Abdulrahim DÜNDAR, Deniz İPEK, Şehmuz KAYA, Sinan ZEHİR

Femur Cisim Kırıkları İçin Talon Distalfix Femoral İntramedüller Çivi ile Tedavi Edilen Hastaların Klinik ve Radyolojik Sonuçları

Amaç: Talon distalfix (TDF) intramedüller çiviler, distal kilitleme vidalarının yerleştirilmesi sırasında yaşanan teknik zorluklara çözüm olarak geliştirilmiştir. Femur şaft kırıklarının tedavisinde geri çekilebilir talon distalfix çivisinin (TDF) radyolojik ve klinik sonuçlarını değerlendirmeyi amaçladık. Gereç ve Yöntem: Ocak 2017-Ocak 2022 tarihleri arasında femur şaft AO tip 32-A, B kırığı olan 28 hasta TDF çivileri ile tedavi edildi. AO Tip 32-A, B kırıkları çalışmaya dahil edildi. Demografik özellikler, takip süreleri, ASA sınıflaması ve kırık tipleri kaydedildi. Ameliyat süresi, intraoperatif kan kaybı, floroskopi süresi (dakika cinsinden) ve kemik kaynamasına kadar geçen süre kaydedildi. Genel ve teknik (kaynamama, yanlış kaynama, malrotasyon ve kısalık) komplikasyonlar değerlendirildi. Klinik fonksiyonel sonuçlar Diz Yaralanması ve Osteoartrit Sonuç Skoru Fiziksel Fonksiyon Kısa Skoru (KOOS-PS), Kalça Yaralanması ve Osteoartrit Sonuç Puanı Fiziksel Fonksiyon Kısa Skoru (HOOS-PS) ve Thoresen kriterleri kullanılarak değerlendirildi. Bulgular: Çalışmaya toplam 28 hasta (11 kadın, 17 erkek) dahil edildi. Ortalama yaş 46.8 yıl, ortalama takip süresi 23.7 ay idi. . Ortalama kemik kaynama süresi 22.6 hafta idi. Hiçbir hastada kaynamama gözlenmedi. Ortalama hastanede kalış süresi 3.4 gün, ortalama BMI 24.2 idi. Ortalama ameliyat süresi 40.3±3.4 dakika, ortalama skopi süresi ise 26.9 saniye idi. Ortalama KOOS-PS skoru ve HOOS-PS skoru sırasıyla 83.4 ve 85.6 idi. Sonuç: TDF çiviler femur orta şaft AO tip A-B kırıklarında güvenle kullanılabilir. TDF çivi uygulaması daha kısa ameliyat süreleri, daha az radyasyona maruz kalma, daha az cerrahi kesi ve daha az kan kaybı gibi avantajlar sağlar. Ayrıca kaynama süresinin geleneksel çivilere göre daha uzun olduğu akılda tutulmalıdır.

Anahtar Kelimeler:

femur şaft kırığı, distal kilitleme, klinik sonuç, malrotasyon, talon distal fiks, yanlış kaynama

Clinical and Radiological Results of Patients Treated with Talon Distalfix Femoral Intramedullary Nail for Femoral Shaft Fractures

Objective: Talon distalfix intramedullary nails have been developed as a solution to the technical difficulties experienced during the placement of locking screws. We aimed to evaluate the radiological and clinical results of retractable talon distal fix for the treatment of femoral shaft fractures. Material and Method: Between January 2017 and January 2022, 28 patients with femoral shaft AO type 32-A and B fractures were treated with Talon distalfix nails. AO Type 32-A and B fractures were included in the study. Demographic characteristics, follow-up times, ASA of Anesthesiologists classification and fracture type were recorded. The duration of the operation, intraoperative blood loss, fluoroscopy time (in min), and time to bone union were recorded. General and technical complications (nonunion, malunion, malrotation, and shortening) were evaluated. Clinical functional outcomes were evaluated using the Knee Injury and the Osteoarthritis Outcome Score Physical Function Shortform (KOOS-PS), Hip Injury and Osteoarthritis Outcome Score Physical Function Shortform (HOOS-PS) and Thoresen criteria. Results: A total of 28 patients (11 female and 17 male) were included in the study. The mean age was 46.8 years and the mean follow-up was 23.7 months. . The mean time to bone union was 22.6 weeks. No nonunion was observed in any of the patients. The mean hospital stay was 3.4 days and the mean Body Mass Index was 24.2. The mean operation time was 40.3±3.4 minutes and the mean scope time was 26.9 seconds. The mean KOOS-PS score and HOOS-PS were 83.4 and 85.6, respectively. Conclusion: Talon distalfix nails can be safely used in AO type A-B fractures of the midshaft femur. Talon distalfix nail application provides advantages including shorter operation times, less radiation exposure, fewer surgical incisions, and less blood loss. In addition, it should be emphasized that the union time is prolonged compared with that of conventional nails.

Keywords:

clinical result, distal locking, femoral shaft fracture, malrotation, malunio, talon distal fix,

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