Yüksel ÖZKAN, Alpaslan ÖZTÜRK, Nazan ÇEVİK, Yavuz AKALIN, Bangin Bekir CANDAN

Radius alt uç eklem içi kırıklarda volar titanyum kilitli plak uygulamalarının erken ve orta dönem etkinliği

Amaç: Erişkin distal radius kırıklarında titanyum volar kilitli plak uygulanan olgularımıza ait fonksiyonel ve radyolojik sonuçların erken ve orta dönem analizinin yapılarak etkinliğinin ortaya konulmasıdır. Hastalar ve Yöntemler: Distal Radius kırığı nedeniyle volar kilitli plak uygulanan 64 hasta (67 kırık ekstremite) retrospektif olarak incelendi. 36 kadın, 31 erkek, yaş ortalaması 53.31(18-75) idi. Frkyman sınıflamasına göre ve AO sınıflamasına göre sınıflandırıldı. Modifiye Gartlant Werley Skoru, Disabilities of the Arm, Shoulder and Hand (DASH) scoru, Modifiye Stewart skorlama sistemine göre değerlendirildi. Bulgular: Modifiye Gartland-Werley Skoruna göre 35(%52.2)’i mükemmel, 27(%39.7)’si iyi, 4(%5.9)’u orta ve 1’i kötü (%1.5) olarak değerlendirildi. DASH skoru ortalama değeri 9,5±8.8(0-35). Palmar eğim ameliyat öncesi -5.58±14.9 [(-50)-(30)], ameliyat sonrası 3.65±10.88[(-30)-(+45)] olarak değerlendirildi. İstatistiksel olarak radial yükseklik, radial inklinasyon ve palmar eğimin anlamlı düzeyde düzeldiği görüldü(p=0.001). Stewart radyolojik skoru değerlendirildiğinde 37(%54.4)’si mükemmel, 26(%38.8)’i iyi, 4(%5.9)’ü orta olarak değerlendirildi. Sonuç: Erişkin distal radius kırıklarında iyi sonuçların elde edilebilmesi kırığın iyi değerlendirilmesi, uygun tedavi şeklinin seçilmesi, uygun cerrahi tekniğin kullanılması, Anatominin iyi oluşturulması ve sağlam fiksasyon ile mümkün olabilir. Titanyum voler kilitli plak ile kırık tesbiti etkili bir tedavi yöntemi olup erken harekete izin vererek iyileşmeyi hızlandırdığı ve sonuça olumlu katkı sağlamaktadır.

Early and mid-term efficacy of volar titanium lock plate applicationsin radial distal intraarticular fractures

Aim: To determine the efficacy of the functional and radiological results of the patients who underwent titanium volar locking plaque in adult distal radius fractures withearly and mid-term analysis.Patients and methods: 64 patients (67 fractured limbs) who underwent volar lockingplate due to distal radius fracture were retrospectively analyzed. The mean age was53.31 (18-75). They were classified according to the Frkyman classification and AOclassification. The modified Gartlant Werley Score, Disability of the Arm, and Hand(DASH) score were evaluated according to Modified Stewart scoring system.Results: According to Modified Gartland-Werley Score, 35 (52.2%) were evaluatedas excellent, 27 (39.7%) as good, 4 (5.9%) as moderate and 1 (1.5%) as poor. Themean value of DASH score was 9.5 ± 8.8 (0-35). Palmar slope preoperatively was-5.58 ± 14.9 [(-50) - (30)], postoperatively 3.65 ± 10.88 [(- 30) - (+ 45)]. Radial height,radial inclination and palmar slope were significantly improved (p = 0.001). WhenStewart radiological score was evaluated, 37 (54.4%) were excellent, 26 (38.8%)were as good and 4 (5.9%) as moderate.Conclusion: It is possible to obtain good results in adult distal radius fractures withgood evaluation of the fracture, choosing the appropriate treatment method, usingthe appropriate surgical technique, good anatomy and robust fixation. Detection offracture with titanium voler plate is an effective treatment method, allowing earlymovement to accelerate healing and contribute positively to the result.

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