OSMAN TUĞRUL EREN, Metin KÜÇÜKKAYA, Yavuz S. KABUKÇUOĞLU, Volkan BALCI, Ünal KUZGUN

Adölesan kapalı femur cisim kırıklarının tedavisinde plak ve vida ile osteosentez

Amaç: Kliniğimizde 11-15 yaş arasındaki adölesanlarda uyguladığımız kapalı femur cisim kırıklarında plak ve vida ile osteosentezin sonuçlarını, avantaj ve dezavantajlarını değerlendirdik. Çalışma planı: Çalışmaya kapalı femur cisim kırığı nedeniyle plak ve vida ile osteosentez yapılan ve izlemi tamamlanan 35 hasta (26 erkek, 9 kız; ort. yaş 13.4) alındı. İki hastada iki taraflı olmak üzere, 17 hastada (%48) sol femur, 16 hastada (%45) ise sağ femur kırığı vardı. Trafik kazası %57 ile en sık görülen kırık nedeni olarak belirlendi. On dokuz hastada kafa travması ve/veya multipl kırık vardı. Ortalama takip süresi 34.9 ay (dağılım 12-156 ay) bulundu. Sonuçlar: Tüm kırıklarda ortalama 10. haftada kaynama elde edildi. Plak kırılması ve refraktür görülmedi. İki hastanın dizinde 20$\circ$ fleksiyon kısıtlılığı saptandı. Dokuz hastada, etkilenen ekstremitede kuadriseps atrofisi gelişti. Skenogram, ortorontgenogram, düz grafiler ve klinik muayene ile yapılan uzunluk ölçümlerinde ortalama 1.2 cm (0.4-1.6 cm) fark bulundu. Çıkarımlar: Plak ve vida ile osteosentezin bazı dezavantajlarına karşın, tam anatomik ve stabil redüksiyon sağlaması nedeniyle bu yaş grubunda uygulanabilecek etkin tedavi seçeneklerinden biri olduğu sonucuna varıldı.

Anahtar Kelimeler:

Kırıklar, kapalı, Ergen, Çocuk, Femur kırıkları, Cerrahi işlemler, operatif, Ortopedik işlemler, Kemik plakları, Kırık tespiti, internal

Plate fixation of closed femoral shaft fractures in adolescents

Objectives: This study was designed to evaluate the results, advantages, and disadvantages of plate fixation of closed femoral shaft fractures in adolescents between the ages of 11 and 15 years. Methods: The study included 35 adolescents (26 males, 9 females; mean age 13.4 years) who were treated by plate fixation for closed femoral shaft fractures and had an adequate follow-up. The fractures were bilateral in two patients, on the left in 17 patients (48%), and on the right in 16 patients (45%). Traffic accidents were the most frequent etiology (57%). Nineteen patients presented with head injuries and/or multiple fractures. The mean follow-up was 34.9 months (range 22 to 156 months). Results: All fractures healed in a mean of 10 weeks (range 6 to 16 weeks). No plate break or refractures occurred. Two patients had a loss of 20 degrees in knee flexion. Atrophy of the quadriceps muscle was observed in nine patients. Evaluations with the use of scanogram, orthorontgenogram, plain radiographs, and clinical examination showed an average overgrowth of 1.2 cm (range 0.4 to 1.6 cm). Conclusion: Despite some disadvantages, plate fixation seems to be an alternative method in the treatment of adolescent femoral fractures, enabling an anatomical reduction and stable internal fixation.

Keywords:

Fractures, Closed, Adolescent, Child, Femoral Fractures, Surgical Procedures, Operative, Orthopedic Procedures, Bone Plates, Fracture Fixation, Internal,

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