Orthopedics and Traumatology

Orthopedics and Traumatology department is the specialty that deals with the diagnosis and treatment of all diseases and injuries of the musculoskeletal system traumatic, congenital or acquired bones, joints and related soft tissues. Arms, legs, spine and pelvis regions, all joints, bones, muscles and related tissues (vessels, nerves, spinal cord) from the skull base to […]

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Orthopedics and Traumatology department is the specialty that deals with the diagnosis and treatment of all diseases and injuries of the musculoskeletal system traumatic, congenital or acquired bones, joints and related soft tissues.

Arms, legs, spine and pelvis regions, all joints, bones, muscles and related tissues (vessels, nerves, spinal cord) from the skull base to the nail tip are included in the field of orthopedics.

In our orthopedics department, the most appropriate medical and surgical treatment opportunities are offered to the patients in cooperation and cooperation with other branches such as physical therapy and rehabilitation, benefiting from the latest technological opportunities. Which diseases are diagnosed and treated in the Orthopedics and Traumatology Department? ARTHOPLASTY SURGERY (JOINT PROSTHESES)
 

What is arthroplasty?

Arthroplasty is another name for joint prosthesis surgery. It is the replacement of severely damaged joints in the body with an artificial joint.

It is usually done in order to eliminate the damage caused by the cartilage structure, which is damaged due to age and traumas, to the joints and to ensure that the person continues his daily activities without any problems. Prostheses made in expert hands and using advanced technology products give successful results.

The most common joints in prosthetic surgery are knee and hip joints. Hip prostheses are applied for tumors around the hip, fracture of the hip circumference, deterioration of the hip joint cartilage and cartilage wear due to bone resorption. In addition, the departments where arthroplasty is performed can be listed as follows:

Shoulder prosthesis, 

Elbow prosthesis

Hip replacement

· Knee arthroplasty

Ankle prosthesis

When is arthroplasty (joint prosthesis) necessary?
 

If it is not possible to treat joint fractures as a result of trauma,

If the joint needs to be removed from the body due to a tumor in the bones,

In advanced ages, due to the disappearance of cartilage tissue,

If it is not possible to treat the joints that allow us to move, Total Joint Prosthesis surgeries are required.

What is the recovery time of total joint prosthesis?

Patients with joint prostheses are discharged from the hospital within 3-5 days after surgery. Depending on the area where the joint is located, it starts to load over time and the patient can return to his daily life between 4 and 8 weeks depending on the area where the operation is performed and the patient’s condition. After the operation, the pain and other complaints of the patients are greatly reduced.

PEDIATRIC ORTHOPEDICS 

In Reyap Hospital Orthopedics and Traumatology Department, the diagnosis, treatment and follow-up of all developmental skeletal problems of children under the age of 16 is possible with advanced imaging, analysis and follow-up methods. 

Congenital disabilities,

Hip Dislocation,

Flat foot, Inward Walking, Crooked Feet,

Growing Pains, Lumbar Bone Curvatures,

Height Growth Problems, Length Differences Between Legs and Arms,

Child Fractures, 

Walking Disorders

Hip Dislocation:

In normal hip joint; the hollow space (acetabulum) in the large pelvis at the hip and the round part at the head of the leg bone (femur bone) are intertwined. In the case of congenital hip dislocation, the bones that make up the hip joint are separated from each other.

Hip dislocation can sometimes develop at later ages. Therefore, this condition is called “developmental hip dislocation” instead of “congenital hip dislocation”.

Hip dislocations can develop due to many reasons. First of all, the 12th-18th in the womb. weeks and the last 4 weeks are important for developmental hip dislocation. Hip dislocation is 5-7 times more common in girls than boys.

Flat Base (Pes planes):

In our normal anatomical structure, when we step on the ground, the inner part of the foot does not touch the ground and creates an arc. In some people, this area touches the ground to varying degrees and this is called flat feet.

The diagnosis of flatfoot is usually made by physical examination. The shape of the arch of the foot is viewed by standing on the ground. If an arch occurs when the foot is raised, it is called flexible flatfoot.

The ankle movement is checked to see if the Achilles tendon is stretched. If necessary, x-rays and tomography of the foot can be taken. Abnormal wear is noted by inspecting the shoes.

If flatfoot is painful, its cause is investigated. Stretching exercises are given if the Achilles tendon is tight. If the shoes wear abnormally, appropriate supports can be given. In some cases, surgical treatment is used.

Cerebral palsy:

Cerebral Palsy is a condition in which the child has difficulty using certain muscles due to damage to the brain. The symptoms of the disease vary depending on which part of the brain the damage is and how widespread it is. For example, some patients may have a slight limp while others may have to use a wheelchair. 

Surgical treatment approaches in cerebral palsy vary according to the age of the patient, the severity of the disease and the area of ​​involvement. Repeated intramuscular botox applications and plaster treatments on both arms and legs in younger patients can reduce the severity of the disease. 

Dislocations of the hip and spine curvatures related to the disease can be successfully treated with modern surgical treatment methods. In cases with arm and hand involvement, the use capacity of the hands can be increased with various muscle beam transplants and bone surgeries.

