Çocuk femur cisim kırıklarının intramedüller Kirschner teli ile tespit sonuçları

Amaç: Bu çalışmamızda, 3 ile 10 yaş arasındaki femur cisim kırıklı çocuk hastalarda intramedüller Kirschner teli (K teli) kullanarak elde ettiğimiz sonuçları değerlendirdik Gereç ve Yöntem: Kliniğimizde 2007-2011 yılları arasında intramedüller K teli ile tespit uygulanan izole femur cisim kırıklı 39 hasta (28 erkek [%71,8], 11 kız [%28,2]) incelendi. Bulgular: Hastaların ortalama yaşı 5,6±2,21 (3-10 yaş) olarak tespit edildi. Bütün kırıklar femur diyafizinde idi. Hepsi kapalı kırıktı. Kırıkların 11'i (%28,2) transvers, 20'si (%51,3) oblik, 8'i (%20,5) spiraldi. Ortalama ameliyat süresi 55,38±12,26 (40-90 dk) dakika olarak bulundu. Hastaların ortalama takip süresi 17,07±3,84 (12-24) ay idi. Ortalama 7,10±0,91 (6-10) haftada tam kaynama saptandı. Ortalama 6,87±1,7 (5-12) ayda K telleri çıkartıldı. Ameliyat sonrası birinci yılda tüm hastaların kalça ve diz hareket genişlikleri tamdı ve klinik olarak rotasyonel veya açısal deformite saptanmadı. Hastalarımızda ortalama 5,05±2,71 (0-10) mm'lik uzunluk farkı belirlendi; Bu hastaların son takiplerinde eşitsizliğin 2,17±1,43 (0-5) mm'ye düştüğü gözlendi. Hastalarımızda ortalama 8,64±4,73 derecelik (0°-16°) varus-valgus açılanması görülmesine rağmen son takiplerinde bu açılanma ortalama 4,15±3,68 dereceye (0°-10°) düştü. Sagital planda görülen ortalama 4,17±3,77 derecelik ( 0°-13°) açılanma son takiplerde 3,10±2,83 dereceye (0°-10°) düştü. Sonuç: Ekstremite eşitsizliği ve açısal dizilim bozukluğu gibi komplikasyonları önleyebilmesi, ilk ameliyat ve tellerin çıkarımı esnasında küçük yara yeri, az kanama ve skar dokusu olması, kolay uygulanabilir ve bulunabilir olması, ucuz olması nedeni ile 3-10 yaş arası çocuklarda görülen femur cisim kırıklarının tedavisinde intramedüller Kirschner teli ile tespitin uygun bir seçenek olduğunu düşünmekteyiz.

The results of intramedullary kirschner wire in fixation of pediatric femoral shaft fractures

Objective: In our this study, we evaluated the results which we obtained by using intramedulary Kirschner wire (K wire) in the children with femoral shaft fractures between the age 3 and 10. Materials and Methods: Between the years 2007 and 2011, 39 patients (28 male, 11 female) with isolated femur fractures, whose intramedullary K wire were applied were studied. Results: The average age of the patients was as 5,6 (age 3-10). All the femur fractures were in diaphysis and all of them were closed fractures. 11 of the fractures (28,2%) were transverse, 20 of them (51,3%) were oblique, 8 of them (20,5%) were spiral. The average operation time was determined as 55,38 (40-90) minutes. The average patient follow-up time was 17,07 (12-24) months, femur union was found almost in 7,10 (6-10) weeks. Approximately, in 6,87 (5-12) months, K wire were removed. In the first year after the operation, all the patients had a full hip and knee range of motion and clinically rotational and angular deformity were not found out. In the last follow-up of these patients, it was observed that inequality reduced to 2,17 (0-5) mm, varus-valgus was average angularity 4,15º (0º-10º), sagittal plane was average angularity 3,10º (0º-10º) . Conclusion: Intramedullary K wire presents the translation of fracture parts. We think that fixation through intramedullary K wire is the suitable choice in healing femoral shaft fractures in children between the age 3-10 of the fact that it can prevent extremity inequality and angular alignment.

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