Femur kırıklarının intrameduller çivi ile tedavisinde radyasyon maruziyeti azaltılabilir mi?

Amaç: Bu çalışmada, serbest el tekniği ve elektromanyetik navigasyon sistemi ile distal kilitleme yapılan intramedüller çivi ameliyatı yapılan olguları, cerrahi süresi ve radyasyon maruziyeti açısından karşılaştırmayı amaçladık. Yöntem: Şubat 2012-Şubat 2013 arasında femur kırığı olan 40 hasta değerlendirildi. Distal manyetik kilitlemeli İntramedüller Çivileme (DMK+) ve distal serbest el kilitli intramedüller çivileme (DMK-) tekniği ile operasyon yapıldı. Distal kilitleme sırasında kullanılan floroskopi süresi, radyasyon maruziyeti ve cerrahi süresi karşılaştırıldı. Alınan radyasyon dozu; TC sivil savunma müdürlüğünden temin edilen NAB 223 marka radyasyon ölçer ile ölçüldü. Bulgular: DMK (-) grubunda 20 femur kırığı mevcuttu. Distal kilitleme sırasında ortalama skopi süresi33,7± 12,6 idi, ameliyat süresi 68.50±7.1dk idi. Radyasyon dozu femur kırığı için 461,7±172,7 idi. DMK (+) grubunda 20 hastada femur kırığı mevcuttu. Distal kilitleme sırasında ortalama skopi süresi 29±17,6 idi, ameliyat süresi 66.25±10.1 dk. İdi. Radyasyon dozu ise 397,3±241,1 idi. Sonuç: Uzun kemik kırıklarına uygulanan İntramedüller Çivileme tekniklerini karşılaştırdığımız bu çalışmada distal manyetik kilitlemeli İntramedüller civilerin alınan skopi sayısı, ameliyat süresi ve kanama miktarını kilitsiz intramedüller çivilere göre anlamlı şekilde azaltmadığı gözlenmiştir (p>0.05).

Anahtar Kelimeler:

Femur kırığı, intramedüller çivileme, distal kilitleme, radyasyon

Can radiation exposure be reduced in thetreatment of femur fractures with the Intrameduller nail?

Aim: In this study, our aim is to compare surgery time and radiation exposure for patients of treated with two different intramedullar nail distal locking systems; free-hand technique and electromagnetic navigation system.Method: We evaluated 40 patients' femur fractures. we treated with Intramedullar Nail due to femur fractures between the dates of February 2012 and February 2013 were operated on by two different distal locking techniques; Distal Electromagnetic guided technique(DML+) and Free-hand Technique(DML-). Radiation exposure was measured by radiationmeter (NAB223) obtained from Civil Defense Directorate. Results: In group DML(-) 20 femur fractures were evaluated. Mean flouroscopy time was 33,7± 12,6, operation time 68.5±7.1 minutes and whole radiation exposure was 461,7±172,7. In group DML(-) 20 femur fractures were evaluated. Mean flouroscopy time was 29±17,6,operation time 66.25±10.1 minutes and whole radiation exposure was 397,3±241,1.Concllusion: In this study we compared distal locking time, radiation exposure and fluoroscopy shoot by using two different distal locking techniques in long bone fractures and found no significant differences in both of techniques (p>0.05).

Keywords:

femur fractures, distal locking, intramedullary nailing, radiation,

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