Baran KÖMÜR, Güzelali ÖZDEMİR, Olgun BİNGÖL, Barış YILMAZ, Enver KILIÇ

Fonksiyonel Breys ile Tedavi Edilen Humerus Şaft Kırıklarında Deformitenin Fonksiyonel Skorlar Üzerine Etkisi

Amaç: Bu çalışmanın amacı, fonksiyonel breys ile konservatif tedavi edilen humerus cisim kırığı hastalarında deformitenin fonksiyonel skorlar üzerindeki etkisini değerlendirmektir. Yöntem: 2014-2019 yılları arasında humerus cisim kırığı olan ve fonksiyonel breys ile tedavi edilen hastalar bu çalışmaya dahil edildi. Kırıktan sonra ikinci veya üçüncü gün, iki parçalı fonksiyonel korse uygulandı. Ön-arka ve yan radyografilerde humerusun deformite açısı ölçüldü ve 3 gruba ayrıldı. Dirsek hareket açıklığı(EHA), omuz abdüksiyonu ve karşı omuza göre dış rotasyon açıklığı farkı değerlendirildi. Ayrıca omuz Constant skorları ve dirsek Mayo skorları değerlendirildi. Bulgular: 42 hasta değerlendirildi. Ortalama iyileşme süresi 12.11 ± 2.31 hafta olarak belirlendi. 37 hasta başarıyla tedavi edildi. Takiplerde sadece 5 hastada kaynamama saptandı. Varus deformitesi 18 hastada 6°-10°, 12 hastada >11° ve 7 hastada 0°-5° arasında ölçüldü. Varus deformitesi gruplarında dış rotasyon ölçümlerinde (p:0.044) ve dirsek EHA ölçümlerinde (p:0.048) istatistiksel olarak anlamlı fark gözlendi. Dış rotasyon ve dirsek EHA ölçümleri farkının nedeni >11° varus deformitesi grubuydu. Varus deformitesi gruplarının omuz abdüksiyon aralığı, Mayo skorları ve omuz constant skorları arasında istatistiksel olarak anlamlı fark yoktu (p>0.05). Sonuç: Klinik ve radyolojik verilerimiz fonksiyonel breys ile tedavi edilen humerus cisim kırıklarının çoğunda tatmin edici sonuçlar alındığını göstermektedir

The Effect of Deformity on Functional Scores in Humeral Shaft Fractures Treated With Functional Bracing

Objectives: The aim of the study is to evaluate the effect of deformity on functional scores of humeral shaft fracture patients who treated conservatively with functional bracing. Materials and Methods: Patients who had humeral shaft fracture and treated with functional bracing between 2014 and 2019, were included in this study. Second or third day, two part functional brace was applied. The deformity angle of the humerus on the anteroposterior radiography was measured and divided into 3 groups. Elbow range of motion (ROM), shoulder abduction and the difference of range of external rotation (ER) compared to contralateral shoulder was evaluated. Moreover, Constant scores of the shoulder and Mayo scores of the elbow were evaluated. Results: Forty-two patients were evaluated. The mean healing time was determined as 12.11 ± 2.31 weeks. Thirty-seven of the patients were successfully treated. Nonunions were detected in only 5 patients during follow-up. The varus deformity was measured between 6°-10° in 18 patients, >11° in 12 patients, and between 0°-5°in 7 patients. In the varus deformity groups, a statistically significant difference was observed for the external rotation measurements (p:0.044) and for elbow ROM measurements (p: 0.048). The reason of the external rotation and elbow ROM measurements difference was >11° varus deformity group. There was no statistically significant difference between the shoulder abduction range, Mayo scores and shoulder constant scores of the varus deformity groups (p>0.05). Conclusion: Our clinical and radiological datas show that satisfactory results are obtained in most of the humeral shaft fractures treated with functional bracing.

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