The effect of catheter use on vein grafting of a peripheral nerve defect: an experimental study.

BACKGROUND: Since vein grafts have been used in the repair of nerve defects, studies regarding this procedure have accumulated, and after coming into clinical use, it was noticed that there is a problem of collapse in the vein graft. METHODS: Forty Sprague-Dawley rats were used, divided into five groups. No surgical intervention was performed in the first group. The defect was created in the sciatic nerve in Group 2 and left unrepaired. In Group 3, the defect was repaired with a nerve graft. In Group 4, the defect was repaired with a vein graft, while in Group 5, the repair was performed using a vein graft with an inserted catheter. In order to evaluate functional recovery and nerve regeneration, walking track analysis, electrophysiologic and histomorphometric analyses were done at the end of the 12th week. RESULTS: Although there were no functional differences between Groups 5 and 4, comparisons regarding nerve conduction velocity demonstrated that the results obtained in Group 5 were better than those in Group 4. When the number of axons on the distal part of the sciatic nerve and mid-segment of the repaired area was taken into account, no significant difference was found between Groups 3 and 5, whereas there was a significant difference between Groups 4 and 5. CONCLUSION: In our study, it was experimentally shown that the problem of collapse of a vein graft occurring after its use in the reconstruction of a nerve defect can be overcome by placing a catheter into the vein graft. Consequently, this method may eliminate the need for the use of a nerve graft in selected cases.

[A retrospective analysis of 204 mandibular fractures]. / Mandibula kiriklari: 204 olgunun retrospektif analizi.

BACKGROUND: We retrospectively reviewed patients who were treated and followed-up for mandibular fractures within a 10-year period. METHODS: A total of 204 patients (158 males, 46 females; mean age 22.4 years; range 5 to 72 years) were retrospectively evaluated with respect to age groups, sex, etiology, associated injuries, localization and type of the fractures, treatment methods, and early and late complications. The follow-up period ranged from four months to 10 years. RESULTS: The most common cause of injury was traffic accidents (44.1%), followed by falling (31.8%), and violence (17.1%). The highest incidence occurred at ages 21 to 30 years. Of 283 fractures detected, the most common fracture sites were the parasymphysis (83 fractures, 29.3%) and the angulus (52 fractures, 18.4%). Forty-eight patients (24%) had associated injuries. The type of the fractures was simple in 80 patients (39.2%), and complex in 62 patients (30.4%). Treatment included open reduction with titanium mini-plates and screws in 130 patients, and intermaxillary fixation in the remaining patients. The fractures recovered without any complications in 167 patients (81.8%). No occlusion-related complications occurred in the late follow-ups. Complications were encountered in 37 patients (18.1%), being in the early (malocclusion in 5.9%, infections in 2.5%, inferior alveolar nerve injuries in 2.5%) or late (plate-screw exposition in 4.4%, ankylosis of the temporomandibular joint in 2%, and orocutaneous fistula in 1%) postoperative periods. CONCLUSION: Rigid fixation should be the first choice of treatment in mandibular fractures.