M. Ömer ARPACIOĞLU, İbrahim AKMAZ, Mahir MAHİROĞULLARI, Ahmet KIRAL, OSMAN RODOP

Erişkinlerde femur cisim kırıklarının kilitli intramedüller çivileme yöntemiyle tedavisi

Amac: Kilitli intramedüller çivileme ile tedavi edilen femur şaft kinkli hastalarda tedavi sonuçları radyolojik, klinik ve fonksiyonel olarak degerlendirildi. Calişma planı: Kırk altı hastaın 48 femur şaft kırığına kilitli intramedüller çivileme ameliyatı yapıldı. Hastaların 35'ierkek, 11'i kadındı (ort. yas, 30.5; dagihm 20-69). Kırıkların 31'i sağ femurda, 13 'ü sol femurda, ikisi ise iki taraflı idi. Kırk dört femurda kapalı kırık, dört femurda açık kırık saptandı. Sonuçlar Thoresen ölçütlerine gore değerlendirildi. Son değerlendirmeye takibi tamamlanan 44 femur kırığı alındı. Hastalar ortalama 26.9 hafta (dagi-hm 20-56 hafta) süreyle izlendi. Sonuçlar: Takibi tamamlanan hastalarda kırıklar ortalama 16.5 haftada kaynadı (dağılım 12-42 hafta). Dört hastada (%9) 5 derece varus, bir hastada (%2.3) 5 derece valgus, bir hastada 10 derece içe rotasyon, bir hastada 10 derece posterior, bir hastada da 10 derece dışa rotasyon ve 10 derece valgus aşılanması oldu. iki hastada (%4.5) 2 cm kısalik oluştu. Bir hastada diz fleksiyonu 90 derece, ekstansiyon kaybı 15 derece oldu. iki hastada diz fleksiyonu 90 derece, bir hastada da 110 derece oldu. Par9ah segmenter femur kingi olan bir hastada kronik osteomiyelit gelişti. Thoresen ölçütlerine göre mükemmel ve iyi sonuç orani %88.6 bulundu. Çikanmlar: Erişkinlerdeki femur şaft kırıklarinin tedavisinde kilitli intramedüller çivilemenin yüksek başarı oranı nedeniyle uygun bir tedavi seçeneği olduğu sonucuna varıldı.

Anahtar Kelimeler:

Kemik vidaları, Ortopedik işlemler, Femur kırıkları, Erişkin, Ortopedik fiksasyon araçları, Kırık tespiti, intramedüller, Kırıklar, kapalı, Kırıklar, açık

Treatment of femoral shaft fracture by interlocking intramedullary nailing in adults

Objectives: We evaluated the radiological, clinical, and functional results of femoral shaft fractures treated by interlocking intramedullary nailing. Methods: Interlocking intramedullary nailing was performed in 48 femoral shaft fractures of 46 patients (35 men, 11 women; mean age 30.5 years; range 20 to 69 years). Of the fractures, 31 were in the right femur, 13 were in the left femur, and two were bilateral. There were 44 closed and four open femoral fractures. The results were evaluated according to the Thoresen criteria. Final evaluations included 44 fractures whose follow-ups (mean 26.9 weeks; range 20 to 56 weeks) were completed. Results: The mean time to union was 16.5 weeks (range 12 to 42 weeks). Four patients (9%) had a varus angulation, and one patient (2.3%) a valgus angulation of 5 degrees; one patient had a posterior angulation of 10 degrees, one patient had an internal rotation of 10 degrees, and one patient had both an external rotation and valgus angulation of 10 degrees. Two patients (4.5%) developed a shortening of 2 cm. Knee flexion was 90 degrees and extension loss was 15 degrees in one patient. Knee flexion was 90 degrees in two patients, and 110 degrees in one patient. Chronic osteomyelitis developed in one patient who had a segmental femoral shaft fracture. According to the Thoresen criteria, 88.6% of patients had excellent or good results. Conclusion: The high success rate obtained with interlocking intramedullary nailing makes it an appropriate method in the treatment of femoral shaft fractures in adults.

Keywords:

Bone Screws, Orthopedic Procedures, Femoral Fractures, Adult, Orthopedic Fixation Devices, Fracture Fixation, Intramedullary, Fractures, Closed, Fractures, Open,

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