Bülent ÖZKURT, Abdullah Yalçın TABAK, Mehmet Ali TÜMÖZ

Açık Tibia Cisim Kırıklarının Tedavisinde İlizarov Tipi Sirküler Eksternal Fiksatör Uygulamalarımızın Orta Dönem Sonuçları

Amaç: İlizarov tipi sirküler eksternal fiksatörün tibia açık kırıklarının tedavisinde etkinliğinin araştırılması. Gereç ve Yöntem: Ankara Numune Eğitim ve Araştırma Hastenesi II. Ortopedi Kliniğinde Haziran 1998 Ocak 2002 tarihleri arasında 51 hastanın 56 tibia açık kırığı İlizarov tipi sirküler eksternal fiksatör uygulanarak tedavi edildi. Otuz beşi (%68.6) erkek 16'sı (%31.4) bayan olan hastalarımızın yaş ortalaması 34.2 (17-56) idi. Olgularımızın 15'i (%26.8) Tip I, 22'si (%39.3) Tip II, 13'ü (%23.2) Tip III A, altısı (%10.7)Tip III B olarak değerlendirildi. Tip I ve Tip II açık kırıkların hepsi ya çok parçalı ya da aşırı kontamineydi. Değerlendirme Johner Wrush kriterlerine göre yapıldı Bulgular: Ortalama 94 (72-109) ay izlem sonucunda 52 tibiada tam kaynama elde edildi. Sadece dört hastada ikinci bir operasyonla grefaj uygulanarak kaynama sağlandı. Kaynama süresi ortalama 19 (1243) hafta idi. Hastaların onunda yüzeyel, birinde derin tel yolu enfeksiyonu gelişti.. Hiçbir hastamızda kozmetik yada fonksiyonel yakınmaya yol açacak açılanma, kısalık, hareket kısıtlılığı olmadı. Sonuç: Açık tibia kırıklarında, özellikle aşırı kontaminasyon, çok parçalanma, segmenter veya defektif olgularda İlizarov tipi sirküler eksternal fiksatör üç boyutlu ve çok seviyeli harekete olanak sağlarken minör travmatizan bir sistem olması nedeniyle avantajlı bir yöntem olarak görülmektedir.©2008, Fırat Üniversitesi, Tıp Fakültesi

Anahtar Kelimeler:

Tibia, açık kırık, sirküler eksternal fiksatör

Middle Term Results of The Ilizarov Type Circular External Fixator Application for The Tibial Diaphyseal Open Fractures

Objectives: To assess results of the İlizarov method and İlizarov type circular external fixator for high energy, open tibial diaphysis fractures. Materials and methods: Between June 1998 and January 2002, 56 tibial open fractures of 51 patients aged 17 to 56 (mean 34.2) years underwent İlizarov type circular external fixation. 35 were male and 16 were female. There were 15 Type I, 22 Type II, 13 Type III A and six Type III B open fractures. All Type I ve Type II open fractures were highly contaminated, comminuted, segmented or defective. Results: the mean follow-up period was 94 (range 72-109) months. 52 of 56 tibia healed nonproblematically but four needed bone grafting with a second operation. The mean union time was 19 (range12-43) weeks. Complications consisted often low grade and one deep pin tract infection, two and three cm shortness in two cases. Conclusion: Our study suggests that İlizarov method and İlizarov type circular external fixator is more beneficial than the other alternatives on open tibial diaphyseal fractures with its giving possibility to three dimensional and multi level movement, minor traumatizing feature. ©2008, Firat University, Medical Faculty.

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Kabul Tarihi:11.11.2008