Karpal skafoidin ayrışmış kırıklarında Herbert-Whipple vidası ile primer tespit

Amaç: Karpal skafoidin ayrışmış akut kırıklarında, primer açık redüksiyon ve Herbert-Whipple vidası ile internal tespitin sonuçlarını değerlendirdik. Çalışma planı: Karpal skafoid ayrışmış akut kırığı nedeniyle primer açık redüksiyon ve Herbert-Whipple vidası ile internal tespit uygulanan 10 hasta ve transskafoid perilunat kırıklı çıkığı olan bir hasta çalışmaya alındı. Hastaların tümü erkekti ve ameliyat sırasında yaş ortalaması 34 (ort. yaş 34; dağılım 23-44) idi. Kırık, dokuz hastada sağ, iki hastada sol el bileğinde idi. Hastalar ameliyattan sonra ortalama 30 ay (dağılım 13-58 ay) süreyle izlendi. Sonuçlar: Hiçbir hastada erken ya da geç komplikasyon gelişmedi. Tüm kırıklarda ortalama 11 haftada (dağılım 9-15 hafta) kaynama elde edildi. Hastaların tümü ameliyattan sonra 4-14 haftalar arasında eski işlerine döndüler. Bu süre masabaşı işi yapanlarda ortalama beş hafta (dağılım 4-7 hafta), diğer hastalarda 10 hafta (dağılım 9-14 hafta) idi. Çıkarımlar: Akut ayrışmış ve instabil skafoid kırıklarının primer açık redüksiyonu ve Herbert-Whipple vidası ile internal tespiti kırığın kaynamasını sağlayan kolay ve güvenilir bir yöntemdir. Erken cerrahi girişim bu kompleks kırıkların konservatif tedavisinde sık görülen malunion, karpal instabilite ve radiokarpal osteoartrozu önlemektedir.

Anahtar Kelimeler:

Karpal kemikler, Radyografi, Psödoartroz, Kırık tespiti, internal, Kemik vidaları, Kırıklar, kapalı, Skafoid kemik

Primary fixation of displaced carpal scaphoid fractures with the Herbert-Whipple screw

Objectives: We evaluated the results of primary open reduction and internal fixation with the Herbert-Whipple screw in acute displaced carpal scaphoid fractures. Methods: The study included 10 patients with acute displaced carpal scaphoid fractures and one patient with transscaphoid perilunate fracture dislocation. All the patients were males (mean age 34 years; range 23 to 44 years) and underwent primary open reduction and internal fixation with the Herbert-Whipple screw. The fractures were in the right and left wrists in nine and two patients, respectively. The mean follow-up period was 30 months (range 13 to 58 months). Results: No early or late complications were encountered. All fractures healed in a mean of 11 weeks (range 9 to 15 weeks). All patients returned to their previous employment between four and 14 weeks postoperatively, being a mean of five weeks (range 4 to 7 weeks) for those employed in office-work and 10 weeks (range 9 to 14 weeks) for others. Conclusion: Primary open reduction and internal fixation with the Herbert-Whipple screw of acute displaced and unstable scaphoid fractures is an easy and reliable method leading to an uneventful union. Early operative intervention may avoid malunion, carpal instability, and radiocarpal osteoarthrosis that are often associated with closed treatment of these complex fractures.

Keywords:

Carpal Bones, Radiography, Pseudarthrosis, Fracture Fixation, Internal, Bone Screws, Fractures, Closed, Scaphoid Bone,

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