Mehmet BULUT, İbrahim AZBOY, Celil ALEMDAR, Emin ÖZKUL, Abdullah DEMİRTAŞ, Mehmet GEM

Mini plakla osteosentez uygulanan metakarp kırıklarında ameliyat sonrası erken hareketin fonksiyonel sonuçlara etkisi

Amaç: Çalışmamızda mini plakla anatomik redüksiyon ve rijit internal fiksasyon uyguladığımız metakarp kırıklı hastaların fonksiyonel ve radyolojik sonuçlarını değerlendirmeyi amaçladık. Yöntemler: Çalışmada metakarp kırığı sonrası mini plakla osteosentez uygulanan 11 hasta (10 erkek, 1 kadın) retrospektif olarak değerlendirildi. Hastaların ortalama yaşı 35 (dağılım 25-46) ve ortalama takip süresi 1,4 (dağılım 1,1-2,2) yıldı. Bütün hastalara postoperatif ikinci gün aktif ve pasif eklem hareket açıklığı egzersizleri başlandı. Fonksiyonel sonuçlar total aktif eklem hareket açıklığı (TAEHA) skalasına göre değerlendirildi. Bulgular: TAEHA skalasına göre 8 hastada (10 metakarp) mükemmel, 2 hastada iyi, 1 hastada orta dereceli sonuç elde edildi. Ortalama 6 hafta (4-7 hafta) içinde bütün hastalarda kaynama görüldü. Redüksiyon kaybı, enfeksiyon, dolaşım bozukluğu, nörolojik araz, osteonekroz, sudeck atrofisi gibi komplikasyonlar görülmedi. Sonuç: Mini-plakla rijit internal osteosentez uygulanan metakarp kırıklı hastalarda, postoperatif erken dönemde aktif ve pasif eklem hareketlerinin başlanması ile tatmin edici radyolojik ve fonksiyonel sonuçlar elde edilebilir.

Effects of postoperative early motion on the results of osteosynthesis with miniplates in metacarpal fractures

Objectives: In our study, we aimed to evaluate the radiological and functional results of rigid internal fixation with mini plate osteosynthesis in the management of metacarpal fractures. Methods: In this study, 11 patients (10 males, 1 female) which were treated with mini plate osteosynthesis for metacarpal fracture (n=13) were evaluated retrospectively. The average age of patients was 35 years (range 25-46 years) with a mean follow-up of 1.4 years (range 1.1 to 2.2-years). Rehabilitation program was started on the postoperative second day. Range of motion was assessed according to the total active range of motion (TAROM) scale. Results: Eight patients (10 metacarpal) had excellent scores, two patients had good scores and one patient had moderate score at final follow-up. Time to union was found an average of 6 weeks (range 4-7 weeks). Complications did not observed such as loss of reduction, infection, circulatory disorders, neurological symptoms, osteonecrosis, sudeck atrophy. Conclusion: Rigid internal fixation with mini plate osteosynthesis could be performed in patients with metacarpal fractures with satisfactory radiological and functional results along with rehabilitation program contains passive and active joint movements initiated at early post-operative period. J Clin Exp Invest 2013; 4 (4): 457-462

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