Cemil KAYALI, Caner ÇİTAK, Taşkın ALTAY, Hüseyin Gökhan KARAHAN, Kamil YAMAK

KİLİTLİ DİNAMİK KALÇA VİDASININ STABİL VE İNSTABİL İNTERTROKANTERİK KALÇA KIRIKLI YAŞLI HASTALARDA ETKİNLİĞİNİN DEĞERLENDİRİLMESİ

Giriş: Bu çalışmada, stabil ve instabil pertrokanterik kırıklar için 135 ° kilitli dinamik kalça çivisi (DHS-LSP) kullanılarak yapılan fiksasyon sonuçlarını değerlendirdik. Gereç ve Yöntem: Çalışmada 2010-2013 yılları arasında 60 yaş ve üzerindeki intertrokanterik kırıklı hastalar değerlendirildi. DHS-LSP uygulanan düzenli takip edilen 42 hasta çalışmaya dahil edildi. Stabil kırıklı hastalar (AO- A1) grup 1 (n = 20) ve stabil olmayan kırıklı hastalar (AO-A2) ise grup 2 olarak ayrılarak değerlendirildi (n = 22). Bulgular: Grup 1'deki hastalar ortalama 36.82 (22-44) ay takip edildi ve grup 2'deki hastalar ortalama 32.25 (19- 49) ay takip edildi (p = 0.077). Tüm hastaların ortalama yaşı (n = 20 grup 1, n = 22 grup 2) 74.81 (61 ila 96) olarak hesaplandı. Harris kalça skorları her iki grupta da iyi-çok iyi bulundu (grup 1 = 80.96, grup 2 = 78.63). İki grup arasında istatistiksel olarak anlamlı fark bulunamadı (p˂0.428). Grup 1'de 3, grup 2'de 6 hastada postoperatif komplikasyon gözlendi. Toplamda 3 hastaya (grup1’de 1, grup2’de 2'hastada) cut-out sebebiyle revizyon cerrahisi (% 7) uygulandı. Ancak iki grup arasında istatistiksel olarak anlamlı fark gözlenmedi (p = 0.401). Sonuç: Dinamik kalça vidasının stabil intertokanterik kırıklar için ideal bir yöntem olduğu bilinmektedir. Kilitli yan plakla güçlendirilmiş dinamik kalça vidası (DHS-LSP) ise instabil kalça kırıklı hastalarda da stabil kırıklı hastalar kadar iyi sonuç vermektedir.

THE EFFECTIVENESS OF FIXATION WITH DYNAMIC HIP SCREW- LOCKING SIDE PLATE FOR STABLE AND UNSTABLE INTERTROCHANTERIC FRACTURES OF THE HIP IN ELDERLY PATIENTS

Introduction: In this study, we evaluated the results of fixation done using 135° dynamic hip screw-locking sideplate (DHS-LSP) for stable and instable pertrochanteric fractures.Material and Method: Between 2010 and 2013, 42 patients who were 60 years of age or older withintertrochanteric fractures, Forty-two patients followed regularly with DHS-LSP were included in the study. Thosewith a stable fracture (AO-A1) were assigned to group 1 (n=20), and those with an unstable fracture (AO-A2) wereassigned to group 2 (n=22)Results: Patients in group 1 were followed up for a mean of 36.82 (22 to 44) months, and patients in group 2were followed up for a mean of 32.25 (19 to 49) months (p=0.077). The mean age of all patients was calculatedas 74.81 (61 to 96). Harris hip scores were found as good-very good in both groups (group 1=80.96, group2=78.63). No statistically significant difference was found between the two groups (p˂0.428).Three patients ingroup 1 and 6 patients in group 2 were observed postoperative complications. Cut-out was observed totaly 3patients (1 of group1, 2 of group2) had a revison surgery (7%). However, there was no statistically significantdifference between the two groups (p=0.401).Conclusion: It is known that dynamic hip screw is the ideal method for stable intertrochanteric fractures. Thedynamic side-plate-reinforced dynamic hip screw (DHS-LSP) is as good result for patients with instable hipfractures as for patients with stable fractures.

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