X’E BAĞLI HİPOFOSFATEMİK RAŞİTİZMDE ALT EKSTREMİTE DEFORMİTELERİNE ORTOPEDİK YAKLAŞIM
X’e bağlı hipofosfatemik raşitizmde özellikle alt ekstremite deformiteleri ile ortopedi kliniğinde karşılaşılmaktadır. Bu deformiteler yürümede güçlük ve yetmezlik kırıklarına sebep olmaktadır. Tedavileri deformitenin ciddiyetine ve yaşa göre şekillenmektedir. Tedavinin esas amacı mekanik aks kadar anatomik aksı da düzeltip yetmezlik kırıklarını ve osteomalaziye sekonder deformite nüksünü önlemektir. Bunun için literatürde bu grup hasta için altın standart tedavi çocuk hastada mekanik aksı düzeltmeye yönelik hemiepifizyodez yöntemi, erişkin hastada ise multipl osteotomilerle metafizden metafize tespit sağlayan intramedülller çivi tespitidir. Fiksatörün deformite düzeltme etkisi ile kombine edilerek (fiksatör yardımlı çivileme) hastaya konforlu bir tedavi sunulabilir. Hasta bu şekilde hayat boyu konforlu bir mobilizasyona sahip olur.
Anahtar Kelimeler:
fiksatör yardımlı çivileme, raşitizmde internal tespit
ORTHOPAEDIC TREATMENT MODALITIES FOR THE LOWER EXTREMITY DEFORMITY CAUSED BY X LINKED HYPOPHOSPHATEMIC RICKETS
X linked hipophosphatemic rickets especially effects lower extremity. It mostly causes insufficiency fractures and difficulty in mobility. Treatment depends on seriosity of the deformity and age of the patients. The main purpose of the treatment is to correct both mechanical and anatomical axis and prevent the recurrence. Hemiepiphysiodesis is the treatment choice fort he young patients. For the adults multiple osteotomy and intramedullary fixation from proximal metaphysis to distal metaphysis is suggested. Combination of the external fixator for the correction ability of the deformity with internal fixation can provide more comfortable mobilization during the life.
Keywords:
fixator assisted nailing, internal fixation in rickets,
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- Başlangıç: 1916
- Yayıncı: İstanbul Üniversitesi Yayınevi