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What is Priformis Syndrome? The priformis muscle is the weakest of the external rotators of the hip. However, since it becomes active especially during hip flexion, it can be easily injured by encountering greater loads than other muscles. Priformis injury can create the typical sciatic nerve area (drop foot and loss of strength in toe elevation) in the acute phase. This situation is temporary. When the priformis edema decreases and the pressure disappears, it can disappear after 2-3 weeks of rest. In chronic cases, the priformis hardened and thickened. By pressing the sciatic nerve just below it, this time it causes pain that does not decrease at rest. What are the Symptoms of Priformis Syndrome? Pain that increases when standing for a long time Weakness in the leg Difficulty walking Pain and numbness radiating to the back of the leg Pain in the hip and coccyx How Is Priformis Syndrome Diagnosed? Diagnosis is difficult, pressure may not be revealed by MRI. EMG can also be confused with root compression, even if there is a herniated disc surgery. Most patients mention sciatica pain that does not decrease despite previous lumbar hernia surgery. In this case, the priformis should be loosened and the sciatica trapped in the canal should be relieved. The patient's complaints decrease and the nerve begins to repair itself. Although surgical treatment is mostly an open surgery, we perform the procedure with endoscopy through a 1 cm hole. Percutaneous endoscopic priformis release is applied under local anesthesia under operating room conditions.

Back Pain - Back Pain During Pregnancy: Fertility, beyond being a reproductive function, includes sacred motherhood; It is a very difficult process where temporary but serious hormonal and emotional peaks are experienced. The expressions on the mother's face created by the accompanying back and back pain have been a source of inspiration for many artists. It is a fact that motherhood constitutes the most serious step of transition to womanhood. Some changes, especially in the genitals and characters, give a "mature woman" appearance by slightly regressing. Such a sacred and respected life experience is like an honorable medallion that emerged with this differentiation in female identity. The response of the musculoskeletal system to hormonal fluctuations in pregnancy is not as rapid as the uterus and breast tissue. Skeletal adaptation develops over months and can be described as the defense that responds to destruction in the adaptation process. The bone roof loses strength, its destruction can cause widespread bone pain. The ligament structures that begin to loosen can cause the limits of the joints to be strained during movement and cause injuries. That is why the excessive load on the disc by loosening ligaments of the spine joints causes ruptures in the wall and waist-neck hernias. Spine pain during pregnancy occurs in different stages at different stages. Therefore, different measures will be required at each stage. Pregnancy is examined in the trimester. However, it would be appropriate to approach pre-pregnancy, pregnancy and puerperium. A mother with a spinal problem before pregnancy should know that her spinal pains will increase and hernias, if any, may progress, and should solve these problems if necessary. In the first trimester, the weight and mass effect of the baby is negligible, but the hormonal effects are severe enough to change the cycles of the skeletal system. At this stage when placenta formation begins, maternal hormones and fetal hormones compete in the maternal circulatory system. First of all, we need to know that female hormones have effects that enable skeletal metabolism and bone cycle to work in the direction of construction, increase carrying power and endurance. It is almost usual for estrogen and progesterone to cause complaints characterized by rhythmic cramps and joint pain, even on the moon. These effects are in the direction of construction, but pregnancy hormones suppress this. Back Pain During Pregnancy - Back Pain During Pregnancy Pregnancy hormone HCG works in the opposite direction by imitating them, just like the genitals, in the steroid structure we call a kind of gonadotropin. With a slow rise, it begins to suppress this cycle of female hormones and literally takes its place, while bones in the skeletal system prepare a calcium store for destruction, the muscles are forced into a sequence that will work in the direction of pushing. All ligaments tend to increase the elastic tissue structure and loosen. All these hormonal influences are essential for the baby to feed, to provide room for growth in the abdomen, and to progress through the birth canal. In the second