Tolga Turker

Interests

Research

Clinical Interests: Hand, Upper extremity and microsurgery. Reconstructive surgery. Congenital disorders of hand and upper extremity

Teaching

Hand Surgery, Orthopedic Surgery, Upper extremity anatomy.

Courses

Scholarly Contributions

Chapters

• Larson, E. E., Larson, E. E., Turker, T., & Turker, T. (2016). Decision Making in Reconstructive Surgery. In Surgical Decision Making: Beyond Evidence Based Surgery. Springer.
• Breidenbach III, W. C., Becker, G. W., Kaplan, B., Turker, T., Muhlemann, C. A., & Schmahl, D. T. (2015). The Animal and Human Experimental Foundation of Vascularized Composite Tissue Allotransplantation. In Operative Microsurgery(pp 1023-1039). New York: McGraw-Hill Professional.
• Breidenbach, W. C., Becker, G. W., Kaplan, B., Turker, T., & Muhlemann, C. (2015). The Animal and Human Experimental Foundation of Vascularized Composite Tissue Allotransplantation. In Operative Microsurgery. New York: McGraw-Hill Professional.
• Larson, E. E., Larson, E. E., Turker, T., & Turker, T. (2016). Decision Making In Reconstructions for Traumatic Defects in Extremity Surgery. In Surgical Decsion Making: Beyond Evidence Based Surgery. Springer.

Journals/Publications

• Turker, T. (2024). Haddad D, Kempton D, Ghotmi J, Türker T. A case series of upper extremity reconstructions utilizing partial ECRB and ECRL tendon autografts. Journal of Surgical Case Reports. Aug 2024;2024(8):rjae278.. Journal of Surgical Case Reports.
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  Haddad D, Kempton D, Ghotmi J, Türker T. A case series of upper extremity reconstructions utilizing partial ECRB and ECRL tendon autografts. Journal of Surgical Case Reports. Aug 2024;2024(8):rjae278.
• Turker, T. (2024). Richard, Brian MD; Abbas, Mohammed MD; Odeneye, Oluwatobi BS; Türker, Tolga MD. Intraoperative O-arm Use for Physeal Bar Excision. Techniques in Orthopaedics 39(4):p 111-118, December 2024. | DOI: 10.1097/BTO.0000000000000670 . Techniques in Orthopaedics.
• Turker, T. (2018). Delayed perfusion evaluation in extremity trauma.. Journal of Orthopaedic Trauma.
• Turker, T. (2022). Hemodynamics in Distally Based Sural Flaps for Lower Leg Reconstruction: A Literature Review. . Journal of Hand and Microsurgery. doi:10.1055/s-0042-1749445
• Turker, T. (2022). Long Head of Triceps Tendon Transfer for Agenesis of Biceps and Brachialis: Two Cases.. Hand. doi:10.1177/15589447221128983
• Turker, T. (2021). Management of Highly Comminuted Intra-articular Fracture Subluxations at the Proximal Interphalangeal Joint by Subchondral Buttress Fixation and Early Mobilization.. Techniques in Hand & Upper Extremity Surgery, 25(5), 258-263.
• Turker, T., & Wild, J. R. (2021). Delayed perfusion evaluation in extremity trauma.. Journal of Clinical Orthopaedics and Trauma.
• Turker, T. (2020). Surgical technique for harvesting ECRL and ECRB concurrently as upper extremity tendon autograft.. Techniques in Hand and Upper Extremity Surgery.
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  Turker T, Gosey GM, Kempton DM. Surgical technique for harvesting ECRL and ECRB concurrently as upper extremity tendon autograft.
• Turker, T., & Ferguson, S. (2020). A Vascular Malformation in the Hand with Compromised Neurologic Status. Annals of Vascular Surgery, 68, e11. doi:10.1016/j.avsg.2020.04.007
• Turker, T., Latt, D. L., & Reyes, MS3, R. (2019). A cuneiform reformation following gunshot wound to the foot.. Foot & Ankle Orthopaedics Journal.
• Turker, T., Latt, L. D., Turker, T., Reyes, R., & Latt, L. D. (2019). Spontaneous Regeneration of Medial Cuneiform Following Gunshot Wound. Foot & Ankle Orthopaedics, 4(3), 247301141987626. doi:10.1177/2473011419876261
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  Level of Evidence: Level V, expert opinion.
• Turker, T., Taljanovic, M. S., Sheppard, J. E., Amerongen, H. M., & Johnston, S. S. (2019). "The Radial and Ulnar Collateral Ligaments of the Wrist are True Ligaments.". Diagnostic and Interventional Radiology.
• Turker, T., Taljanovic, M. S., Sheppard, J. E., Amerongen, H. M., & Johnston, S. S. (2019). "The Radial and Ulnar Collateral Ligaments of the Wrist are True Ligaments."
  
