Proksimal Humerus Kırıklarında Deltopektoral Yaklaşım ile Uygulanan Plaklıosteosentez Sonuçlarımız

ÖZ Amaç: Proksimal humerus kırıklarında deltopektoral yaklaşım ile plaklıosteosentez yapılan hastaların sağlam omuzuna göre fonksiyonel ve radyolojik sonuçlarının değerlendirmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışmaya Ocak 2015-Ocak 2017 tarihlerinde proksimal humerus kırığı (PHK) nedeniyle deltopektoral yaklaşım ile proksimal humerus anotomik kilitli plak uygulanan 33 hasta dâhil edildi. Retrospektif çalışmamıza 18 yaş üstü, kapalı humerus kırığı olan, contralateral humerusu ve omuzu sağlam olan hastalar alınmıştır. Hastaların ameliyatlı ve sağlam taraflar arası fonksiyonel sonuçlar Constant-Murley skorunun (6.ay) ve radyolografik sonuçlar (6.ay) tam anteroposterior grafi ile kollodiafizer açılarının karşılaştırılması ile değerlendirildi. Bulgular: Hastalarda Constant Murley skorlama kategorik veri yapısına göre ameliyatlı taraf %6.1 (n=2) kötü, %6.1 (n=2) orta, %39.4 (n=13) iyi ve %48.5 (n=16) mükemmel iken, sağlam taraf % 0 (n=0) kötü, % 3 (n=1) orta, %30,3 (n=10) iyi ve %66,7 (n:22) mükemmel sonuç elde edildi. Hastalarda Constant Murley skorlama kategorik veri yapısına göre ameliyat edilen taraf ile sağlam taraf arasında istatistiksel bir fark tesbit edilmiştir (p>0,05). Ameliyatlı tarafın Constant Murley skoru ortalaması 85,82 ± 7,07 iken, sağlam tarafın Constant Murley skoru ortalaması 90,67 ± 5,76 idi. Ameliyatlı tarafın kollodiafizer açıları ortalaması 130,03± 4,64 iken; sağlam tarafın açıların ortalaması 135,64 ± 5,04 ’tür. Hastaların Constant Murley omuz skorları ve kollodiafizer açı değerleri açısından; ameliyat edilen taraf ile sağlam taraf arasında istatistiksel bir farklılık gözlemlendi (p<0,05). Sonuç: Proksimal humerus kırıklarında deltopektoral yaklaşım ile proksimal humerus anotomik kilitli plak kullanılarak yapılan plaklıosteosentez sonrası hastaların hem klinik hemde fonksiyonel sonuçlarının başarılı olduğu görülmüştür.

Anahtar Kelimeler:

Proksimal humerus kırığı, deltopektoral yaklaşım, plaklıosteosentez

Results of Plate Osteosynthesis with Deltopectoral Approach for Proximal Humerus Fractures

ABSTRACT Aim: The aim of this study was to evaluate the functional and radiological results of patients who underwent plate osteosynthesis with the deltopectoral approach in proximal humerus fractures, according to the intact shoulder. Materials and Methods: Our study included 33 patients who underwent proximal humeral anatomic locking plate with deltopectoral approach due to proximal humeral fracture (PHF) between 2015 and 2017. Patients over 18 years of age, with closed humeral fractures, and with intact contralateral humerus and shoulder were included in our retrospective study. The functional results between the operated and healthy sides of the patients were evaluated by comparing the Constant-Murley score and radiological results with the full anteroposterior radiography and the collodiaphyseal angles. Results: According to the Constant Murley scoring categorical data structure of the patients, the operated side was 6.1% (n=2) poor, 6.1% (n=2) moderate, 39.4% (n=13) good, 48.5% (n=16) excellent, while the healthy side was %. Results were 0 (n=0) poor, 3% (n=1) moderate, 30.3% (n=10) good, and 66.7% (n:22) excellent. According to the Constant Murley scoring categorical data structure, a statistical difference was found between the operated side and the healthy side (p>0.05). While the mean Constant Murley score of the operated side was 85.82 ± 7.07, the mean Constant Murley score of the healthy side was 90.67 ± 5.76. While the average of the collodiaphyseal angles of the operated side was 130.03± 4.64; the mean of the angles of the intact side is 135.64 ± 5.04. In terms of Constant Murley shoulder scores and collodiaphyseal angle values of the patients; a statistical difference was observed between the operated side and the healthy side (p<0.05). Conclusion: It has been observed that both clinical and functional results of the patients were successful after plate osteosynthesis using the deltopectoral approach and proximal humerus anatomical locking plate in proximal humerus fractures.

Keywords:

proximal humerus fracture, deltopectoral approach, plate osteosynthesis,

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