Şenol AKMAN, Erden R ERTÜRER, Mehmet TEZER, Mustafa TEKEŞİN, Ünal KUZGUN

Olekranon lırıklı olgularda gergi bandı tipi osteosentez tekniğinin geç dönem sonuçları

Amaç: Olekranon kırıklarında uyguladığımız gergi bandı tipi (Zuggurtung) osteosentez tekniğinin geç dönem sonuçları değerlendirildi. Çalışma planı: Olekranon kırığı nedeniyle cerrahi tedavi uygulanan 41 hasta (28 erkek, 13 kadın; ort. yaş 48; dağılım 20-85) çalışmaya alındı. Olguların tümünde gergi bandı tekniği ile osteosentez yöntemi uygulandı. Kırıklar 25 olguda sağ, 16 olguda sol tarafta idi. On altı olguda başka kemik ve yumuşak doku yaralanmaları, üç olguda açık kırık vardı (iki Gustilo tip 1 kırık, bir Gustilo tip 2 kırık). Kırıklar Schatzker sistemine göre sınıflandırıldı. Sonuçlar Murphy'nin skorlama sistemine göre değerlendirildi. Olgular ortalama 46.7 ay (dağılım 12-141 ay) süreyle izlendi. Sonuçlar: Tüm olgularda tam kaynama sağlandı. Murphy skorlamasına göre 31 olguda çok iyi ve iyi (%75.6), beş olguda orta (%12.2), beş olguda (%12.2) kötü sonuç alındı. Tedavi sonucunun, kırık tipi ve eşlik eden travmadan etkilendiği görüldü. Açık kırıklı üç olgunun ikisinde kötü, birinde orta sonuç alındı. Orta ve kötü sonuç olarak değerlendirilen 10 olgunun sekizinde kemik yaralanması da vardı. Komplikasyon olarak iki olguda K-teli migrasyonu gözlendi; dört olguda geç dönemde K-teline karşı reaksiyon gelişti. Çıkarımlar: Deplase olekranon kırıklarında gergi bandı tipi osteosentez yönteminin stabil bir fiksasyon sağladığı, eklem hareket kısıtlılığının erken dönemde dirsek hareketi verilerek önlendiği, geç dönemde görülen alt düzeydeki kısıtlılığın fonksiyonel bir kusur oluşturmadığı ve uygulama maliyetinin son derece düşük olduğu görüldü.

Anahtar Kelimeler:

Kemik telleri, Cerrahi işlemler, operatif, Hareket açıklığı, eklem, Ortopedik işlemler, Ortopedik gereçler, Dirsek eklemi, Kırık tespiti, internal, Humerus kırıkları

Long-term results of olecranon fractures treated with tension-band wiring technique

Objectives: We evaluated the long-term results of olecranon fractures treated with tension-band wiring (Zuggurtung) technique. Methods: The study included 41 patients (28 males, 13 females; mean age 48 years; range 20 to 85 years) who underwent tension-band wiring osteosynthesis for olecranon fractures. The involved side was the right in 25 patients, and the left in 16 patients. Associated bone and soft-tissue injuries were detected in 16 patients. There were open fractures of Gustilo type 1 in two patients, and type 2 in one patient. The fractures were classified according to the Schatzker's system, and the results according to the Murphy's system. The mean follow-up was 46.7 months (range 12 to 141 months). Results: Complete union was obtained in all fractures. According to the Murphy's system, the results were very good and good in 31 patients (75.6%), fair in five patients (12.2%), and poor in five patients (12.2%). It was obvious that fracture type and accompanying trauma had influenced the treatment results. Of open fractures, the results were poor in two patients, and fair in one patient. Of 10 patients with a fair or poor outcome, eight patients had accompanying bone injuries. Complications included migration of the K-wire in two patients, and irritation related to K-wires in four patients. Conclusion: Osteosynthesis with tension-band wiring technique in olecranon fractures offers considerable advantages: a stable fixation is obtained at a very low cost, development of joint stiffness is avoided by early elbow range of motion, and minimal joint stiffness seen in the long term does not present as a functional disability.

Keywords:

Bone Wires, Surgical Procedures, Operative, Range of Motion, Articular, Orthopedic Procedures, Orthopedic Equipment, Elbow Joint, Fracture Fixation, Internal, Humeral Fractures,

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