Erden ERDURER, Faik SEÇKİN, Şenol AKMAN, Serdar TOKER, Seçkin SARI, İRFAN ÖZTÜRK

The results of open reduction and screw or K-wire fixation for isolated type II radial head fractures

Amaç: Bu çalışmada, açık redüksiyon sonrası vida ya da Kirschner teli (K-teli) ile tespit uygulanan izole Mason tip II radius başı kırıklı olgularda fonksiyonel ve radyografik sonuçlar değerlendirildi. Çalışma planı: İzole tip II radius başı kırığı nedeniyle açık redüksiyon sonrası mini vida (n=11) ya da K-teli (n=10) ile tespit uygulanan 21 hasta (14 erkek, 7 kadın; ort. yaş 36; dağılım 25-58) çalışmaya alındı. Fonksiyonel sonuçlar modifiye Morrey fonksiyonel derecelendirme indeksi ile değerlendirildi. Radyografik olarak osteoartrit ya da heterotopik ossifikasyon gelişimi araştırıldı. Ortalama takip süresi K-teli grubunda 30.5 ay, mini vida grubunda 32.1 ay idi. Sonuçlar: Tüm hastalarda, vida grubunda ortalama 6.2 haftada, K-teli grubunda 5.8 haftada kaynama sağlandı. Dirsek fleksiyon-ekstansiyon hareket açıklığı vida ve K-teli gruplarında sırasıyla ortalama 131.4° ve 127.5°, pronasyon-supinasyon hareket açıklığı 144.4° ve 146.5° bulundu. Vida grubunda ortalama Morrey indeksi 94.5 (dağılım 73-100) bulundu ve 10 hastada mükemmel veya iyi fonksiyonel sonuç alındı. Orta sonuç alınan bir hastada eklemde 2 mm’lik basamaklanma gelişti ve osteoartrit gözlendi. K-teli grubunda dokuz hastada mükemmel veya iyi, bir hastada orta sonuç elde edildi; ortalama indeks değeri 92.1 (dağılım 73-100) idi. Tüm hastalar kırık öncesi işlerine, vida grubunda ortalama 11.7 haftada, K-teli grubunda 12.5 haftada sorunsuz olarak döndü. Hiçbir hastada heterotopik ossifikasyon gözlenmedi. İki grup arasında kaynama süresi, eklem hareket açıklığı, Morrey skoru ve işe dönüş süresi açısından anlamlı fark saptanmadı (p>0.05). Çıkarımlar: İzole Mason tip II kırıklarda tespit materyali olarak vida ya da K-teli kullanılmasıyla yeterli tespit sağlandığı ve benzer fonksiyonel sonuçlara ulaşıldığı görüldü.

Anahtar Kelimeler:

Kemik oluşumu, Kemik telleri, İnternal fiksatörler, Hareket açıklığı, eklem, Tedavi sonucu, Kemik vidaları, Kırık tespiti, internal, Radius kırıkları

İzole tip II radius başı kırıklarında açık redüksiyon sonrası vida veya K-teli ile tespit sonuçları

Objectives: We evaluated the functional and radiographic results of patients treated with open reduction and screw or K-wire fixation for isolated Mason type II radial head fractures. Methods: The study included 21 patients (14 men, 7 women; mean age 36 years; range 25 to 58 years) who were treated with open reduction followed by mini screw (n=11) or K-wire (n=10) fixation for isolated type II radial head fractures. Functional results were evaluated using the modified Morrey functional rating index. Radiographically, osteoarthritis or heterotopic ossification were investigated. The mean follow-up was 30.5 months for K-wire fixation, and 32.1 months for screw fixation. Results: Union was achieved in all the patients, within a mean of 6.2 weeks with screw fixation, and 5.8 weeks with K-wire fixation. The range of motion of elbow flexion-extension and pronation-supination were 131.4° and 144.4° with screw fixation, and 127.5° and 146.5° with K-wire fixation, respectively. The mean Morrey index was 94.5 (range 73 to 100) with screw fixation, yielding excellent or good results in 10 patients. One patient whose result was fair had a 2-mm step-off on the joint surface, resulting in osteoarthritis. The mean Morrey index was 92.1 (range 73 to 100) in the K-wire group, with excellent or good results in nine patients, and fair in one patient. All the patients returned to preinjury work in a mean of 11.7 weeks and 12.5 weeks in screw and K-wire groups, respectively. Heterotopic ossification was not observed. The two fixation groups were similar with respect to union time, joint range of motion, Morrey score, and time to return to work (p>0.05). Conclusion: Our results suggest that both methods provide sufficient fixation resulting in similar functional results in isolated type II radial head fractures.

Keywords:

Osteogenesis, Bone Wires, Internal Fixators, Range of Motion, Articular, Treatment Outcome, Bone Screws, Fracture Fixation, Internal, Radius Fractures,

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