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    Estimating the adequacy of the free quadriceps tendon autograft length using anthropometric measures in anterior cruciate ligament reconstruction
    (Springer, 2022) Yuksel, Yavuz; Kose, Ozkan; Torun, Ebru; Ergun, Tarkan; Yardibi, Fatma; Sarikcioglu, Levent
    Objective This prospective study aimed to predict the adequacy of free quadriceps tendon (QT) autograft length using simple anthropometric measures. Materials and methods One hundred and eighty-four consecutive patients who underwent knee high-resolution MRI were enrolled in this study. The QT and native anterior cruciate ligament (ACL) length were measured using the oblique sagittal section. The adequate free QT length was calculated using the native ACL length and 30 mm for femoral and tibial tunnels in each patient. A QT shorter than the calculated length was considered inadequate. Age, sex, height, weight, body mass index, thigh circumference, and activity score were used to predict the adequacy of QT length with regression analysis. Results There were 92 men and 92 women with a mean age of 34.1 +/- 8.0 years (range 18-45). The mean QT and ACL lengths were 69.0 +/- 8.8 mm (range 48.1-90.3 mm) and 35.6 +/- 2.5 mm (range 29.2-42.6 mm), respectively. The QT and the ACL lengths were longer in men (p < 0.001 for both). Twenty-three men and 39 women (total: 62, 33.7%) had inadequate QT length for a free QT autograft, and 6 patients (3 males, 3 females, 3.3%) had inadequate QT length with the bone block technique. There was a weak positive correlation between QT length and height (p < 0.001), weight (p < 0.001), and activity score (p = 0.007). Height was the only independent variable that predicted the QT length adequacy (r(2) = 0.051, p = 0.009) but ROC analysis showed that height did not have an ability to detect a subject with an inadequate QT length (AUC: 0.384, 95% CI 0.300-0.468). Conclusions Free QT autografts may be inadequate in one-third of the patients, while a QT autograft with a bone block is almost always sufficient. Inadequate free QT autograft is more common in women. Although QT length correlated with height, it cannot be used as an accurate diagnostic tool to identify patients with an inadequate QT autograft. Preoperative measurement of the ACL and QT lengths by MRI might be beneficial to decide whether QT is usable, especially when harvesting without a bone block.
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    Morphometric evaluation of cerebellar lobules in individuals with unilateral vertebral artery hypoplasia
    (Springer France, 2023) Ozen, Ozkan; Yuksel, Yavuz; Torun, Ebru; Ergun, Tarkan
    Purpose Vertebral arteries (VAs) provide blood circulation to the posterior fossa in general and are the main blood supply of the posterior fossa structures of the brain. Our aim in this study is to analyze the segmental volumetric values of cerebellar structures with the voxel-based volumetric analysis system in individuals with unilateral vertebral artery hypoplasia. Methods In this retrospective study, segmental volumetric values/percentile ratios of cerebellar lobules were calculated using 3D fast spoiled gradient recall acquisition in steady-state (3D T1 FSPGR) MRI sequence images of the brain in individuals with unilateral vertebral artery hypoplasia (VAH) and in those without bilateral VAH and any symptoms of vertebrobasilar insufficiency as the control group was evaluated in volBrain. Results The VAH group consisted of 50 (19 males/31 females) and the control group had 50 (21 males/29 females) individuals. The cerebellar lobule III, IV, VIIIA and X total volumes and the cerebellar lobule I-II, III, IV, VIIIA and X gray matter volumes were lower in the hypoplastic side than the non-hypoplastic cases and also than the contralateral side of the hypoplastic cases in the VAH group. In addition, it was found that that lobules IV and V had lower cortical thickness and lobules I-II had a higher coverage rate in the intracranial cavity in the hypoplastic side than the non-hypoplastic cases and also than the contralateral side of the hypoplastic cases (p < 0.05). Conclusion In this study, it was found that cerebellar lobule III, IV, VIIIA, X total volumes and cerebellar lobule I-II, III, IV, VIIIA, X gray matter volumes in addition to lobule IV, V cortical thicknesses were low in individuals with unilateral VAH. Being aware of these variations and taking them into account during future volumetric studies on the cerebellum are very important.
