Cumhur Cevdet KESEMENLİ, Mehmet SUBAŞI, HÜSEYİN ARSLAN, Serdar NECMİOĞLU, Ahmet KAPUKAYA

Humerus kırıklı olgularda kilitli intramedüller çivi ve plak ile tedavi sonuçlarının karşılaştırılması

Amaç: Humerus diafiz kırığı nedeniyle, kilitli intramedüller çivi veya plakvida ile tedavi edilen hastaların sonuçları karşılaştırıldı. Çalışma planı: Humerus diafiz kırığı nedeniyle cerrahi tedavi gören 60 hasta (43 erkek, 17 kadın; ört. yaş 38; dağılım 19-61) çalışmaya alındı. Hastaların 33'ü kilitli intramedüller çivi, 27'si plakvida ile tedavi edildi. Fonksiyonel sonuçlar Stewart Hundley ölçütlerine göre değerlendirildi. Kaynama süreleri ve morbiditeleri istatistiksel olarak karşılaştırıldı. Ortalama takip süresi 42 ay (dağılım 28-72 ay) idi. Sonuçlar: Hasta grupları arasında iyileşme süreleri bakımından anlamlı fark yoktu (p>0.05). Radial sinir paralizisi, plak-vida ile tedavi edilen dört olguda gelişirken, int-ramedüller çivi ile tedavi edilen olgularda görülmedi. İntramedüller çivi ile tedavi edilen olgularda anlamlı düzeyde daha yüksek kaynamama oranı görüldü (p

Anahtar Kelimeler:

Kemik çivileri, Kemik plakları, Kırık tespiti, internal, Humerus kırıkları, Kırık tespiti, intramedüller, Karşılaştırmalı çalışma

Comparison between the results of intramedullary nailing and compression plate fixation in the treatment of humerus fractures

Objectives: The results of open reduction and internal fixation of humeral shaft fractures by either an intramedullary nail or a dynamic compression plate were compared. Methods: The study included 60 patients (43 males, 17 females; mean age 38 years; range 19 to 61 years) with humerus fractures. Thirty-three patients were treated with intramedullary nails and 27 patients with dynamic compression plates. Functional results were evaluated according to the Stewart and Hundley's criteria. The two methods were compared. The mean follow-up period was 42 months (range 28 to 72 months). Results: Healing times did not differ between the two treatment groups (p>0.05). Radial nerve palsy occurred only in the dynamic compression plate group, with four patients being affected. On the other hand, the rate of non-union was significantly higher in patients treated with intramedullary nailing (p<0.05). Conclusion: No ideal fixation technique exists in the treatment of humerus fractures. Despite higher non-union rates, intramedullary nailing may be the method of choice in the treatment of humerus fractures because of such advantages as low morbidity, small dissection of soft tissues, and greater ease of application.

Keywords:

Bone Nails, Bone Plates, Fracture Fixation, Internal, Humeral Fractures, Fracture Fixation, Intramedullary, Comparative Study,

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