phase, hormonal effects begin to balance. Maternal and infant circulation begin to diverge. As the gestational months increase, the weight of the fetus becomes increasingly vulnerable to daily traumas with asymmetrical loads on the joints due to loose ligaments and the loading of the muscles working in different directions against a moment that will change the body weight center. The second trimester is the transition phase in this respect, the muscles increase their strength against load. In the first two stages, the biggest difficulty in diagnosing the pain of the musculoskeletal system is that the radiological examinations cannot be performed and the drugs that will harm the baby cannot be used. In the third stage, there is a spine placed in the birth canal in the abdomen that resists an extra 10-15 kg of overload. In this period, if there is aches of muscles that are tired of contraction, joints and ligaments that are injured and healed during pregnancy, pain due to progress in waist and neck hernias occur. When the causes of pain become unbearable, radiological examinations that will cause less harm to the baby are often not accepted by mothers. Drug use may be more appropriate if or not to cross the placental barrier. When our mothers do not agree to take these drugs, it is not possible to relieve the pain. Labor at the end of pregnancy is a painful process in which the musculoskeletal system is subjected to extraordinary loads. While this miracle is happening, all muscle structures put serious strains on weak and loose bone structures. With a new burden after birth, miraculous hormones (oxytocin, prolactin) that help the milk secretion grow to the rescue of the mother in the postpartum phase. These hormones release growth hormone-equivalent replacement agents (somatomedins). Mothers literally reach the capacity of renewal in a child's development. This does not occur in normal situations in women who are not mothers, as in men Breastfeeding mothers suffer less pain after childbirth, and these hormones, which have an endorphin-like effect, relieve pain and also have a miraculous healing function, enter a dramatic production / repair phase within 3-6 weeks. However, the repair process is also painful. These are responsible for the mothers of fatigue, sleepiness, and the tendency to consume sugary foods (puerperal sherbet). So what should we do so that we can fight back pain? Spine problems, if any, should be known before pregnancy and their aggravation should be prevented during later pregnancy. From the first stage of pregnancy, weight training can be performed in addition to exercises such as plates that strengthen the carrier properties of the back and abdominal muscles. However, as we approach the second stage, where the risk of miscarriage will continue to increase, exercises should be performed with plates and isometric movements. Painful situations should be eliminated with cold-hot applications and medical massage, especially without triggering fibromyalgia. Pregnancy is the period of life when ergonomic life is most necessary. Strict compliance with the rules is essential, from the preferred stair step while walking, your seat setting in the vehicle, the way you travel in the bus, the seat at home, to the bench level in the kitchen. Nutrition, and especially a diet containing calcium, phosphate and plenty of protein, greatly reduces the destruction of the skeletal and muscle structure for the baby's needs. The mother who is not well nourished is weakened primarily by the body code that nourishes the baby, and it is inevitable that the spine-muscle-originated pains will increase. If you have a weak body before pregnancy, you should definitely do muscle strengthening in the first months. In the advancing 2nd and 3rd stages, birth preparation groups in pregnancy centers will greatly reduce the pain caused by the skeletal system. Considering that the muscle groups that are tired in the last phase will need more breaks, less repetitive exercises with frequent breaks are preferred. The needs of the skeleton that heals and regenerates rapidly in the 3-6 week period after pregnancy should be met with rich contents with low calories during pregnancy. The weight gained should be lost, the loads on the spine should be reduced. Pain reduces the transition to some drug treatments in mothers who are not breastfeeding, but I would like to emphasize the presence of natural painkillers for breastfeeding mothers, in this respect, breastfeeding is a great advantage with reducing spinal pain and increasing regeneration. Pregnancy is the most beautiful period of holy motherhood. Let's not forget that this period will pass with the least pain and a smiling face, with a healthy diet and regular exercise.