  Diagn Interv Radiol. 2019 Nov; 25(6): 473–479.Published online 2019 Sep 19. doi: 10.5152/dir.2019.19036. Diagnostic and Interventional Radiology, 25(6), 473-479. doi:10.5152/dir.2019.19036
• Turker, T., & Roettges, P. (2017). Manuscript ID HAND-16-0259 - "Ulnar Nerve Injury as result of Galeazzi Fracture - A Case Report and Literature Review". HAND.
• Turker, T., & Roettges, P. S. (2017). Ulnar Nerve Injury as a Result of Galeazzi Fracture: A Case Report and Literature Review.. Hand (New York, N.Y.), 12(5), NP162-NP165. doi:10.1177/1558944717715137
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  Sparse documentation of Galeazzi fracture with associated nerve injury exists in the medical literature. The purpose of this report is to review the available literature in regard to incidence, nerve injury type, treatment strategies, and expected outcomes..We present a classic Galeazzi fracture dislocation with associated complete ulnar nerve transection injury at the level of the wrist. After rigid internal bony stabilization, allograft nerve repair was performed. The patient's presentation, operative management, recovery, and a thorough literature review are discussed..Fracture union was attained with near full wrist and elbow range of motion. Despite lack of ulnar nerve function return, the patient was able to resume manual labor occupation..Despite its close proximity to the dislocating distal radioulnar joint (DRUJ), thorough review reveals rare associated ulnar nerve palsy. If there is suspicion for nerve injury in the setting of open DRUJ dislocation, the nerve should be explored to identify possible entrapment or transection. Literature supports likely return of nerve function in cases of intact nerve; however, management of nerve transection remains debatable.
• Turker, T., Lawson, K. A., & Larson, E. E. (2017). Wrap technique to cover exposed Achilles tendon with the soleus muscle. European Journal of Plastic Surgery, 40(1), 57-60. doi:10.1007/s00238-016-1214-6
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  Numerous etiologies may lead to loss of Achilles tendon coverage. Currently, multiple coverage options are available to the reconstructive surgeon; however, described techniques may not meet every patient’s need. In this case report, we describe the use of a simple technique, utilizing the soleus to cover exposed Achilles by folding the muscle circumferentially around the tendon. The technique described is a local option, creates minimum morbidity, does not require microsurgical skills, and can be performed quickly.
• Breidenbach, W. C., Meister, E. A., Becker, G. W., Turker, T., Gorantla, V. S., Hassan, K., & Kaplan, B. (2016). A Statistical Comparative Assessment of Face and Hand Transplantation Outcomes to Determine Whether Either Meets the Standard of Care Threshold. Plastic and reconstructive surgery, 137(1), 214e-22e.
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  Hand and face transplantation has established itself as a clinical option for certain reconstructive problems. The purpose of this study was to carry out a rigorous statistical analysis of all hand and face transplantations to determine whether hand and/or face transplantation is the standard of care.
• Breidenbach, W. C., Meister, E. A., Turker, T., Becker, G. W., Gorantla, V. S., & Levin, L. S. (2016). A Methodology for Determining Standard of Care Status for a New Surgical Procedure: Hand Transplantation. Plastic and reconstructive surgery, 137(1), 367-73.
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  Hand allotransplantation was initially criticized as unethical and unlikely to succeed. The results proved to be better than anticipated, now raising the issue of whether hand transplantation is the standard of care. The purpose of this article is to outline a reasonable methodology for determining whether a surgical procedure is the standard of care, and then to apply that methodology to hand transplantation.
• Breidenbach, W. C., Meister, E. A., Turker, T., Becker, G. W., Gorantla, V. S., & Levin, L. S. (2016). A Statistical Comparative Assessment of Face and Hand Transplantation Outcomes to Determine Whether Either Meets the Standard of Care. Plast. Reconstr. Surg., 137(1), 214e-22e.
• Larson, E. E., Larson, E. E., Turker, T., Turker, T., Lawson, K., & Lawson, K. (2016). Wrap technique to cover exposed Achilles tendon with the Soleus Muscle. Eur Jour Plas Surg.
• Türker, T., Hassan, K., & Capdarest-Arest, N. (2016). Extensor tendon gap reconstruction: a review. Journal of plastic surgery and hand surgery, 50(1), 1-6.
