Gökhun ARICAN, Özay SUBAŞI, Ahmet ÖZMERİÇ, Serkan İLTAR, Kadir Bahadır ALEMDAROĞLU, Veysel Ercan DİNÇEL

Talon Proksimal Femoral Çivileme(Pfn) Proksimal Femoral Çivi-Antirotasyon (Pfna) Kadar Başarılı Mı?

Amaç: PFN-A kullanılarak tedavi edilen hastaların fonksiyonel ve radyolojik sonuçlarını ve radyasyon maruziyetini Talon kilitli PFN ile karşılaştırdık.Yöntem: Çalışmaya 2014-2018 tarihleri arasında proksimal femur kırığı tanısı ile PFN yapılan 60 yaşından büyük 92 hasta (43 kadın,49 erkek; ort. yaş 75.01 yıl) dahil edildi. Retrospektif çalışmamızda hastalar Talon kilitli PFN grubu (grup 1, n=46) ve PFN-A grubu (grup 2, n=46) olmak üzere iki gruba ayrıldı. Hastaların demografik verileri, kırık tipleri, takip süreleri, kırık kaynama zamanları, radyografik bulguları, WOMAC skorları ile C-kollu skopi çekim sayıları değerlendirmeye alındı.Bulgular: Hastaların ortalama takip süreleri 11.05 aydı. Mortalite Grup I de %4.3, Grup II de %6.5 olarak bulundu. Kollodiafizer açı Grup I de 129.5±3.4, Grup II de 126.8±3.6 (p=0.01); Singh indeksi Grup I de 4.1, Grup II de 3.62 (p=0.06); kayna-ma Grup I de 4.62±1.06, Grup II de 5.1±1.51(p=0.68) olarak gözlendi. Skopi çekim süresi Grup I de 53.08 (45-89), Grup II de 97.4 (76-150) (p<0.05) olarak gözlendi. Kırık kaynama süreleri Grup I de 4.62±1.06, Grup II de 5.1±1.51 (p=0.68), WOM-AC skorları Grup I de 69.9±4.26, Grup II de 70.2±5.75 (p=0.78) olarak tespit edildi. Grup I de 2 hastada (%4.3) komplikasyon gözlenirken, Grup II de 5 hastada (%10.8) komplikasyon gözlendi.Sonuç: Talon kilitli PFN, radyasyon maruziyetinin az olması, cerrahi sürenin daha kısa olması sebebiyle PFN sistemlerinin kolay ve güvenilir bir alternatifidir.

Anahtar Kelimeler:

PFN, PFN-A, talon, intertrokanterik kırık

Is PFN with talon locking system as successful as PFNA in geriatric hip fracture?

Aim: We compared the functional and radiological results and radiation exposure of patients treated with PFN-A and the Talon-locked PFN.Methods: The study included 92 patients (43 women, 49 men; mean age 75.01 years) who underwent PFN with the diagnosis of proximal femur fracture between 2014-2018. In our retrospective study, patients were divided into two groups: the Talon locked PFN group 1 (n= 46) and the PFN-A group 2 (n = 46). Demographic data, radiographic findings, WOMAC scores and C-arm scopy shots were evaluated.Results : The mean follow-up period was 11.05 months. Mortality was %4.3 in Group I and %6.5 in Group II. The collodiaphyseal angle was 129.5 ± 3.4 in Group I and 126.8 ± 3.6 in Group II (p = 0.01); Singh index was found to be 4.1 in Group I and 3.62 in Group II (p = 0.06); union was 4.62 ± 1.06 in Group I and 5.1 ± 1.51 in Group II (p = 0.68). The duration of fluoroscopy was 53.08 (45-89) in Group I and 97.4 (76- 150) in Group II (p <0.05). The duration of fracture union was 4.62 ± 1.06 in Group I, 5.1 ± 1.51 (p = 0.68) in Group II, 69.9 ± 4.26 in Group I and 70.2 ± 5.75 in Group II (p = 0.78).Conclusion: As a result, PFN with Talon lock is an easy and reliable alternative to PFN systems because of less radiation exposure and shorter surgical time.

Keywords:

PFN, PFN-A, talon, intertrochanteric fracture,

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