Tahir ÖZTÜRK, Çağatay Eyüp ZENGİN, Hakan ERTEM, Mehmet Burtaç EREN, Orhan BALTA, Osman DEMİR

FEMUR INTRAMEDÜLLER ÇIVILEME: SUPIN VE LATERAL DEKÜBIT POZISYONDA MANUEL TRAKSIYONUN KARŞILAŞTIRILMASI

Giriş: Bu çalışmanın amacı supin veya lateral dekübit pozisyonda manuel traksiyon kullanılarak antegrad intramedüller(im) çivi uygulanan hastaları operasyon zamanı, komplikasyon ve fonksiyonel açıdan karşılaştırmaktır. Gereç ve Yöntem: Çalışmaya; AO/ASIF Type 32 izole femur kırığı ,takip süresi en az bir yıl olan antegrad im çivi uygulanan tüm yaş grubundaki hastalar dahil edildi.Hastalar iki gruba ayrıldı.Grup 1 supin pozisyonda ışın geçiren masada elle traksiyon uygulanarak opere edilen hastalardan,Grup 2 ise lateral dekübit pozisyonda standart cerrahi masada elle traksiyon uygulanarak opere edilen hastalardan oluşturuldu.Dahil edilme kriterlerine uyan 124 hasta çalışmaya dahil edildi.Hastaların hastanede kalma süreleri, operasyon süreleri, operasyon esnasında kanama miktarları, insizyonun büyüklüğü, kaynama zamanları ve komplikasyonlar kayıt edildi. Hastalara son kontrolde bacak uzunluk grafisi çekilerek her iki ekstremite arasındaki uzunluk farkı kayıt edildi. Bulgular: Hastaların operasyon sürelerine baktığımızda lateral dekübit pozisyonda, supin pozisyona kıyasla operasyonun daha kısa sürdüğü görüldü. Hastanede kalma süreleri, operasyon esnasında kanama miktarı, insizyon büyüklüğü açısından gruplar arasında fark bulunmadı. Postoperatif takip süreleri ve kaynama zamanı benzer olarak bulundu Sonuç: Sonuç olarak manuel traksiyon hem supin hem de lateral dekübit pozisyonda güvenle kullanılabilir. Lateral dekübit pozisyon giriş yerine kolay ulaşım sağlaması ve proksimale yakın kırıklarda proksimal parçaya daha hakim olmaya imkan sağlaması açısından operasyon süresini kısaltmayı sağlamaktadır.

FEMORAL INTRAMEDULLARY NAILING: COMPARISON OF MANUAL TRACTION IN SUPINE AND LATERAL DECUBITUS POSITION

Introduction:The aim of this study was to compare patients who underwent IM-nailing using manual traction in the supine or lateral decubitus position, in terms of surgical times, complications and function. Materials and methods:Patients in all age groups who were diagnosed with AO / ASIF Type 32 isolated femoral shaft fracture with antegrade im nails and a follow-up period of at least one year were included in the study. Patients were divided into two groups; Group 1 comprised patients operated on by manual traction, on the radiolucent fracture table in the supine position. Group 2 comprised patients operated on by manuel traction on the standard surgical table, in the lateral decubitus position. 124 patients who met the inclusion criteria were included. Hospital stay, surgerytimes and bleeding rates during surgery,incision size, union times and complications were all recorded. At the last control, x ray was taken to assess limb length discrepancy. Results:Surgery times were shorter in the lateral decubitus position (Group 2) when compared to the supine position (Group 1). No differences between groups were observed in terms of hospital stay, bleeding levels during surgeryand incision size. Postoperative follow-up and union times were similar for both groups. Conclusion:Manual traction can be safely used in both the supine and lateral decubitus positions. Lateral decubit position generates shorter surgery times, and provides easy access to the entrance, allowing more control of the proximal part of femur fractures.

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