Ender ALAGÖZ, Oktay ADANIR, Serdar YÜKSEL, Ozan BEYTEMUR, Mehmet Akif GÜLEÇ, Kahraman DEMİRYONTAR

Kompleks humerus alt uç kırıklarının paralel plaklama tekniği sonrası fonksiyonel sonuçları

Çalışmamızda, kompleks dirsek kırığı nedeniyle başvuran hastalarda, dirsek medial ve lateral kolonlarına uygulanan paralel plaklama tekniğinin fonksiyonel sonuçları değerlendirildi. Kompleks dirsek kırığı nedeniyle başvuran 23 hastaya (14 erkek, 9 kadın) paralel plaklama tekniği ile, açık redüksiyon ve internal tespit uygulandı. Ortalama yaş 39.8 yıl idi. Kırık oluş mekanizması 9 hastada trafik kazası, 6 hastada basit düşme, 8 hastada yüksekten düşme idi. Kırık oluş anı ile ameliyat zamanı arasında geçen süre ortalama 5 gün idi. Dirsek fonksiyonel durumu, Mayo dirsek performans skoru ve kol, omuz ve el engellilik (DASH) skoru ile değerlendirildi. Ayrıca tüm hastalar, eklem hareket açıklıkları ve dirsek instabilitesi açısından değerlendirildi. Ortalama takip süresi 21 aydı. Ortalama fleksiyon/ekstansiyon arkı 101,8 derece, ortalama fleksiyon 125,4 derece, ortalama ekstansiyon 26,3 derece bulundu. Mayo dirsek performans skoru ortalama 80,4 olarak tespit edildi. DASH skoru ortama 11,1 bulundu. Bir hastada olekranon osteotomisinde, bir hastada da kırık bölgesinde kaynama olmadığı görüldü. Beş hastada (%21,7) heterotopik ossifikasyon geliştiği saptandı. Beş hastada operasyon sonrası enfeksiyon bulguları saptandı ve bunlardan bir tanesinde derin enfeksiyon nedeniyle debridman ihtiyacı oldu. Üç hastada olekranon tespit materyallerinin rahatsız etmesi nedeniyle, vida ve serklaj teli çıkarıldı. Sonuç olarak kompleks dirsek kırıklarında erken harekete izin veren stabil bir osteosentez sonrası fonksiyonel sonuçlar tatmin edicidir.

Anahtar Kelimeler:

Dirsek eklemi; kırık fiksasyonu; parçalı kırık.

The functional results of complex distal humeral fractures treated with parallel plate technique

In our study the functional results of parallel plate technique applied to medial and lateral columns of elbow, in patients with complex elbow fracture were evaluated. Open reduction and internal fixation was performed by using parallel plate technique in 23 patients with complex elbow fracture (14 men, 9 women). Mean age was 39,8 year. The fracture mechanisms were traffic accident in 9 patients, simple fall in 6 patients, fall from high in 8 patients. Mean time from trauma to surgery was 5 days. Functional results were evaluated by using disabilities of the Arm, Shoulder and Hand score (DASH) and Mayo elbow performance score. Range of motion and instability of the elbow joint was also evaluated. Mean follow up was 21 months. Mean flexion/extension arch was 101,8 degree, mean flexion was 125,4 degree, mean extension was 26,3 degree. Mean Mayo elbow performance score was 80,4. Mean DASH score was 11,1. One patient had a nonunion of olecranon osteotomy, one patient had a nonunion at the fracture. Heterotophic ossification was devoloped in 5 patients (21,7%). Surgery was complicated by an infection in 5 patients, and one of them needed debridement due to deep infection. In 3 patients screw and cerclage wires at the osteotomy site were removed due to symptomatic implants. As a result the functional outcomes of the complex elbow fractures that are treated with stabile osteosynthesis which permits early range of motion are satisfactory.

Keywords:

Comminuted fracture; elbow joint; fracture fixation.,

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