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  The extensor tendons of the hand are located in a superficial position on the dorsal aspect of the hand and are highly susceptible to injury. Laceration, crush and avulsion injuries are common extensor tendon injuries presenting for acute care. Such injuries that involve tendon loss or gaps in the extensor tendons require specialised attention and can be some of the most challenging to repair, as extensor tendons have less excursion than flexor tendons. Reconstructive techniques for such defects may differ according to the location of the defect, especially in Verdan's extensor zones 1-5. Adequate repair of extensor tendon defects in zones 1-5 is especially important because (a) even a 1 mm tendon gap in those zones may cause 20° extension loss, and (b) shortening of the extensor tendon by as little as 1 mm may cause decreased finger flexion.
• Zangeneh, T., Turker, T., & Hassan, K. (2016). Disseminated sporotrichosis in an immunocompetent patient.. Case reports in plastic surgery & hand surgery, 3(1), 44-7. doi:10.3109/23320885.2016.1168703
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  Sporothrix schenckii, the causative agent of sporotrichosis, is a relatively rare infection. Local infection usually occurs through direct inoculation of the organism through the skin; disseminated disease is rarely seen. This article describes a case of disseminated sporotrichosis in a middle-aged man without the commonly seen risk factors for dissemination.
• Larson, E. E., Turker, T., & Lawson, K. (2015). Wrap technique to cover exposed Achilles tendon with the Soleus Muscle. Eur Jour Plas Surg.
• McKee, D., & Turker, T. (2015). Hematoma Evacuation to Improve Closed Reduction of Bennett Fracture. Journal of hand and microsurgery, 7(1), 114-5.
• Turker, T. (2015). Current concepts in hand infections. BMC Proceedings, 9(3), 1-2. doi:10.1186/1753-6561-9-s3-a102
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  Hand infections are common occurrences, usually resulting from an injury, that when left untreated can quickly lead to tissue destruction and loss of function or permanent disability. Infections may be categorized anatomically: superficial, involving the tendon and tendon sheath, involving joint or bone, or affecting the deep spaces of the hand. Infections may be caused by different microorganisms, and, increasingly, by community-acquired methicillin-resistant Staphylococcus aureus (MRSA). Currently MRSA accounts for as much as 65% of Staphylococcus aureus isolates, complicating the course of medical treatment. Brown and Young state that major metropolitan hospitals should expect 25-50 admissions annually for serious hand infection. Hand infections primarily occur after delayed treatment after minor trauma. Laceration, unknown causation, thorn, human bite (e.g., often “fight-bite” injuries), IV injection injury, dog bite, insect bite, blunt trauma, cat bite, snake bite, and pressure injections. The palm or dorsum of the hand, the middle finger and the index finger are most frequent locations of infection. It is reported that the most common hand infections are cellulitis and paronychia/eponychia (70%) and more severe infections such as septic arthritis and osteomyelitis occur less often (3%). A wide variety of approaches to antibiotic treatment have been used and evolved over the years as antibiotic resistance and occurrence of community-acquired antibiotic-resistant infections have increased. Even though the choice of antibiotics is evolving from those used in the past due to changes in microorganisms and developing antibiotic resistance, the treatment principles set forth by Brown and Young of 3-5 days of IV antibiotic treatment followed by 7-10 days of oral antibiotic treatment remains a valid treatment plan for hand infection patients. Another important issue in hand infections is delay in seeking treatment and/or delayed surgical drainage. Glass reported that delay in treatment causes slower resolution; for example, if the delay is more than 2.5 days, about 70% of those patients showed delayed recovery. Surgical treatment is an important component of clinical management. A detailed, comprehensive initial surgical approach may minimize the need for multiple surgeries. Intraoperative care should be comprehensive, using copious Dakin’s solution, hydrogen peroxide, sterile water, and bacitracin in normal saline to irrigate the infected area. Postoperatively, usage of Dakin’s solution for immediate soaking of the open wound 1-2 times per day for 10 minutes for 3 days may help to decrease the load of bacteria. Although traditionally, post-operative splinting may be suggested for hand infection treatment, we recommend application of a soft dressing and starting early range of motion exercises in order to decrease stiffness. In conclusion, with prompt and appropriate care, most soft tissue hand infection patients can achieve full resolution of their infections. Treating infections promptly with surgical incision and drainage using a large incision with copious irrigation and then using a regimen of soaking and use of soft dressing with early range of motion exercises are key to achieving good outcomes and avoiding multiple surgical procedures. In conjunction with surgical treatment, judicious antibiotic treatment is also important. After cultures are obtained, antibiotic treatment should be tailored more specifically to the organisms. Consultation with an infectious diseases specialist can sometimes be helpful in choosing the most appropriate regimen.
