Önder KALENDERER, Osman GÜNEŞ, İ. Türkay ÖZÇALABI, Serkan ÖZLÜK

Açık redüksiyon ve internal fiksasyon uygulanan tibia pilon kırıklarında klinik sonuçlar

Amaç: Açık redüksiyon ve internal fiksasyon yöntemi ile tedavi edilen pilon kırıklı olguların sonuçlan değerlendirildi. Çalışma planı: Tibia pilon kırıklı 18 olgu (ört. yaş 36; dağılım 19-56) retrospektif olarak değerlendirildi. Ruedi ve Allgöwer sınıflamasına göre üç adet tip I, dokuz adet tip II, altı adet tip III kırık vardı. Gustilo-Anderson sınıflamasına göre üçü tip II, ikisi tip III olmak üzere toplam beş açık kırık vardı. Değerlendirmede Burwell-Charnley ölçütleri kullanıldı. Takip süresi ortalama 54 ay (dağılım 9-86 ay) idi. Sonuçlar: Burwell-Charnley ölçütlerine göre, 12 olguda (%66) iyi, üç olguda (%17) orta, üç olguda (%17) kötü sonuç alındı. En sık rastlanan komplikasyon post-travmatik dejeneratif artrit (%28) idi; bunu yara enfeksiyonu (%22), Sudeck atrofisi (%22), kaynama gecikmesi (%17) ve angülasyon (%11) izlemekteydi. Çıkarımlar: Erken anatomik redüksiyon, stabil fiksasyon, erken hareket ve geç yüklenme yüksek enerjili travmalar sonucu oluşan tibia pilon kırıklarının uzun dönem sonuçlan olumlu yönde etkilemektedir.

Anahtar Kelimeler:

Kırık tespiti, internal, Tibia, Ayak bileği yaralanmaları, Ayak bileği eklemi, Tibia kırıkları

Clinical results of tibial pilon fractures treated by open reduction and internal fixation

Objectives: We evaluated the results of pilon fractures treated by open reduction and internal fixation. Methods: The study included 18 patients (mean age 36 years; range 19 to 56 years) with pilon fractures. According to the Ruedi and Allgower's classification, there were three type I, nine type II, and six type III fractures. Five fractures were open including three of Gustilo-Anderson type II, and two fractures of type III. The results were assessed using the Burwell-Charnley criteria. The mean follow-up was 54 months (range 9 to 86 months). Results: According to the Burwell-Charnley criteria, the results were good in 12 patients (66%), fair in three patients (17%), and poor in three patients (17%). The most common complication was posttraumatic degenerative arthritis, followed by wound infection (22%), Sudeck atrophy (22%), delayed union (17%), and angulation (11%). Conclusion: Early anatomical reduction, a stable fixation, early mobilization, and delayed weight-bearing seem to improve long-term results of treatment in pilon fractures caused by high energy trauma.

Keywords:

Fracture Fixation, Internal, Tibia, Ankle Injuries, Ankle Joint, Tibial Fractures,

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