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    Functional results of patients treated with modular prosthetic replacement for bone tumors of the extremities
    (Turkish Assoc Orthopaedics Traumatology, 2008) Yalniz, Erol; Ciftdemir, Mert; Memisoglu, Serdar
    Objectives: We evaluated functional results of patients who were treated with cemented modular prosthetic replacement for bone tumors of the extremities. Methods: The stud included 23 patients (12 males, 11 fey males mean age 49 years, range 14-81 years) who underwent wide resection and cemented endoprosthetic replacement with the TMTS (Turkish Musculoskeletal Tumor Society) prosthesis for bone tumors. Twelve patients (52.2%; mean age 63.5 years) had metastatic, 11 patients (47.8%; mean age 38 years) had primary tumors. The most common site of involvement was the femur (n=17). followed by the humerus (n=5). Functional evaluations were made with the Musculoskeletal Tumor Society (MSTS) scoring system. The mean followup up period was 24 months (range I to 108 months), being 30 months for primary, and 3 months for metastatic tumors. Results: Postoperative complications were seen in seven patients (30.4%), being local recurrences in three patients. During the follow-up period, I I patients died due to tumoral causes, distant metastasis developed in three patients, and nine patients were tumor-free. Survival was significantly better in patients with primary tumors (p<0.001). All the patients were able to walk without crutches in the postoperative period. The mean MSTS score was 58.9% (range 40% to 90%) in survivors, which was 71.5% (range 60% to 90%) for primary tumors, and 47.4% (range 40% to 73%) for metastatic tumors (p<0.001). Conclusion: Reconstruction with cemented modular endoprostheses is an appropriate surgical alternative in the treatment of large segmental defects after resection of extremity tumors, with satisfactory functional results particularly in primary tumors.
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    Osteosarcoma of the lumbar vertebra: case report and a review of the literature
    (Springer, 2009) Yalniz, Erol; Ozcan, Mert; Copuroglu, Cem; Memisoglu, Serdar; Yalcin, Oemer
    Classic osteosarcoma (OS) is a highly malignant sarcoma with the production of osteoid matrix. The most common sites of origin are the metaphyseal regions of the distal femur, proximal tibia, and proximal humerus, although the tumor can develop in any bone. Flat bone involvement is very rare (8%). Vertebral involvement is also very rare with 2-4% of all cases. In this report, we presented a 27-year-old woman with OS of the fourth lumbar vertebra. She was treated with surgical debulking and posterior enstrumentation, followed by radiotherapy and chemotherapy. She is now in the 15th year postoperatively and still alive without any neurological impairment. This case has the longest survival reported in the literature with primary vertebral osteosarcoma.
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    Which Classification System is More Useful for Intertrochanteric Fractures? AO/ASIF or Jensen?
    (Aves Yayincilik, Ibrahim Kara, 2008) Memisoglu, Serdar; Eskin, Deniz; Yamak, Erkan; Guerbuez, Aydin; Saridogan, Kenan; Duelger, Hakan
    Objectives: The aim of this study was to determine intra- and interobserver reliability of AO/ASIF and Jensen classification systems, and to compare reliability when applied by unexperienced and experienced orthopaedic surgeons. Patients and Methods: The anteroposterior and lateral radiographs of 60 intertrochanteric hip fractures were reviewed and classified by two groups (G1, G2) of orthopaedic surgeons using the AO and Jensen classification systems on two separate occasions three months apart. Each group consisted of five orthopaedic surgeons. Group 1 had less than five years, and group 2 had more than 10 years of experience. Kappa statistical analysis was used for determination of intra- and interobserver variation. Results: For the AO classification system without subgroups, the mean kappa value was 0.67 (range 0.47-0.90) for intraobserver variation and 0.42 (range 0.10-0.73) for interobserver variation. For the Jensen classification, the mean kappa value was 0.57 (range 0.35-0.80) for intraobserver variation and 0.30 (range 0.10-0.60) for interobserver variation. For the AO classification system with subgroups, the mean kappa value was 0.49 (range 0.21-0.81) for intraobserver variation and 0.23 (range 0.09-0.51) for interobserver variation. Conclusion: Although these classification systems have disadvantages, this study suggests that AO system without subgroups is more useful than Jensen and AO system with subgroups to classify intertrochanteric fractures of the proximal femur.