• Turker, T. (2015). Extensor tendon traumatic gap reconstruction. BMC Proceedings, 9(3), 1-2. doi:10.1186/1753-6561-9-s3-a69
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  Repair of extensor tendon defects or gap injuries often require complicated surgical techniques. Unlike flexor tendons, which have good excursion that can help mobilize the flexor tendon allowing for repair of up to 1 cm gaps, extensor tendons only have 1-2 mm of excursion, especially in Verdan’s extensor Zones 1 to 5. Furthermore, a 1-mm tendon gap in Zones 1 to 5 may cause 20 degrees extension loss or shortening of the extensor tendon, and a gap even as small as 1 mm may cause decreased finger flexion. Due to such significant potential damage and loss of function caused by extensor tendon defect injuries, especially in Zones 1-5, solutions most often require some type of reconstruction techniques.
• Türker, T., & Sheppard, J. E. (2015). Emergency Open Reduction for an Irreducible Dislocation of the Metacarpophalangeal Joint of the Thumb in a Child. Journal of hand and microsurgery, 7(1), 166-9.
• Türker, T., Gonzalez, J. P., & Capdarest-Arest, N. (2015). Deepithelized posterior interosseous artery flap for 3-dimensional defect coverage in the hand. Techniques in hand & upper extremity surgery, 19(2), 51-4.
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  The posterior interosseous artery (PIA) flap is a pedicle flap that can be harvested at the posterior forearm based on blood supply from the PIA and its concomitant veins. The flap can be used for posttrauma coverage of exposed bones, tendons, and defects; for treatment of a surgical wound; or as a spacer in congenital or burn-related contracture releases. The surgical technique has been reported with limited donor morbidity and few complications to cover exposed structures. In this article, we present our methods and experience using a modification of the posterior interosseous flap that was deepithelized to fill a 3-dimensional cavity in the hand. This method has been successfully used, and the example of the patient shows good outcome, function, and range of motion with no significant complications. The deepithelized PIA flap is a technique that surgeons may add to their toolbox for 3-dimensional defect coverage in the hand. It offers the following advantages: (a) technically uncomplicated; (b) does not create significant donor site morbidity; (c) does not sacrifice any major vessels; and (d) provides good cosmetic appearance, especially in the dorsum of the hand.
• Capdarest-Arest, N., Gonzalez, J. P., & Türker, T. (2014). Hypotheses for ongoing evolution of muscles of the upper extremity. Medical hypotheses, 82(4), 452-6.
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  There are organs and muscles in the human body that may be considered rudimentary in that they have insignificant or undetermined function. Several such muscles are found in the upper extremity. In this review, four muscles that appear to be undergoing evolutionary changes are discussed: flexor digitorum superficialis to the fifth finger, anconeus, palmaris longus, and anconeus epitrochlearis. The present study synthesizes, advances and extends previously described work about these muscles and extends the hypotheses and concludes that: (a) the flexor digitorum superficialis to the fifth finger is currently under adaptive evolution, (b) the anconeus has currently stabilized its evolution and is serving as a transient stability augmenter during a short portion of the human lifespan, and (c) the entire distal upper extremity is currently in the process of undergoing evolutionary change. Understanding of these muscles and their evolutionary context is important for understanding of impact on function, dysfunction, treatment and future research.
• Turker, T. (2014). A Composite Tissue Model in Swine to Test the Limits of Tolerable Ischemia.. TRANSPLANTATION, 98, 692.
• Turker, T. (2014). A Statistical Analysis of the World Wide Experience of Vascularized Composite Tissue Transplantation of Face, Hand and Knee: Outcome, Function, and Late Allograft Loss. TRANSPLANTATION, 98, 692.
• Türker, T., & Capdarest-Arest, N. (2014). Acute hand ischemia after radial artery cannulation resulting in amputation. Chirurgie de la main, 33(4), 299-302.