Dislocations are very common in the shoulder joint, which is the most mobile joint in our body. What is Shoulder Dislocation? How is Shoulder Dislocation Surgery and Treatment Performed? You can find out all about Shoulder Dislocation in this article. What is Shoulder Dislocation? It is when the shoulder joint comes out of its socket. In reality, the shoulder joint does not have a seat. Instead of a slot covering the sphericity of the shoulder head, the labrum lip of approximately 1 mm, which acts as a suction cup on a flat structure that we call the gleonoid, and the capsule, ligament and muscles covering it, can keep the shoulder joint in place. This allows the shoulder to rotate nearly 360 degrees, allowing it to function as the most mobile joint of our body. In Which Situations Is Arthroscopy Preferred For Shoulder Dislocation? Treatment of shoulder dislocation is immediate placement in the first 6 hours and fixation with a bandage. Detection should not be less than 6 weeks. Although this period of recurrent shoulder dislocation is reduced to 3 weeks, 6 weeks is recommended as a safer period in our clinic. The diagnosis of "habitual dislocation" (Habituel) is made in people who have shoulder prolapse more than three times. The ligament and labrum structures of the shoulder should be repaired in the habitual shoulder dislocation and primary (first) shoulder dislocation with tears in the anterior region of the labrum. Arthroscopic shoulder dislocation repair is the gold standard. Today, open surgery is very rare and cannot be performed. How is Shoulder Dislocation Arthroscopy Performed? It is like standard shoulder arthroscopy. If the width of the labyrinth tear is large, an additional portal can be opened. Stitches placed in the labraum are repaired and shoulder stability is checked. If necessary, the capsule can be intervened in the same session. How Long Does Shoulder Dislocation Arthroscopy Take? The optimal time varies between 30-60 minutes. What Should the Patient Do Before Shoulder Dislocation Arthroscopy? Preparation for shoulder arthroscopy is done in the hospital. What is the Recovery Process After the Surgery? After arthroscopic shoulder dislocation surgery, rehabilitation and movement are started immediately. First of all, after pandular movements, joint range of motion is actively provided. After 3 weeks, passive, active resistive exercises can be started in the presence of a physiotherapist. The rehabilitation period may vary depending on the patient's location and profession. Will It Repeat After Surgery? It is not expected to reappear in sedentary life. It is possible for the shoulder to dislocate after a new trauma that pushes the shoulder limits, but in daily life, it is not seen as a spontaneous or habitual dislocation. How Much is the Surgery Fee? It is determined according to the options suitable for the hospital and the patient's budget.

A fracture is a condition in which our bone integrity is impaired. So how do you understand the fracture? You can read about this and other details below. What are the Differences Between Fracture and Crack? Although an unallocated fracture is considered a crack, it is essentially a fracture as both break bone integrity. How to Tell a Fracture? How Is A Fracture Diagnosed? Fracture findings; pain, swelling, excessive movement are in the form of deformity. In cases where there is no deformity, a definitive diagnosis should be avoided without radiological imaging of the bone. Some fractures line a fairly thin line and can be missed, in which case MRI or tomography may be required. Fatigue fractures can only be noticed on MRI. If it is not compatible with conventional x-ray examination, MRI should be considered without hesitation. For fractures that cannot be localized, the location may be determined by bone scintigraphy and diagnosed by localized MRI or tomography. What is the Fracture Treatment Process? Fractures heal with a plaster splint in 6-12 weeks if the contact surface is more than 50 percent, there is no rotation, the angulation is not more than 15 degrees in the direction of movement, the anterior-posterior 10 degrees and is stable during fixation. Non-healing delay exceeding 5 months, nonunion is accepted in cases exceeding 7 months. At Which Stage Is Fracture Surgery Required? If there is no contact between the fracture ends or if it is less than 50 percent, angulation is high and stability cannot be achieved, surgery should be performed. Some fractures (hip neck fracture, muscle attachment ruptures, epicondyle and malleolus fractures) are treated promptly. If muscle and connective tissue have entered between the broken ends, surgery is also performed. What Are The Surgery Options - How Is It Done - How Long Does It Take? In open surgery, the fracture ends are brought face to face and fixation is provided with plates and metals from the bone marrow (intramedullary) long bones from the surface. In rigid and solid fixings, joint movement can be given immediately and weight can be given. If the surgical fixation is insufficient, timing should be done with the surgeon's decision. What is the Recovery Process After the Surgery? Fracture healing is best achieved without surgery. Fracture union is completed in 6-12 weeks with or without surgery. Weight-bearing and joint movement are planned according to the load carried by the bone. Does It Recur After Surgery? If the boiling is not completed, it can be separated from the same place again. The probability of breaking the unbroken bone is the same as the fracture at the same place after union. How Much is the Surgery Fee? It is planned according to the patient's budget.

