Konservatif yöntemle tedavi edilen distal radius kırıklı hastalarda erken ve geç dönem fonksiyonel ve radyolojik sonuçların karşılaştırılması

Amaç: Bu çalışmada, distal radius kırıklarının tedavisinde, kapalı redüksiyon ve alçılı tespit yönteminin etkinliği araştırıldı. Çalışma planı: 1992-1994 yılları arasında distal radius kırığı nedeniyle kapalı redüksiyon ve alçılı tespit yöntemiyle tedavi edilen 20 hasta (yaş dağılımı 23-87) çalışmaya alındı. Tedavi sonucunda elde edilen sekiz haftalık erken ve beş yıllık geç dönem fonksiyonel ve radyolojik sonuçlar değerlendirildi. Kırıkların tiplendirilmesinde Frykman sınıflaması kullanıldı; fonksiyonel sonuçlar Gartland ve Werley, radyolojik sonuçlar ise Porter ve Stockley tarafından tanımlanan puanlama sistemleriyle değerlendirildi. Sonuçlar: Fonksiyonel sonuçlar erken ve geç dönemlerde sırasıyla %15 ve %50 mükemmel, %45 ve %50 iyi, %40 ve 0% orta düzeyde bulundu. Aynı dönemlerdeki radyolojik sonuçlar ise sırasıyla %5 ve %20 mükemmel, %70 ve %75 iyi, %25 ve %5 orta düzeydeydi. Çıkarımlar: Distal radius kırıkları, düzgün redüksiyon, yakın takip ve etkili rehabilitasyon şeklindeki konservatif yöntemle fonksiyonel ve radyolojik olarak başarılı biçimde tedavi edilebilir. Erken ve geç dönem için en önemli takip kriterlerinin radial kısalık, dorsal açılanma ve intraartikuler deplasman olduğu görüldü. Bu parametrelerin dikkatle izlenmesi, hastanın yıllar sonrasındaki fonksiyonel kapasitesiyle ilgili bilgi sağlayabilir.

Anahtar Kelimeler:

Kırık tespiti, Tedavi sonucu, El bileği yaralanmaları, Cerrahi işlemler, operatif, Radius, Radyografi, Radius kırıkları

Comparison of short- and long-term functional and radiological results of patients treated conservatively for distal radius fractures

Objectives: To determine the effectiveness of closed reduction and plaster cast immobilization in the treatment of distal radius fractures. Methods: The study included 20 patients (age range 23-87 years) who underwent treatment with conventional closed reduction and plaster-cast immobilization for distal radius fractures between 1992 and 1994. Early (8 weeks) and late (5 years) functional and radiologic results were evaluated. Fractures were classified according to the Frykman classification. Functional and radiologic results were evaluated using Gartland and Werley, and Porter and Stockle scorings, respectively. Results: Early and late functional results were as follows: excellent 15% vs 50%, good 45% vs 50%, and fair 40% vs 0%. The corresponding radiologic results were excellent 5% vs 20%, good 70% vs 75%, and fair 25% vs 5%. Conclusion: Fractures of the distal radius can be treated conservatively with proper reduction, close follow-up, and effective rehabilitation, with satisfactory functional and radiologic results. The most important criteria for early and late follow-up appear to be radial shortening, dorsal angulation, and intraarticular deplacement. Careful evaluation of these parameters may provide valuable information even about functional capacity in the remote future.

Keywords:

Fracture Fixation, Treatment Outcome, Wrist Injuries, Surgical Procedures, Operative, Radius, Radiography, Radius Fractures,

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