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  Although radial artery cannulation is a common procedure, in rare cases, it can cause thrombosis leading to severe ischemia of the hand and potentially subsequent gangrene resulting in tissue loss. In this case report, a patient who developed a severely ischemic left hand subsequent to radial artery cannulation is presented. Doppler ultrasound studies showed adequate flow in the patient's hand, however complete thrombosis of the radial artery and significant low flow of the ulnar artery were found using arterial angiogram. The ischemia progressed and surgical intervention to revascularize the hand was unsuccessful, which led to the ultimate amputation of the patient's hand. In cases such as these, where Doppler ultrasound findings show flow but the hand ischemia continues to progress, further diagnostic studies and surgical intervention should be performed as soon as possible to minimize the amount of tissue loss.
• Türker, T., Capdarest-Arest, N., & Schmahl, D. T. (2014). Zone I extensor reconstruction with tendon salvaged from another finger. The Journal of hand surgery, 39(5), 976-80.
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  Laceration, crush, and avulsion injuries are common acute extensor tendon injuries. Simple lacerations may often be repaired in the emergency room, but crush or avulsion injuries may involve tendon loss and gaps in the extensor tendons. Reconstruction can be difficult. The purpose of this article is to present a salvage technique for reconstruction of large extensor tendon gaps in extensor zone I in patients with severe injuries to multiple fingers. This technique, in which a tendon is transplanted from an unsalvageable finger to another with a terminal tendon gap in the same patient, may be a reasonable remedy for reconstruction of tendon loss or gaps and may offer advantages over other traditional reconstructive techniques in certain cases.
• Türker, T., Capdarest-Arest, N., Bertoch, S. T., Bakken, E. C., Hoover, S. E., & Zou, J. (2014). Hand infections: a retrospective analysis. PeerJ, 2, e513.
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  Purpose. Hand infections are common, usually resulting from an untreated injury. In this retrospective study, we report on hand infection cases needing surgical drainage in order to assess patient demographics, causation of infection, clinical course, and clinical management. Methods. Medical records of patients presenting with hand infections, excluding post-surgical infections, treated with incision and debridement over a one-year period were reviewed. Patient demographics; past medical history; infection site(s) and causation; intervals between onset of infection, hospital admission, surgical intervention and days of hospitalization; gram stains and cultures; choice of antibiotics; complications; and outcomes were reviewed. Results. Most infections were caused by laceration and the most common site of infection was the palm or dorsum of the hand. Mean length of hospitalization was 6 days. Methicillin-resistant Staphylococcus aureus, beta-hemolytic Streptococcus and methicillin-susceptible Staphylococcus aureus were the most commonly cultured microorganisms. Cephalosporins, clindamycin, amoxicillin/clavulanate, penicillin, vancomycin, and trimethoprim/sulfamethoxazole were major antibiotic choices. Amputations and contracture were the primary complications. Conclusions. Surgery along with medical management were key to treatment and most soft tissue infections resolved without further complications. With prompt and appropriate care, most hand infection patients can achieve full resolution of their infection.
• Turker, T., & Capdarest-Arest, N. (2013). Management of gunshot wounds to the hand: a literature review. The Journal of hand surgery, 38(8), 1641-50.
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  Hand trauma resulting from firearms is becoming more common in civilian life. In the past, as in wartime, infection was a main source of concern following firearm-related hand injuries, whereas in current civilian life with modern medical care, infection rates are actually low for such injuries. As infection is now of lesser concern, the focus should shift to improve functional outcomes. This review summarizes available literature regarding the management of gunshot wounds to the hand, with particular focus on functional outcomes. In conducting this review, we found that there is not comprehensive information regarding management of gunshot wounds to the hand, and literature discussing functional recovery of the hand is limited. Given the current evidence related to management of gunshot wounds to the hand, we believe that early debridement, antibiotic treatment, reconstruction, and rehabilitation offer patients the best chance for full functional recovery.
• Turker, T., & Capdarest-Arest, N. (2013). Open isolated extensor carpi radialis brevis avulsion injury: a case report. Hand (New York, N.Y.), 8(3), 354-7.
