Tacettin ÇEKİN, MEHMET TÜKENMEZ, Gündüz TEZEREN

Dana modelinde transvers patella kırıklarında üç farklı tespit yönteminin karşılaştırılması

Amaç: Dana patellasında oluşturulan transvers kırık tespitinde uygulanan üç farklı yöntemin distraksiyon kuvvetlerine karşı dayanıklılıkları araştırıldı. Çalışma planı: Otuz adet dana patellası rastgele yöntemle 10’arlı üç gruba ayrıldı. Tüm patellalarda aynı yerden transvers kırık oluşturuldu. Kırıklar birinci grupta modifiye anterior gergi bandı tekniği, ikinci grupta Acutrak 4/5 vida, üçüncü grupta ise bu vida yoluyla gergi bandı tekniği kullanılarak tespit edildi. Patellalar tespit sonrasında klempler aracılığıyla kuadriseps ve patellar tendonlardan kompresyon-distraksiyon makinesine yerleştirildi. Her bir test grubundaki patellalara eşit zamanlı ve eşit olarak artan distraksiyon kuvvetleri uygulandı. Kırık hattında yetmezlik anındaki kuvvet değerleri kaydedildi. Bu değerler Friedman testi ile karşılaştırıldı. Sonuçlar: Tespitte yetersizlik oluşturan kuvvet ortalamaları, birinci grupta 288.8±40.1 Newton, ikinci grupta 878.5±68.6 Newton, üçüncü grupta 938.6±38.8 Newton bulundu. Üç grubun ortalama değerleri arasında anlamlı farklılık saptandı (p

Anahtar Kelimeler:

Kırık tespiti, intramedüller, Biyomekanik, Kemik telleri, Hastalık modelleri, hayvan, Kemik vidaları, Kırıklar, kemik, Hayvanlar, yenidoğan

Comparison of three fixation methods in transverse fractures of the patella in a calf model

Objectives: We evaluated the strength of three different fixation methods against distraction forces in a transverse fracture model of calf patellae. Methods: Thirty calf patellae were randomly divided into three groups equal in number. Transverse fractures were induced at the same localization in all the samples. The fractures were fixed with a modified anterior tension band technique, Acutrak 4/5 screws, and a combination of Acutrak 4/5 screws and tension band technique in three groups, respectively. Following fixation, each patella was mounted in a compression-distraction testing machine from the quadriceps and patellar tendons on each side of the patella, and equal distraction forces were applied to each patella. The average load to failure at the fracture site was calculated and the results were compared with the Friedman test. Results: The mean failure loads were significantly different in three groups, being 288.8±40.1 newton (N), 878.5±68.6 N, and 938.6±38.8 N, respectively (p<0.001). The most efficient stabilization was obtained in the third group in which Acutrak 4/5 screws and the tension band application were used in combination, while the modified anterior tension band technique alone was found to be the weakest fixation technique. Conclusion: Our results showed that Acutrak 4/5 screws enabled a rigid fixation in the surgical treatment of patellar fractures.

Keywords:

Fracture Fixation, Intramedullary, Biomechanics, Bone Wires, Disease Models, Animal, Bone Screws, Fractures, Bone, Animals, Newborn,

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