Before giving information about Shoulder Rotator Muscle Tear Treatment, let's answer the question "What is a Rotator Muscle Tear". What is a Shoulder Rotator Tear? It is a tear of the rotator muscles of the shoulder. The outer rotator muscle group is mostly torn. While it occurs due to eccentric strain in athletes, even housewives who have never done sports, the tear can progress after shoulder impingement syndrome. In fact, the main factor that causes the impingement syndrome is the inflammatory reaction that develops as a result of the failure to repair the muscle tear in a timely manner. How is Shoulder Rotator Tear Treatment Performed? Arthroscopic surgery is the gold standard. Most muscle tears are removed by arthroscopy, which is a closed surgery. Arthroscopy is preferred even in full-thickness complete tears with large muscle defects or excessive muscle retraction, rarely when grafting is required, semi-open surgery may be required. In Which Situations Is Arthroscopy Preferred? Surgical repair is required in cases of shoulder pain, limitation of movement, loss of function and strength. How is Shoulder Rotator Tear Arthroscopy Performed? It is standard shoulder arthroscopy. In tears that occur after shoulder compression, the sharp bone ends that cause muscle tears, which we call acromioplasty, are firstly leveled. Subsequently, the tear is refreshed and the rupture area is reattached to the bone and the suture is completed. Midline intramuscular tears are closed with special stitches. If a patch needs to be placed in large muscle defects, rarely, the skin can be opened to place the patch (semi-open technique-mini open). How Long Does Arthroscopy Take? 30-60 minutes. takes. The arthroscopy time may vary depending on the technique and the size of the tear What Should the Patient Do Before Arthroscopy? Apart from the preoperative preparation, information is given directly. What is the Recovery Process After the Surgery? Shoulder fixation is applied to protect the stitches in muscle repairs. Active movements are not allowed for 3-6 weeks. Passive assisted shoulder exercises, which we call pillow exercises, are started immediately in order to prevent the joint from freezing. According to the resistance of the sutures, pendular exercise is started after surgery according to the surgeon's decision. Physical therapy is extremely important. As of the sixth week, fixation can be terminated with intensive exercises and return to daily life. The return to sports for professional athletes is in the 3rd month, it can be extended to the 6th month with special training. Will It Repeat After Surgery? Degenerative tears can rarely recur without trauma after a good healing. This is very difficult, except in the case of a person with muscle and nutritional weaknesses. Traumatic muscle tears can rarely cause problems in the same place after a good repair and healing process. With the new trauma, injuries may occur in all kinds of limit strain. This condition usually has nothing to do with treatment. How Much is the Surgery Fee? The surgery fee is arranged according to the patient's budget.

Before giving information about flatfoot treatment, let's answer the questions "What is Flat Insoles and What are the Effects on the Skeletal System". It can be congenital or acquired. Flat foot is the foot sitting on the ground with a large surface as a result of the loss of the arch of the foot. This situation causes the force that creates the spinning wheel mechanism by spreading to three different points like the stool foot during the transfer of weight, losing this effect on the wide base and causing the resultant force to move the mechanical axle to an unknown area without springing, the alignment is disrupted. The hip-spine-knees are positioned according to the resultant force-mechanical axis relationship. Varus-Valgus internal or external rotations - Excessive lordosis-kyphosis occurs in the spine, posture deteriorates. Since the axis change will disrupt the joint mechanics, abrasions occur and become vulnerable to trauma, falls increase. How is Flat Insoles Treatment Performed? Congenital flat feet may require early surgery. In cases that do not require surgery, massage treatments and shoes with ankle support are given after walking. At the age of two years, axis corrective heel wedges can be added to shoes that support the arch and grip the heel. While it is ensured that the foot bones are in contact with the arch supports at certain angles until the age of six, when ossification is achieved, softer shoes can be used with exercises. Arch support should be continued during the rapid growth period such as adolescence. After the growth is complete, the benefit of padded shoes decreases. If angular changes continue, surgery is considered. Closed flatfoot surgery (Arthroereisis-Arthroerez) is one of the best options. Other options are fusing the foot bones to each other on the axis they should be (Triple Arthrodesis). The foot loses its elasticity, although the axes are straightened, movement becomes difficult when the spring is broken. Acquired flatfoot is treated similarly at an early age. If there is tendon failure, it can be repaired. Wrong sideburns due to fracture are corrected. It usually requires surgical intervention. Which Age Group Is Flatfoot Treatment Applied? Different approaches are applied in all age groups. The application range of closed surgical methods such as arthroeresis may be 14-50 years. It can be applied in selected cases outside these limits. In arthroeresis surgery, a special screw is placed in the space adjacent to the joint of the bones forming the arch called sinus tarsi, allowing the bones to return to their normal axis relations without freezing. Since the foot does not lose its flexibility after this procedure, the spring-spinning mechanism does not deteriorate, the walking mechanics are improved and the strength increases. How Long Does The Flat-Foot Closed Surgery Treatment Take? In 30-45 minutes, the surgery is completed bilaterally. What is the Recovery Process After the Surgery? It can be walked with a special walking boot for 3 weeks. During this period, a cane may be required. 3-6 shoes that cover the ankle with arch support are preferred. Exercises are started with soft walking shoes for 6-12 weeks.

