M Ali FİLİZ, Taşkın ALTAY, Zafer KEMENT, Tayfun Göre SERHAN, Cemil KAYALI

TİBİA PİLON KIRIKLARINDA AÇIK REDÜKSİYON-İÇTEN TESPİT İLE TEDAVİ SONUÇLARI

Bu çalışmada amacımız, açık redüksiyonla içten tespit edilen tibia pilon kırıklarının orta dönem klinik ve radyolojik sonuçlarını incelemektir. 2005-2009 yılları arasında cerrahi olarak tedavi edilmiş 14 pilon kırıklı hasta çalışmaya alındı. Olguların 2’ si kadın, 12’ si erkekti. Ortalama takip süresi 37 ay idi. Ortalama yaş 41 yıl idi. Olguların 5’ i açık kırıktı 2’si tip1, 2’ si tip 2, 1’ i tip 3 . Ruedi-Allgöwer sınıflamasına göre 3 hastada tip 1, 5 hastada tip 2 ve 6 hastada tip 3 kırık saptandı. AO sınıflamasına göre ise 1 A3, 1 B1, 4 B3, 2 C1, 2 C2 ve 4 C3 tipi kırık belirlendi. Değerlendirmede WEBER ve AOFAS kriterleri beraber kullanıldı. Weber’ e göre %14 mükemmel, %36 iyi ve tatminkar, % 50 kötü sonuç elde edildi. AOFAS’ a göre %58 iyi ve %42 kötü sonuç elde edildi. Komplikasyon olarak posttravmatik dejeneratif artrit, enfeksiyon, tespit materyali yetmezliği, kaynamama ve varus açılanması ile karşılaştık. Açık yerleştirme ve içten tespit tedavisi, tibia pilon kırıklarında tedavi sonuçları açısından güncel ve tercih edilebilir bir yöntemdir. Ancak yüksek enerjili yaralanmalar olduğundan yeterli klinik sonuç için cerrah stabil tespitin ardından erken rehabilitasyonu göz önünde bulundurmalıdır

Anahtar Kelimeler:

Tibia, pilon kırığı, içten tespit, artroz

TİBİA PİLON KIRIKLARINDA AÇIK REDÜKSİYON-İÇTEN TESPİT İLE TEDAVİ SONUÇLARI

In this study our aim was to evaluate medium term results of tibial pilon fractures clinically and radiologicaly that treated with open reduction and internal fixation. Between 2005 and 2009, 14 patients who had tibial pilon fractures included in the study. Two of the cases were women and 12 men. Mean follow up period was 37 months . Mean age was 41 years . Five of the cases were open fractures 2 type I, 2 type II and 1 type III . There were 3 type 1, 5 type 2, and 6 type 3 fractures and 1 A3, 1 B1, 4 B3, 2 C1, 2 C2, and 4 C3 type fractures according to Ruedi-Allgöwer and AO classifications respectively. Evaluation was done via WEBER and AOFAS criteria. We had 14% excellent, 36% good, and 50% poor results and 58% good, and 42% poor results respectively. As complications; we noted posttraumatic arthrosis, infection, hardware failure, nonunion, and varus malalignment deformity. Open reduction and internal fixation is current and favourable method for the treatment of tibial pilon fractures. However; although they are caused from high energy trauma, surgeon should consider stable fixation and early rehabilitation for satisfactory results

Keywords:

Tibia, pilon fracture, internal fixation, arthrosis,

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Yazının alınma tarihi:08.04.2013
Kabül tarihi:22.04.2013
Online basım: 02.05.2013
İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi,2013;17:63-71