Foot deformities:

Pressing In:

Femoral torsion is the thigh bone pointing too forward. While these children are walking, their knees are facing each other and they sit diagonally on the floor. It usually resolves spontaneously until the age of 9-10.

Sometimes intrusion is too far, it can cause the child’s feet to tangle and fall. Such ingrowths should be followed up and if they do not improve in their natural course, they should be treated surgically.

Clubfoot:

It is possible to notice this deformity in the feet as soon as the child is born. The toes and heel are turned inward and will not straighten even if manually straightened. In addition to this deformity in the feet, the legs are also thinner and shorter than normal.

Clubfoot is painless. One in 1,000 newborns has this foot deformity. In 1/3 of these children, the deformity is bilateral. 2/3 of the children with clubfoot are boys.

Treatment is started with the method of stretching and plastering. If the patient does not respond to this treatment, surgical intervention is considered. This surgery is usually performed when the child is 6–12 months old. If not treated, the foot deformity increases and the child becomes disabled.

TRAUMATOLOGY 

Traumatology is a branch that includes emergency treatment in cases caused by trauma. Briefly, traumatology deals with traumatic lesions such as wounds, fractures, burns, bruises, dislocations. Traumatology aims to restore damaged and injured movement system elements (bones, joints) to their former functions and to save the life of the injured.

Traumatology;

Covers topics such as upper extremity fractures,
lower extremity fractures, 
pseudoarthrosis and malunions (union disorders),
traumatology radiology,
fractures requiring surgical treatment, 
vertebral fractures, 
pelvis fractures, 
acetabulum fractures, 
child fractures, 
dislocations . 

What are the techniques applied in the treatment of diseases that develop due to trauma?

Functional fixation technique: Instead of the classical hard and long plaster cast in cases that do not require surgery; It is a new plastering technique that allows shorter, semi-rigid, early weight bearing and muscle function. The plaster used here; It does not cause itching, allergies, and allows easy bathing and even swimming in the sea-pool.
 Bone Stimulators: particularly bone healing time with ultrasonic waves in stress fractures and small bone fractures is reduced by half.
Closed intramedullary nailing techniques: fractures of long bones in the legs and arms (simple parts) and applied in the majority of hip fracture without opening the fracture line, are techniques that shorten the structures and fracture healing time of 2-3 cm incision.

Small invasive operations performed with arthroscopic assistance: In some of the intra-articular fractures, it enables the fixation of the fractures without opening the joint; In this way, they are the techniques that reduce the possibility of joint stiffness that may occur after surgery and shorten the time to reach full function and physical therapy.

Prosthetic surgery: These are the applications that give the elderly the chance to apply to more of the hip and shoulder fractures and provide walking in a short time with new prosthesis designs.
Radical major surgeries:It offers successful treatment opportunities even in difficult cases such as developing diagnosis and surgical methods, large pelvis fractures, comminuted fractures in large joints. 

ATROSCOPY AND SPORTS SURGERY

This department deals with especially cartilage, ligament and meniscus lesions, intra-articular and extra-articular problems resulting from sports injuries.

What is arthroscopy?

Arthroscopy is a treatment method that can take between 20 minutes and 2 hours, providing the diagnosis and treatment of diseases and injuries in the joints by visualizing the inside of the joints with the help of an optical camera.

In open surgeries, large incisions are required to reach the joint. However, it is often not possible to see all parts of the joint. With arthroscopy, a more complete examination is possible, as areas that cannot be reached during open surgery can also be imaged.

Most of my arthroscopic surgical procedures are outpatient surgical procedures. Surgery can only be performed through an incision smaller than one centimeter. The main benefit of the technique is seen after surgery.

Since the joint is not opened, physical therapy and rehabilitation can be started earlier. Arthroscopic surgery is the least damaging method to normal tissues because it is made through very small incisions.

Patients’ postoperative pain is much less than open surgical procedures. Thus, the patient heals faster and returns to his active life earlier. It is a great advantage for athletes to return to sports early.

If enough exercise is done after arthroscopy, the risk of developing limitation of motion in the joint is almost negligible. Likewise, problems such as infection and thrombophlebitis are less common. For all these reasons, the recovery time after arthroscopic surgery is shorter.

WHAT IS ARTHROSCOPY REQUIRED?

The diagnosis of joint diseases is made with the help of a good history, physical examination, direct radiographs and laboratory examinations. Computed tomography and magnetic resonance imaging can be used when necessary.

In spite of all this, when the diagnosis is difficult, arthroscopic examination is performed. Today, arthroscopy is frequently used in the treatment of diseases involving the joints. The application is made in knee, ankle, wrist, elbow and hip joints.