Failed Low Back Surgery Syndrome is generally omitted or neglected foraminal strictures. Correct diagnosis, correct surgical indication, good surgical technique and equipment are very important in order to minimize the occurrence of this syndrome. What is Failed Low Back Surgery Syndrome? The fact that the back problem has not been resolved even though it has been treated with revision surgery at least once, the conservative treatments for at least 6 months are insufficient or the patient is not satisfied. What are the Symptoms of Failed Low Back Surgery Syndrome? The recurrence of the previous complaints of the patient, does not decrease or increase at all. How Is It Diagnosed? The diagnosis of Failed Low Back Surgery is a multidisciplinary decision. Evaluating all the pre-treatment examinations of the patient together with the physicians who treat other disciplines makes it easier to reach the correct diagnosis. Patient compliance is required. In order to find the source of pain, the target should be determined well with temporary injection treatments. How Is It Treated? If it is thought that the problem in the treatment is caused by the methods used in the old treatment, for example, if there is an infection and implant failure, this situation should be resolved first. It is possible to remove or renew the implant. It is appropriate to avoid a new open surgery in the minimally invasive approach. Often omitted or neglected foramen nerve compression is emphasized. After determining the target and level, the cause of pain is removed with foraminoscopy. How Long Does Endoscopic Surgery Take? Endoscopic surgery can take 1-2 hours. Although the optimal time is 30-45 minutes, it increases the time to differentiate the nerve tissues due to the intervention of the anatomy deformed tissues. What is the Recovery Process After the Surgery? In the procedures performed under local anesthesia, we confirm that the pain has passed on the operating table. The patient can get off the table without pain. However, under general anesthesia, we remove the patients after eating 4 hours after the effect of anesthesia is over. The painful process can mimic the old in the inflammatory phase after 72 hours. Similar pain occurs in the first ten days, but gradually decreases. When the exercises are started 3 weeks after the operation, new pain may develop. Due to the pain, coping with neuropathic symptoms or even psychological support may be required. Mesotherapy-acupuncture helps the physical therapy process. Although this situation is not seen in some patients, both patient groups start to work to regain their belief in the treatment in a few months. Patients should be returned to normal life within 6 months. The problem is completely resolved in the following months and 2 years. How Much is the Surgery Fee? It is determined according to the hospital and patient budget.

“Beauty of style and harmony and grace and good rhythm depend on simplicity.” (Plato) We would not be overly ambitious to apply Plato’s maxim to simplifying surgical treatments. To name a few would include successful results of minimally invasive and endoscopic surgeries on failed back syndrome; simple surgical drainage, even on severe diskitis, instead of complicated surgeries; percutaneous endoscopic posterior cervical applications; and contralateral endoscopic approaches. In the ISMISS guide, the term MISS means causing less trauma. The Fourth ISMISS Congress in Turkey continues its objective with the topic, “Minimally Invasive Spine Surgery.” In 2011, the world’s most advanced authorities will once again participate in this event. In this regard, there is now a more imminent preference for endoscopic surgery when desiring less traumatic methods in today’s applications. Making it even more possible to identify disk and foramen endoscopic lesions and treatments are HD camera systems – which heighten human perception multiple times – and greater recording, archiving and classifying potential, with or without various robotic-navigation or targeting systems. Because of spine problems in joint surgery, in addition to macroscopic or microscopic examinations, the necessity of examining without bleeding by using natural gas or liquid must be indicated to observe unattended conditions for identifying the pathologies of tissues. In this respect, new surgical solutions will be accessible through the guidance of our endoscopy ISMISS sessions. Organized on a scientific platform, the sessions will focus on surgical approaches along with multidisciplinary approaches, while encouraging team work and highlighting the philosophy of algorithmic treatment. Each year we have continued to point out innovative studies on minimal invasive surgery. The approved studies will be strongly encouraged during this period. We have also reiterated the principle, Primum nil nocere, or “first, do no harm,” with respect to MISS – which first appeared alongside traditional surgeries but has now moved to the forefront. We invite our colleagues to an academic festive on our scientific platform. Tolgay Satana, M.D. Course Coordinator

