Ufuk ÖZKAYA, Ayhan KILIÇ, Ümit ÖZDOĞAN, Kubilay BENG, Yavuz KABUKÇUOĞLU

Erişkinlerdeki önkol kırıklarının tedavisinde kilitli intramedüller çivi ve plak-vida osteosentezi yöntemlerinin karşılaştırılması

Amaç: Erişkinlerdeki önkol çift kırıklarının cerrahi tedavisinde uyguladığımız iki farklı yöntemin sonuçları değerlendirildi. Çalışma planı: Önkol kırıklı 42 erişkin hasta geriye dönük olarak incelendi. Bunlardan 22 hasta (7 kadın, 15 erkek; ort. yaş 32; dağılım 18-69) açık redüksiyon ve plak-vida ile tespit yöntemi, 20 hasta (6 kadın, 14 erkek; ort. yaş 33; dağılım 18-70) kapalı redüksiyon ve kilitli kanaliçi çivi yöntemi ile tedavi edildi. Kırıklar AO/OTA sistemine göre sınıflandırıldı. Hastalar, son kontrollerde Grace-Eversmann ölçütlerine göre ve DASH (Disabilities of the Arm, Shoulder and Hand) skoru ile değerlendirildi. Ortalama takip süresi plak-vida grubunda 30 ay (dağılım 12-45 ay), kilitli kanaliçi çivi grubunda 23 aydı (dağılım 12-34 ay) idi. Sonuçlar: Ortalama ameliyat süresi plak-vida grubunda 65 dk (dağılım 40-97 dk), kanaliçi çivi grubunda 61 dk (dağılım 35-90 dk) idi (p>0.05). Ortalama kaynama süresi kanaliçi çivi grubunda anlamlı derecede daha kısa bulundu (10 hafta ve 14 hafta; p0.05). Ameliyat sonrası komplikasyon plak-vida grubunda üç hastada (%13.6), kanaliçi çivi grubunda iki hastada (%10) görüldü. Çıkarımlar: Erişkinlerdeki önkol çift kırıklarının cerrahi tedavisinde iki tespit yönteminin fonksiyonel iyileşme ve hasta memnuniyeti açısından sonuçları benzer bulundu.

Anahtar Kelimeler:

Kemik çivileri, Kemik plakları, Radius kırıkları, İzleme çalışmaları, Diyafiz, Erişkin, Ulna kırıkları, Kırık tespiti, intramedüller

Comparison between locked intramedullary nailing and plate osteosynthesis in the management of adult forearm fractures

Objectives: We evaluated the results of two different surgical methods for the treatment of adult diaphyseal fractures of both forearm bones. Methods: Forty-two adult patients with forearm fractures were retrospectively evaluated. Of these, 22 patients (7 women, 15 men; mean age 32 years; range 18 to 69 years) underwent open reduction and plate-screw fixation, and 20 patients (6 women, 14 men; mean age 33 years; range 18 to 70 years) underwent closed reduction and locked intramedullary nail fixation. The fractures were classified according to the AO/OTA system. The patients were assessed using the Grace-Eversmann criteria and the DASH (Disability of the Arm, Shoulder and Hand) questionnaire. The mean followup was 30 months (range 12 to 45) with plate-screw fixation, and 23 months (range 12 to 34) with intramedullary nailing. Results: The mean operation time was 65 minutes (range 40 to 97 min) with plate-screw fixation, and 61 minutes (range 35 to 90 min) with intramedullary nailing (p>0.05). The mean time to union was significantly shorter with intramedullary nailing (10 weeks vs. 14 weeks; p<0.05). According to the Grace-Eversmann criteria, the results were excellent or good in 18 patients (81.8%) and acceptable in four patients (18.2%) treated with plate-screw fixation, compared to 18 patients (90%) and two patients (10%), respectively, treated with intramedullary nailing. The mean DASH scores were 15 (range 4 to 30) and 13 (range 3 to 25), respectively. The two groups did not differ significantly with respect to functional results and DASH scores (p>0.05). Postoperative complications were seen in three patients (13.6%) and two patients (10%) with plate-screw fixation and intramedullary nailing, respectively. Conclusion: The two fixation methods yield similar results in terms of functional healing and patient satisfaction in the management of adult forearm fractures.

Keywords:

Bone Nails, Bone Plates, Radius Fractures, Follow-Up Studies, Diaphyses, Adult, Ulna Fractures, Fracture Fixation, Intramedullary,

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