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İntertrokanterik femur kırığı sonrasında proksimal femur çivisi ile başarılı osteosentez elde edilen hastaların fonksiyonel sonuçları

Amaç: Bu çalışmanın amacı, intertrokanterik kırık tanısı ile proksimal femur antirotasyon çivisi (PFNA) kullanılarak başarılı radyolojik kaynama elde edilmiş hastaların, postoperatif dönemdeki klinik fonksiyonel durumlarının araştırılmasıdır.Gereç ve Yöntem: Tek bir merkezde, 2015 – 2017 yılları arasında, düşme sonucu başvurarak, intertrokanterik femur kırığı tanısı ile PFNA kullanılarak opere edilen 65 yaş üzeri hastalar çalışmaya dahil edildi. Hastaların günlük aktivite düzeyinin ve kalça kaynaklı fonksiyonel durumlarının araştırılması için Türkçe geçerlilik ve güvenilirlik çalışması yapılmış olan “Oxford kalça skoru (OKS)” ve “Kalça yetersizliği ve osteoartrit sonuç skoru – Fiziksel fonksiyon kısa form (HOOS-PS)” değerlendirmeleri, hastaların kendileri veya birinci derece yakınları ile iletişime geçilip yanıtları işlenerek kullanıldı. İstirahat halinde ve aktivite sırasındaki ağrıyı değerlendirmek üzere ortalama istirahat ve aktivite vizüel analog skala (VAS) skorları kullanıldı. Mobilizasyon düzeylerini araştırmak için “Palmer – Parker Mobility Score (PPM)” kullanıldı. Bulgular: Yirmi bir hastanın fonksiyonel skor değerlendirmeleri ameliyattan ortalama 18,1±9 ay sonra araştırıldı. Bu 21 hastanın; ortalama istirahat VAS skorları 2.3±1.4, aktivite VAS skorları 3,5±1,8; OKS 30,4±12,2; HOOS-PS 10,9±5,1 ve PPM 5,5±3,3 olarak kaydedildi. Sonuç: Geriatrik populasyonda sık görülen femur intertrokanterik kırıklarında, PFNA ile osteosentez uygulanarak başarılı radyolojik sonuçlar sağlanan hastalar; her ne kadar ağrı yönünden iyi sonuçlara sahip olsalarda, fonksiyonel ve mobilizasyon düzeyleri düşük olmaktadır.

Anahtar Kelimeler:

osteoporosis, geriatric fracture, hip fracture, intertrochanteric fracture, proximal femoral nail

Functional results of intertrochanteric femur fractures after successful osteosynthesis with proximal femoral nails

Purpose: The aim of this study is to investigate the post-operative functional condition of patients who had intertrochanteric fractures and had successful fracture healing with proximal femoral nail (PFNA).Materials and Methods: Patients over 65 years who were admitted to a single center with intertrochanteric femur fractures after fall injury between 2015-2017 and treated using PFNA were included to the study. To investigate daily activity levels and functional status related to hip joint, Turkish versions of “Oxford Hip Score (OHS)” and “Hip Disability and Osteoarthritis Outcome Score – Physical Function Shortform (HOOS-PS)” were used to question patients or their first-degree relatives. To inspect pain at rest or with activity, visual analogue scale (VAS) was used. To investigate mobility levels, “Palmer – Parker Mobility Score (PPM)” was used.Results: Functional levels were investigated in 21 patients 18,1±9 months after the operation. 21 patients who were questioned had mean VAS score at rest 2.3±1.4, mean VAS score with activity 3.5±1,.; OHS 30.4±12.2; HOOS-PS 10.9±5.1 and PPM 5.5±3.3. Conclusion: Although PFNA is a successful treatment method in intertrochanteric femur fractures, patients do not reach the anticipated mobilization and functional levels when compared with healthy individuals at same age, even though they have low pain levels.

Keywords:

Intertrochanteric femur fractures, geriatric fractures, proximal femoral nail, mobility,

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