Foreword by Translation Editors If the patient satisfaction of surgical treatment, which remains indispensable among modern medical treatment options, is less than expected, it may not be realistic to question the reasons. In this case, even if an equal distribution is made in the Patient-Surgeon-Treatment triangle, the morbidity of the treatment is always found to be higher than the recessive methods. What should be the ideal treatment in spine surgery? Instead of waiting for the answer to the question to be solved within the same triangle, it would not be misleading to take Hippocrates’ motto “do no harm first” as a guide. Reducing the morbidity of the surgery can be possible by preserving the anatomical integrity as much as possible while reaching the goal and performing the repair duly during the closure. The habit of reaching the target with laminotomy and flavumectomy in disc surgery has been ongoing since 1913. This means that irreversible anatomical deformation during surgery cannot be corrected during closure. Although it is possible to reduce the radicular pain symptoms of the patient, chronic low back pain may inevitably create new problems. Although Pool of 1937 tried to perform surgery with an illuminated tube, it did not contribute to reducing the morbidity of the method. In 1920, Eugen Bircher published the first diagnostic applications of arthroscopy in joint surgery. Although Bricher attempted a thoracoparoscopic treatment, this form of treatment was neglected until the early 1970s. The habit continued with Mallis in disc surgery. In 1955, Mallis used a microscope to reduce damage to anatomical structures and greatly reduce postoperative fibrosis. However, changing the path or method to achieve the goal is the most rational solution. Concurrent with the resumption of arthroscopy in early 1980, Hijikata, Asher and Kambin described the transforaminal safe triangle in the intradiscal treatment pathway for disc surgery. Kambin safe triangle has been published and the concept of “spinal arthroscopy” has been defined. When the first applications were made, and among the confusion of concept and definition, the 1990s was just beginning when special instruments were designed for endoscopic disc surgery. Yeung, Leu and Knight systems had taken their place in the markets by the Wolf, Storz and Endospine companies, respectively. Concurrently, the American minimally invasive spine academy started regular magazine publications, which laid the foundation for the book we are holding. The book was first published in 2000. It was a review of leading publications published in the Minimally Invasive Spine Surgery Journal. However, its most important feature was that it had a multidisciplinary structure. It resembled a consensus text that included all the elements on which minimally invasive surgery was based. Endoscopic surgery was spreading rapidly. While Kambin students were creating the academy, they started reporting successful treatments in Europe and Korea. When the preparation of the new edition of the book became inevitable, a resource book in the form of a textbook was obtained in 2005, without the pioneers taking the background. Martin Savitz was no longer there, but John Chiu was holding the Miss flag, Benjamin Alli was keeping the academy afloat. In our country, there were no specialized sources other than the special issue we published in the Imlas Congress and Joint Disease Surgery magazine, which was held for the first time in 2005. When we held the Ismiss congress in 2008, the congress book was published in English like before. We raised this issue with American Academy members and John Chiu, whom we received support before the second Ismiss congress. brought the source and got the permission of the Turkish translation of the source. Although the work that started in December was a short time, it was concluded quickly and the book was brought to our language. Our country has never lagged behind the world in medical treatments. While minimally invasive surgery is considered as the surgery of the future, when it is indispensable tomorrow, we have no doubt that the best practices will be applied in our country. In this context, we consider the creation of this book a sacred duty. Therefore, we owe a debt of gratitude to my colleagues who accepted the translation and did not spare their assistance, to the employees of Güneş bookstore in the person of Nuran Karacan, and to our congress operations manager Yeşim Tanrıverdi. Dr. Tolgay Şatana To Buy The Book: Nobelkitapevi.com Akademisyen.com Tercihkitabevi.com