• Türker, T., Murphy, E., Kaufman, C. L., Kutz, J. E., Meister, E. A., & Hoying, J. B. (2013). Response of dupuytren fibroblasts to different oxygen environments. The Journal of hand surgery, 38(12), 2365-9.
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  It is thought that local ischemia and oxygen radicals are responsible for fibroblast-to-myofibroblast cell transformation and proliferation. We hypothesized that hypoxia could differentially activate the contractility of fibroblasts from normal human palmar fascia and from fibroblasts-myofibroblasts of Dupuytren cords.
• Costas-Chavarri, A., Turker, T., & Kutz, J. E. (2012). Flexor tendon lacerations due to high-pressure water injection injury: a case report. Hand (New York, N.Y.), 7(1), 121-3.
• Fırat, T., & Türker, T. (2012). Is the long sarcomere length responsible for non-traumatic supraspinatus tendinopathy? Potential novel pathophysiology and implications for physiotherapy. Pathophysiology : the official journal of the International Society for Pathophysiology / ISP, 19(3), 179-83.
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  Several theories have been proposed to explain the mechanism of non-traumatic supraspinatus tendinopathy, which causes rotator cuff tendinitis and rotator cuff ruptures. However, these theories have not addressed all potential causes of rotator cuff tendinopathy. We propose that the microanatomy of the supraspinatus muscle and its response to gravity is the mechanism that responsible for non-traumatic supraspinatus tendinopathy and rotator cuff tears. Gravity causes chronic traction to the supraspinatus muscle, which results in elongation in the sarcomere length. Elongated sarcomere length causes compression on the micro vessels in the muscle which compromises internal microcirculation of the muscle and tendon. Poor microcirculation triggers ischemia and ischemia triggers inflammation process in the muscle and the tendon. This results in a higher incidence of tendinopathy. We also propose a new physiotherapeutic approach that may provide improved healing for rotator cuff tendinopathy.
• Ozyurekoglu, T., & Turker, T. (2012). Results of a method of 4-corner arthrodesis using headless compression screws. The Journal of hand surgery, 37(3), 486-92.
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  To evaluate the functional and radiographic results of a scaphoid excision and four-corner arthrodesis technique using percutaneous headless compression screws.
• Turker, T., Tekdemir, I., Sen, T., Leblebicioglu, A. G., Kendir, S., Firat, T., & Elhan, A. (2012). Motor nerve lengths of twenty-seven muscles in upper extremity.. Clinical anatomy (New York, N.Y.), 25(3), 373-8. doi:10.1002/ca.21247
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  The purpose of this study is to determine the lengths of motor nerves in the upper extremity. Motor nerves of 27 muscles in 10 cadavers (16 extremities) were dissected from their roots at the level of intervertebral foramen to the entry point of the nerves to the corresponding muscles. Distance between acromion and the lateral epicondyle of the humerus was also measured in all cadavers. Nerve length of the coracobrachialis muscle was the shortest (18.26 ± 1.64 cm), while the longest was the nerve of the extensor indicis (59.51 ± 4.80 cm). The biceps brachii, the extensor digitorum communis, and the brachialis muscles showed highest coefficient of variation that makes these nerve lengths of muscles inconsistent about their lengths. This study also offers quotients using division of the lengths of each nerve to acromion-the lateral epicondyle distance. Knowledge of the nerve lengths in the upper extremity may provide a better understanding the reinnervation sequence and the recovery time in the multilevel injuries such as brachial plexus lesions. Quotients may be used to estimate average lengths of nerves of upper extremity in infants and children. Moreover, reliability of the biceps brachii as a determinant factor for surgery in obstetrical brachial plexus lesions should be reconsidered due to its highest variation coefficient.
• Turker, T., Tsai, T., & Thirkannad, S. (2012). Size discrepancy in vessels during microvascular anastomosis: two techniques to overcome this problem. Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand, 17(3), 413-7.
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  The problem of size discrepancy between vessels during microvascular procedures is well known. Inability to successfully overcome this problem can lead to turbulent flow at the anastomotic site with consequent thrombosis. Various techniques have been described to overcome this problem. We describe two techniques that have been used for over two decades in our institution. Both these techniques enable the surgeon to overcome far more significant size mismatches than other available techniques while still allowing for end-to-end anastomosis.
