Muharrem İNAN, Mehmet TUNCEL, Sinan KARAOĞLU, Mehmet HALICI

Tip II ve tip III açık tibia kırıklarının ilizarov eksternal fiksatör ile tedavisi

Amaç: Ilizarov eksternal fiksatör ile tedavi edilen tip II ve tip III açık tibia kırıklı hastaların sonuçlarını değerlendirdik. Çalışma planı: Hizarov eksternal fiksatör kullanılarak tedavi edilen 45 hasta (4 kadın, 41 erkek; ort. yaş 33; dağılım 8-65) çalışmaya alındı. Gustilo-Mendoza sınıflamasına göre 12 hastada tip II, 20 hastada tip IIIA, dokuz hastada tip IIIB, dört hastada tip IIIC kırık vardı. Hastalar ortalama 58 ay 4 gün (dağılım 42 ay 10 gün-66 ay 11 gün) süreyle takip edildi. Fiksatörler ortalama 17.2 haftada (dağılım 6.8-55.7 hafta) çıkarıldı. Sonuçlar: Tüm hastaların kırıkları kaynadı. Tip II ve tip III açık kırıklarda kaynama süreleri arasında istatistiksel olarak anlamlı farklılık bulundu (p

Anahtar Kelimeler:

Kırık tespiti, Kırıklar, açık, Ilizarov tekniği, Tibia kırıkları, Eksternal fiksatörler

Treatment of type II and III open tibial fractures with ilizarov external fixation

Objectives: We evaluated the results of patients who were treated with Ilizarov external fixation for type II and III open tibial fractures. Methods: Forty-five patients (4 females, 41 males; mean age 33 years; range 8 to 65 years) with open tibial fractures were treated with the Ilizarov external fixator. According to the Gustilo-Mendoza classification, the fractures were type II, IIIA IIIB, and IIIC in 12, 20, 9, and 4 patients, respectively. The mean follow-up was 58 months and 4 days (range 42 months 10 days to 66 months and 11 days). The fixators were applied for a mean of 17.2 weeks (range 6.8 to 55.7 weeks). Results: Union was achieved in all cases. A significant difference was observed between type II and III fractures in terms of time to union (p<0.05). Compared to type IIIA fractures, the time to union was significantly longer in type IIIB and IIIC fractures (p<0.05). The most frequent complication was pintract infections (27.1%). Refracture occurred in four cases (8.8%). Three patients developed late infections at the fracture site. Radiographically, the results were excellent in 14 patients (31%), good in 22 patients (48.8%), moderate in five patients (11.1%), and poor in four patients (8.8%). Functional results were excellent in 21 patients (46.6%), good in 20 patients (44.4%), and moderate in four patients (8.8%). Conclusion: Despite technical difficulties and problems associated with pin-tract infections, the Ilizarov external fixator may be the preferred technique in open tibial fractures because of high union rates, the use of thin K-wires with minimal traumatic effect, and more successful functional results.

Keywords:

Fracture Fixation, Fractures, Open, Ilizarov Technique, Tibial Fractures, External Fixators,

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