Riding a motorcycle and enjoying it is a situation that can arise as machine and human harmony increases. While walking to a café after a short drive, I witnessed the distorted facial expressions of limping, holding back his waist, or removing gloves from his numb hand. In my opinion, if we are committed to this business, first of all, driving has to be a part of life and the motorcycle has to be like a part of our body. Although our fit varies according to our motorcycle style, the seat height must necessarily match our leg length, our distance should neither be close to nor far from the handlebar. This situation is much more important for touring or long-distance drivers. Human-machine harmony, that is “ergonomics”, which I briefly mentioned above, is of vital importance in motorcycle riding. Misuse can make our spine vulnerable to direct strain, with joints stretched, muscles ruptured, or even injured. For this reason, ergonomics is indispensable for effortless traveling, especially on long rides. How to Increase Motorcycle Ride Comfort? More or less seat height causes deterioration of posture and pain and fatigue after a while as a result of unbalanced sitting. In racing engines, the handlebars and grips are relatively far away, and reach is required. This situation causes stress on the shoulder joint and strains as a result of excessive bending in the elbow. This type of motor is therefore not used for long rides. It is a very wrong choice to use racing engines for street excursions as well. The opposite of this situation poses a problem in terms of ergonomics. The close distance of the handlebars causes excessive bending of the elbows and the distance (Chopper; monkey sling style handlebars) causes the shoulder to hang, impairing control and causing chronic shoulder disorders. On the ideal handlebar; The wrist angle should be parallel and straight to the ground, the handlebar height should be kept below the shoulder level and the distance to the elbows should be 95-100 degrees. Shoulders should not come forward too much, the spine should be able to reach a relatively upright position and all pedals and grips to be able to control the machine should be easily accessible. At the correct handlebar distance and seat height; Remember that when the maximum turning limits of the handlebars are reached, your elbow should never be in line with the shoulder. Correct adjustment of the handlebar and seat will give you maximum control, as well as fatigue-free and safe driving. Handlebars are tubular in some engine types and can be easily adjusted. Here, a straight wrist will maximize your grip strength. Make sure that the handles are suitable for the size of your hand and that they are thick enough to make a full grip. Do not forget that the throttle, gear and brake synchronization, and therefore the pleasant ride, depends on your grip and full control. If you do not have heated grips for cold weather, you can also use rubber covers that do not transmit cold. Motorcycle Riding Comfort; Although the seat and handlebar body’s participation in upright or reclining driving depends on the type of engine, in some cases, we see that the tour or city motors are leaning forward under the spoiler, especially at high speeds. In addition, lying in a model designed for an upright sitting will overload the spine, making it susceptible to injury during torsion and stress. A windbreaker designed at the right height is also very important in this respect. Vibrations from the Road; The position of the foot steps should be parallel to the ground in order for the driver to counteract the vibrations from the road and reduce the load on the body and spine. Chopper-style pegs, which are unusually arranged, prepared for the feet to balance the body that is tilted back rather than to meet the load, can cause the load to spread directly to the discs between the vertebrae and even cause hernias. In racing type engines, the foot position is designed to direct the vehicle like a crowbar while the driver is lying down, so it is not enough to meet the load on the spine. Using such motors with strong body muscles in an athletic structure, avoiding long rides and non-racing uses will prevent injuries. The position of the aftershock or passenger seat also changes according to the engine type. The engines most suitable for the passenger are enduro, touring style or cruiser engines. In sporty models, the passenger stays quite high and the handles are not suitable and the seating area is very narrow. This type of driving can be quite dangerous for aftershocks, and because it is a light engine, it can create moments that affect stable driving. For long rides, if possible, there should be ergonomic foot rests and handles for the passenger. In addition, in some engine types, precautions have been taken in such a way that the passenger will rest (sissybar). So, as a result, we can say that the rider must determine a motorcycle suitable for his height and weight. Remember, there is always a motorcycle suitable for your height and weight. In the second stage, you have to define your style: long ride, track, city use … Remember that each engine has a different ergonomics according to its area of ​​use. Enjoyable Rides.

Editor: Prof. Dr. O. Sahap ATIK Authors: Dr. Tolgay SATANA, Dr. Sezgin SARBAN, Dr. Murat A. HERSEKLI Publisher: Meteksan, Ankara, 1998 http://www.tevak.org/?page=books

The frequency of carpal instability after radius distal tip fractures, Istanbul University, Istanbul Faculty of Medicine, which hosted live surgery courses in Istanbul in the past years and supported the ISMISS congress, this tradition OMID "Spine Minimal Invasive and Interventional Surgery Association" and ISMISS "The International Society for Minimal Intervention in Spinal Surgery will continue with the courses it will organize in June and September.