• Oroglu, B., Turker, T., Aktas, S., Olgac, V., & Alp, M. (2011). Effect of hyperbaric oxygen therapy on tense repair of the peripheral nerves. Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc, 38(5), 367-73.
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  After a peripheral nerve cut, tense repair of a nerve compromises circulation of the nerve at the injury site, making the site hypoxic. Hyperbaric oxygen might increase tissue oxygenation and therefore diminish the effects of injury. We investigated whether hyperbaric oxygen treatment affects peripheral nerve healing when repaired nerves are under tension.
• Turker, T., & Kutz, J. E. (2011). Can oral levofloxacin cause of flexor digitorum profundus rupture?. Medical hypotheses, 77(4), 696-7.
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  Fluoroquinolones are broad-spectrum antibacterial agents. Reports of Achilles tendon rupture as a possible side effect of the quinolones have been previously presented but mechanism of the side effect of the medication is still unknown. Tendon rupture in the forearm associated with fluoroquinolone use has not been reported. We present a patient who underwent levofloxacin treatment for skin infections and subsequently developed left small finger flexor digitorum profundus rupture. We propose that this rupture may be related to the side effect of the medication. If it is, clinicians have to be aware of possible tendon ruptures in the upper extremity due to side effects of quinolones and patients have to be informed about it.
• Turker, T., & Thirkannad, S. (2011). Trapezio-metacarpal arthritis: The price of an opposable thumb!. Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India, 44(2), 308-16.
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  Trapezio-metacarpal arthritis is the most common arthritic problem of the hand for which patients seek surgical treatment. The current article reviews the etio-pathogenesis, epidemiology, classification and management of this widespread problem. The anatomy and unique biomechanics of this joint are also reviewed. In addition, the article provides a detailed description of our preferred method of trapezio-metacarpal arthroplasty.
• Türker, T., Robertson, G. A., & Thirkannad, S. M. (2010). A classification system for anomalies of the extensor pollicis longus. Hand (New York, N.Y.), 5(4), 403-7.
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  Variations of the long extensor tendon to the thumb are very rare.
• Ogüt, T., Akgün, I., Kesmezacar, H., Türker, T., Uzün, I., Demirci, S., Marur, T., Can, G., & Akkin, S. M. (2004). Navigation for ankle arthroscopy: anatomical study of the anterolateral portal with reference to the superficial peroneal nerve. Surgical and radiologic anatomy : SRA, 26(4), 268-74.
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  We aimed to navigate the surgeon regarding the localization of the main anatomical structures at the anterior part of the ankle joint, in order to find easily the safest anatomical points with reference to the superficial peroneal nerve (SPN), in particular for anterolateral portal placement in ankle arthroscopy. Sixty-three ankles in 36 fresh cadavers were dissected. In all specimens we examined (1) the distance between the SPN bifurcation and the most distal point of the lateral malleolus; and at the level of ankle joint, (2) the number of SPN, (3) the distance between the medial and intermediate dorsal cutaneous nerves, which are branches of the SPN, (4) the localization of the peroneus tertius (PT) tendon in relation to the lateral malleolus, (5) the width of the extensor digitorum longus (EDL) tendon, (6) the relationship of the PT tendon and (7) the relationship of the extensor hallucis longus (EHL) tendon with the SPN. The results were as follows: (1) In 41 ankles with bifurcation (65%) the average distance was 71.8+/-35.3 mm. (2) There were two SPN branches in 39 (62%), three branches in seven (11%) and one branch in 17 (27%) cases. (3) In 39 ankles with two branches of the SPN, the mean distance was 15.2+/-7.1 mm. (4) The lateral border of the PT tendon was positioned a mean distance of 20.8+/-3.3 mm proximal and 25.2+/-5.8 mm medial to the reference points. (5) The mean width was 10.1+/-2.9 mm. (6) In 42 ankles (67%) the distance between the lateral border of the PT tendon and the SPN was a mean of 6.2+/-6.6 mm, median of 3 mm (range 0-22 mm lateral to the tendon). (7) In 56 cases (89%) a branch of the SPN was found a mean of 6.6+/-4 mm and a median of 6 mm lateral to the EHL tendon, and in seven cases (11%) on the tendon. According to our study, in ankle arthroscopy the risk of the SPN injury is maximal in the 0-3 mm lateral to the PT tendon. To avoid injury to the SPN, the safest placement of the anterolateral portal is 4 mm lateral to the PT tendon.