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    Prevalence of the Peroneus Quartus Muscle and Its Association with Peroneal Tendon Pathologies: An MRI Study of 1160 Ankles
    (Mdpi, 2025) Yuksel, Yavuz; Ergun, Tarkan; Kose, Ozkan
    Background/Objectives: The peroneus quartus (PQ) muscle is a supernumerary muscle in the lateral compartment of the leg. Although frequently asymptomatic, it may contribute to peroneal tendon (PT) disorders due to mechanical crowding in the retromalleolar groove. This study aimed to determine the prevalence of the PQ muscle on MRI and assess its association with PT pathologies. Materials and Methods: This retrospective study evaluated 1160 ankle MRI scans from 1073 patients (mean age, 42.7 +/- 14.5 years; 643 females, 430 males). The presence of the PQ muscle and associated PT pathologies, including tenosynovitis, tendinitis, and tendon tears of the peroneus brevis tendon (PBT) and peroneus longus tendon (PLT), was recorded. Statistical analyses were performed using chi-square tests, and associations were expressed as odds ratios (OR) with 95% confidence intervals (CI). Results: The PQ muscle was identified in 123 of 1160 ankles, corresponding to a prevalence of 10.6%. Its incidence was significantly higher in males (12.7%) than in females (9.2%) (p = 0.018), while the side distribution showed no statistically significant difference. PQ presence was associated with PBT pathology, particularly tendinitis and longitudinal tears, and with PLT tendinitis, whereas no clear association was observed with tenosynovitis or PLT tears. Conclusions: The PQ muscle is a relatively common anatomical variant, present in 10.6% of ankles on MRI scans. Its presence is significantly associated with PT abnormalities, especially PBT tendinitis and tears. Awareness of PQ may aid clinicians and radiologists in assessing lateral ankle pain and peroneal tendon disorders.
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    The Relationship Between Craniocervical Morphology and the Presence and Level of Cervical Facet Joint Degeneration
    (Lippincott Williams & Wilkins, 2025) Torun, Ebru; Yuksel, Yavuz
    ObjectiveTo investigate the relationship between craniocervical morphology and the presence and level of cervical facet joint degeneration (FJD).MethodsA total of 108 consecutive female patients aged 45-55 years who had undergone neck + brain CT angiography were included in this retrospective sectional study. Only patients of a certain age and of the same gender were included in order to eliminate the differences that create a disposition to the development of spinal degeneration. The presence of facet joint (FJ) arthritis (grade >= 2 degeneration in at least one affected facet joint) and the grade of the facet joint degeneration for each patient were recorded. A total of 20 lengths and 3 angles of craniocervical morphology were measured. The differences between the individuals with and without FJ arthritis were investigated with the independent-sample t test, and the relationship between the FJD grade and craniocervical morphology was investigated using the Spearman correlation test.ResultsIndividuals with FJ arthritis were found to have longer Grabb-Oakes measurement, shorter FM AP length, lower ADI, lower EOP thickness, higher clivus length, higher crista gall-ATS distance, lower CCA angle, lower distance between the C1 vertebra lateral masses, and higher BAI than those without FJ arthritis (P < 0.05). Besides, we found that the FJD grade increased as the Grabb-Oakes measurement increased, ADI distance decreased, FM AP length decreased, EOP thickness decreased, clivus length increased, basal angle increased, distance between the C1 vertebra lateral masses decreased, and BAI increased (P < 0.05).ConclusionsDifferences in craniocervical morphology are statistically associated with degenerative processes that result in degenerative changes in the facet joint. Therefore, some morphological changes in craniocervical anatomy cause changes in the momentum and distribution of the load on the facet joints, predisposing the patient to facet arthropathy and osteoarthritis.
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    Tr ansient Complete Right Bundle Branch Block Due _ to _ Lung _ Contusion: Case Re port
    (Emergency Medicine Physicians Assoc Turkey, 2024) Kozaci, Nalan; Aydin, Ismail Erkan; Ersahin, Durmus Ali; Yuksel, Yavuz
    Right bundle branch block (RBBB) may occur in lung diseases and cardiovascular diseases. A 25-year-old male patient was admitted to emergency department after a motorcycle accident. Contusion was detected in bilateral lungs, and pneumothorax with laceration were detected in the right lung. ECG revealed103 bpm, right axis deviation, and complete RBBB. ECGrevealed 83 bpm, complete RBBB continued at the 6th hour after tube thoracostomy, andhigh sensitive TnI was normal. Chest X-ray wasnormal on the 4th day of hospitalization, and ECG revealed74 bpm, normal sinus rhythm. In thoracic trauma, ECG changes may develop as a result of lung contusion. ECG findings improve as the lung contusion heals.