The main procedures that can be done arthroscopically, ie closed:

On the knee:

Removal of torn menicus pieces,

Sewing of some meniscus tears,

Anterior and posterior cruciate ligament repairs,

Early treatment of osteoarthritis [arthritis],

Osteochondritis [cartilage detachments or joint mice],

Fractures involving the knee joint

Fresh cartilage transplants,

Correction of the patella (kneecap) axis,

Treatment of knee cap dislocations

Relief of joint inflammations,

Removing the diseased joint membrane (synovectomy)

Opening of movement restrictions that occur after an accident or illness,

Removal of benign intra-articular tumors and cysts

Treatment of internal and external lateral ligament tears

On the shoulder:

Treatment of muscle tightness and recurrent shoulder dislocations,

Interventions for cartilage and muscle crunch diseases in the shoulder joint

Early treatment of osteoarthritis [arthritis],

Sinevectomy in rheumatic diseases [removal of the membrane lining the thickened joint],

Removal of intra-articular free bodies 

Rotator cuff tear

Slap lesions

Impingement syndromes

Frozen shoulder treatment

On the ankle:

Intra-articular fractures, osteochondritis [fragmentation from cartilage and joint mice],

Meniscoid lesions [tissue compression after recurrent sprains],

Early osteoarthritis [calcification],

Arthroscopic diagnosis and treatment of rheumatic diseases

Haglundg deformity 

Achilles tendinitis

On the wrist:

Treatment of intra-articular fractures,

Loosening of nerve compression,

Treatment of ligament tears between the wrist bones,

Treatment of joint cartilage damages,

TFCC [special cartilage pad inside the joint] correction of tears 

Ganglion cyst excision,

Scaphoid fracture repair

At the elbow:

Treatment of osteochondritis [cartilage decomposition and joint mice],

Removal of free bodies,

Filing of bone protrusions that prevent movement,

Sinevectomy in rheumatic diseases [removal of the membrane lining the thickened joint],

Removal of benign intra-articular tumors and cysts

HAND SURGERY AND MICROSURGERY

Hand surgery; that adversely affect the functions of the hand and, accordingly, wrist, forearm, elbow and arm; It is a specialty that treats acute soft tissue traumas, vascular, tendon and nerve cuts, skin and muscle tissue loss caused by crushing and compression, hand and wrist pain, trigger finger, nerve compression, tennis elbow, ganglion cysts.

Thanks to the microsurgical technique, vessels and nerves smaller than 1 mm in diameter can be operated using needles and threads that are barely visible to the naked eye. Thus; organs such as the severed hand, arm, foot, leg can be replaced, and by repairing very thin nerve fibers, the replaced limb can feel and move again. 

FOOT AND ANKLE SURGERY

The problems of our feet, which have been carrying the human generation for centuries, are among the most important fields of Orthopedics. Problems related to foot and ankle are solved in a short time thanks to our expert teams, advanced technological solutions and experienced physical therapy team and equipment:

· Heel pains
· Calluses and Ingrown Toenails
· Hallux Valgus (bowing of the thumb)
· Foot and Ankle Calcification
· Muscle, Tendon Ligament Injuries, Nerve Jams,
· Foot Problems in Children, Flat Soles, Crooked Feet,
· Deformations in Heel and Finger Bones,
· All unresolved foot pain, swelling and deformities 
Hallux Valgus: It is an orthopedic disease that is quite common in the big toe and its prevalence is increasing. It refers to the bony protrusion of the inner side of the big toe. If this disease, the exact cause of which is not known, is not treated in time, it can lead to loss of work force, quality of life and aesthetic problems along with symptoms that may concern not only the big toe but the whole foot.
Hallux Rijidus: The reduced movement of the thumb is called Hallux Rigidus, which means hard finger. With advanced age, problems such as limitation of movement in the big toe, bone spurs, and inability to wear shoes may occur. Erosion of the cartilage tissue of the big toe between the comb bone and the finger bone and the formation of bone protrusions around the joint constrains the finger movement and causes pain in the big toe.
Pes Planus: It is a foot deformity characterized by the disappearance of the inner long arch of the foot, which is normally known as flatfoot. Flat feet that have pain and have passed the initial stage should be corrected surgically. If the surgery is done on time, it is possible to correct the flat feet without fixing the joints, but in cases of delay, the only remedy is to fix the joints (freezing). Flatfoot surgery provides patients with a better quality of life.
Pes Cavus: In contrast to flat feet in this condition, here the inner arc of the foot is too inclined and steep. In advanced cases, the foot may shorten and the toes are bent towards the ground. In very advanced cases, surgically straightening the bent fingers and cutting the plantar fascia, which stretches the sole of the foot and increases the slope too much, is used.

DEFORMITY CORRECTION AND EXTENSION

Bowed legs, functional disorders caused by inequality between legs, short stature are orthopedic problems that can be treated with the Ilizarov method today. Thanks to this method, which is successfully applied in Reyap Health Group Orthopedics and Traumatology Departments, the difference in the length of the legs; Compensation for shortness is equalized by shortening the long leg and lengthening the short leg. 

What is the Ilizarov Method?

The Ilizarov method is a system in which the bone is fixed with thin wires and hoops. It aims to keep bone growth under control by means of hoops and wires placed around the limbs. The most common area where Ilizarov is applied is heightening.

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