Presentations

• Turker, T. (2019, February). (Presentation x 2) 1) Adipose-derived stem cells for CMC arthritis; 2) Investigation effectiveness of vibratory stimulus in trigger finger injections.. UA Research Day Data BlitzUniversity of Arizona.
• Gimber, L. H., Taljanovic, M., Krupinski, E., Desilva, G. L., Turker, T., Chadaz, T., Becker, G. W., Sheppard, J. E., Sheppard, J. E., Becker, G. W., Chadaz, T., Turker, T., Krupinski, E., Desilva, G. L., Taljanovic, M., & Gimber, L. H. (2018, March). Diffusion Tensor Imaging of the median nerve with ultrasound correlation in patients with carpal tunnel syndrome before and after flexor retinacular release. Society of Skeletal Radiology Annual Meeting. Austin, Texas: SSR.
• Turker, T., Capdarest-Arest, N., Obukowica, S., Hassan, K., & Jarrouj, A. (2016, June). Abstract A-0279 - Oral Presentation "Transforming Finger Trauma Care: Considering Cultural Preferences". XXI FESSH 2016 Conference. Santander, Spain.

Poster Presentations

• Gimber, L. H., Taljanovic, M., Krupinski, E. A., Desilva, G. L., Turker, T., Chadaz, T., Becker, G. W., Sheppard, J. E., Sheppard, J. E., Becker, G. W., Chadaz, T., Turker, T., Desilva, G. L., Krupinski, E. A., Taljanovic, M., & Gimber, L. H. (2018, March). Diffusion Tensor Imaging of the Median Nerve with Ultrasound Correlation in Patients with Carpal Tunnel Syndrome Before and After Flexor Retinacular Release. 41st Annual Meeting of the Society of Skeletal Radiology (SSR). Austin, TX.
• Taljanovic, M., Gimber, L. H., Gimber, L. H., Desilva, G. L., Krupinski, E. A., Krupinski, E. A., Chadaz, T., Turker, T., Turker, T., Sheppard, J. E., Becker, G. W., Becker, G. W., Becker, G. W., Sheppard, J. E., Sheppard, J. E., Turker, T., Chadaz, T., Chadaz, T., Krupinski, E. A., , Desilva, G. L., et al. (2017, November). Diffusion Tensor Imaging of the Median Nerve with Ultrasound Correlation in Patients with Carpal Tunnel Syndrome Before and After Flexor Retinacular Release. Radiological Society of North America (RSNA). Chicago.