Mehmet Kerem CANBORA, Hasan BOMBACI, Abdullah DEMİRTAŞ, Tamer COŞKUN, Atilla POLAT, Şevki ERDEM, Hakan Serhat YANIK

İzole humerus tüberkulum majus kırıklarında tedavi sonuçları

Amaç: Bu çalışmanın amacı, izole humerus tüberkulum majus kırığı (TMK) bulunan hastaların konservatif ve cerrahi tedavi sonuçlarını değerlendirmektir. Gereç ve yöntem: 2008-2011 yılları arasında kliniğimize başvuran ve TMK bulunan 23 olgu (11 kadın, 12 erkek)nun 24 omuzu (% 54 dominant) çalışmaya dahil edildi. Tüm olguların travma sonrası MR görüntüleri ile yumuşak doku patolojileri değerlendirildi. Üç olguda TMKya eşlik eden supraspinatus yırtığı tespit edildi. Kırıkla birlikte supraspinatus yırtığı tespit edilen üç olguya osteosentez yapılmaksızın rotator manşet onarımı yapıldı. Üç olguda vida ile osteosentez, iki olguda sutur (ethibond) ile kırık tespit edildi. Onbeş olgunun on altı omuzu konservatif yöntemle tedavi edildi. Tedavi sonrası omuz fonksiyonlarının değerlendirilmesinde Constant skorlaması (CS), Quick- Dash skorlaması (QDS) ve Görsel Analog Skala (VAS) kullanıldı. Bulgular: Vida ile osteosentez yapılan üç olgunun ortalama CS puanı 68,6, QDS puanı 12,8 ve VAS değerleri 1,66 olarak bulundu. TMK nın sutur ile yerine dikildiği iki olgunun CS puanı 67,5, Quick-DASH skoru 5,7 ve VAS değerleri 2 olarak bulundu. Rotator manşet yırtığı onarımı yapılan üç olgunun Constant skoru 82,6, Quick-DASH skoru 16,6 ve VAS değerleri 2,33 olarak tespit edildi. Konservatif olarak tedavi edilen 16 olgunun CS puanı 63,9, QDS puanı 26,1 ve VAS değerleri 2,96 puan olarak bulundu. Sonuç: Çalışmamızda konservatif ve cerrahi tedavi uygulanan olgularımızın fonksiyonel sonuçları tatminkar bulundu. Ağrı açısından sonuçlarımız ise mükemmel bulunmuştur. Sonuç olarak TMKlar nadir görülen, yakın takip ve yeterli rehabilitasyonla sorunsuz iyileşen yaralanmalardır.

Treatment results in isolated humerus majus fractures

Introduction: The aim of this study is to evaluate the results of patients with the isolated greater tubercul fractures (GTF) of humerus who conservatively or surgically treated. Materials and methods: 23 patients were admitted (11 women, 12 men) with GTF (54% dominant side of 24 shoulder) between 2008 and 2011. All of patient were evaluated with MRI as preoperatively soft tissue injury. There was supraspinatus muscle tear together with GTF in 3 case and their shoulder were arthroscopically assisted rotator cuff repair. Osteosynthesis was performed in 3 case with screw and fixation in 2 case with suture. GTF of 16 shoulder were conservatively treated. Shoulder function after treatment were evaluated according to Constant score (CS), Quick-DASH score (QDS) and VAS score. Results: Three patients with screw fixation had CS 68,6 points, QDS 12,8 points, VAS score 1,66. Two patients with suture fixation had 67,5 CS points, 5,1 QDS pointsp, and 2 VAS score. Three patients with rotator cuff tear repair had 82,6 CS points, 16,6 QDS points, and 2,33 VAS score. In patients with conservatively treated mean CS was 63,9 points, QDS 26,1 points, VAS 2,96 points. Conclusions: In this study, conservative and surgical treatment results were satisfactory. In terms of pain the results were excellent. In conclusion, GTFs are rare but trouble-free with a good observation and sufficient rehabilitation.

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