=0.764).CONCLUSION: Although talon IMN reduces radiation exposure, locked conventional IMN has lower nonunion rates and achieves union faster.