Beşir DİKMEN, İbrahim Gökhan DUMAN, Raif ÖZDEN, Vedat URUÇ, Yunus DOĞRAMACI, AYDINER KALACI, Serhat KARAPINAR

Çocuklarda suprakondiler humerus kırıklarında cerrahi tedavi sonuçlarımız

Amaç: Çocuklarda humerus alt uç kırıkları, ön kol kırıklarından sonra ikinci en sık görülen kırıklardır. Bu çalışmanın amacı, kliniğimizde cerrahi olarak tedavi edilen çocuk suprakondiler humerus kırıklarında uygulanan tedavi yöntemimizi değerlendirmek ve literatürle karşılaştırmaktır. Yöntemler: 2006 ve 2011 yılları arasında kliniğimizde tedavi edilen 54 suprakondiler kırıklı hasta değerlendirmeye alındı. Çalışmada hastaların demografik verileri, kırığın oluş nedenleri, kırık tipleri, eşlik eden yaralanmalar, postoperatif komplikasyonlar, radyolojik parametreler, kozmetik ve fonksiyonel sonuçlar değerlendirildi. Bulgular: 38 erkek (%70,4) ve 16 kız hasta çalışmaya dahil edildi. Ortalama yaş 5,51 (yaş aralığı:1-11) olarak bulundu. Hastanede ortalama yatış süresinin 2,29 gün yine ortalama takip süresinin ise 140 hafta olduğu görüldü. İyatrojenik damar ve sinir yaralanmasına rastlanmadı. Bir hastada çivi dibi enfeksiyonu diğer bir hastada ise heterotopik ossifikasyon saptandı. Flynn kriterlerine göre fonksiyonel sonuçlar %90, 7 mükemmel, %9,3 iyi; kozmetik sonuçlar ise %90, 7 mükemmel, %5,6 iyi, %1,9 orta, %1,9 kötü olarak bulundu. Sonuç: Çocuklarda suprakondiler humerus kırıklarında hastanede yatış süresi, nörovasküler komplikasyonlar, fonksiyonel ve kozmetik sonuçlar göz önüne alındığında posterior yaklaşım ile medial ve lateralden çapraz K-teli ile tespitin güvenli ve etkin bir yöntem olduğu görüldü.

Our results of surgical treatment of supracondylar humeral fractures in children

Objective: The second most common pediatric age fracture after the forearm fractures is distal humeral fractures. The aim of the current study is to retrospectively evaluate the results of the surgical treatment of pediatric supracondylar fractures in our clinic and compare it to the literature. Methods: During the period between 2006-2011 54 patients having supracondylar humeral fractures who were surgically treated with open reduction and crossed medial and lateral K wire fixation through posterior approach in our institution included in the study. The sex, etiology and type of the fracture, accompanying injuries, postoperative complications, radiologic parameters, cosmetic and functional results were evaluated. Results: 38 (70,4%) male and 16 (29,6%) female patients were evaluated with a mean age of 5.51 (range;111) years. The mean length of hospital stay was 2,29 days. The average follow up was 140 weeks. There was no iatrogenic vascular and nerve injuries. Pin tract infection and heterotopic ossification were observed only in one patient respectively. The functional results were excellent in 90,7%, good in 9,3% and cosmetic results were 90,7 excellent, 5,6% good, 1,9% satisfied, 1,9% bad according to the Flynn criteria. Conclusion: When taking into consideration the duration of hospital stay, the rate of neurovascular complication, the functional and cosmetic results it seems that treating the supracondylar humeral fractures using the posterior approach with crossed medial and lateral K-wire is a safe and effective method.

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