Toygun Kağan EREN, Atakan ERDOĞAN, Cem Nuri AKTEKİN

PRİMER ANTERİOR OMUZ ÇIKIĞINDA KONSERVATİF TEDAVİ YETERİ KADAR BAŞARILI MI?

Amaç: Primer anterior omuz çıkığı nedeniyle hastaneye başvuran hastaların tedavi sonuçlarını, tekrar çıkık oranlarını ve tedavi sonuçlarına etki eden faktörleri değerlendirmek Gereç ve Yöntem: Ocak 2016 ve Ocak 2020 tarihleri arasında, ilk kez (primer) anterior omuz çıkığı nedeniyle hastanemize başvuran ve kapalı redüksiyon sonrası geçici immobilizasyon yöntemiyle konservatif olarak tedavi edilen hastaların verileri değerlendirildi. Daha önceden çıkık öyküsü olan, romatolojik hastalığı olan veya verileri eksik olan hastalar çalışmaya dahil edilmedi. Hastaların tekrar çıkık öyküsü olup olmadığı; eğer tekrar çıkık geliştiyse, ilk travmadan ne kadar süre sonra gerçekleştiği bilgileri incelendi. Ayrıca, tüm hastaların fonksiyonel değerlendirmeleri Oxford Shoulder Instability Score (OSIS) ile yapıldı. Bulgular: Çalışmaya 43 hasta dahil edildi. Hastaların ortalama yaşı 45,23 ± 17,2 olup hasta yaşları 20-76 arasındaydı. Hastaların 33’ü (%76,7) erkek, 10’u (%23,3) kadındı. Hastaların ortalama takip süresi ise 48,8 ± 12,4 olarak bulundu (En az 31, en çok 86 ay). Hastaların son takipteki ortalama OSIS değeri 45 ± 3,45 olarak bulundu. Hastaların takiplerinde, 21 hastada (%48,8) tekrar omuz çıkığı görüldü. Kırk yaş üstü ve 40 yaş altındaki hastalar karşılaştırıldığında tekrar çıkık oranları sırasıyla, 9/25 (%36) ve 12/18 (%66,6) olarak bulundu (p=0,094). Kırık eşlik eden 6 hastada rekürren omuz çıkığı görülmedi. Sonuç: Primer anterior omuz instabilitesi sonrası, geçici immobilizasyon ile konservatif tedavi edilen hastalarda tekrar çıkık görülme oranları yüksek olduğu bulunmuştur. Proksimal humerusta eşlik eden kırık varlığında tekrar çıkık daha az görülmüştür.

Anahtar Kelimeler:

omuz eklemi, omuz çıkığı, eklem instabilitesi, nüks, proksimal humerus kırığı

IS CONSERVATIVE TREATMENT SUCCESSFUL ENOUGH FOR THE TREATMENT OF PRIMARY ANTERIOR SHOULDER DISLOCATION?

Objective: To evaluate the treatment results, recurrence rate and factors affecting the treatment results of patients admitted to the hospital with primary anterior shoulder dislocation. Materials and Methods: Patients who applied to our hospital for the first time (primary) anterior shoulder dislocation between January 2016 - January 2020 and were treated conservatively with temporary immobilization after closed reduction were evaluated. Patients with a previous history of dislocation, rheumatological disease or incomplete data were not included in the study. The history of recurrence and in case of recurrence, duration after the first dislocation was also examined. In addition, evaluations of all patients were made with the Oxford Shoulder Instability Score (OSIS). Results: 43 patients were included in the study. The mean age of the patients was 45.23 ± 17.2, and the patient's age ranged from 20 to 76. Thirty-three (76.7%) of the patients were male and 10 (23.3%) were female. The mean follow-up period of the patients was found to be 48.8 ± 12.4 (minimum 31, maximum 86 months). The mean OSIS value of the patients at the last follow-up was 45 ± 3.45. In the follow-up of the patients, recurrence was observed in 21 patients (48.8%). When patients older than 40 years and younger than 40 years of age were compared, recurrence rate were found to be 9/25 (36%) and 12/18 (66.6%), respectively (p=0.094). No recurrent shoulder dislocation was observed in 6 patients with accompanying proximal humerus fractures. Conclusion: After primary anterior shoulder instability, recurrence rate was found to be high in patients treated conservatively with temporary immobilization. Recurrence is less common in the presence of accompanying fracture at the proximal humerus.

Keywords:

shoulder joint shoulder dislocation, joint instability, recurrence, humeral fractures, proximal,

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