Mallet Kırıklarında Ekstansiyon Blok Pinleme: Erken ve Gecikmeli Cerrahi Karşılaştırması

Amaç: Bu çalışmanın amacı, erken dönem mallet kırığı cerrahisi yapılan hastalarla gecikmiş dönem cerrahi tedavi uygulanan hastaların sonuçlarını karşılaştırmaktı. Gereç ve Yöntem: Bu retrospektif kohort çalışmaya Doyle Tip 4B mallet kırığı nedeniyle kapalı ekstansiyon-blok pinleme tekniği uygulanan, iskelet matürasyonu tamamlanmış erişkin hastalar dahil edilmiştir. Distal interfalangeal eklem ekstansiyon, fleksiyon kaybı ve cerrahi sonrası ağrı sonuçlarını değerlendirmek için Crawford kriterleri kullanıldı. Tüm hastalar klinik ve radyografik olarak değerlendirildi. Bulgular: Bu çalışmada 48 hastadan 16'sı kadın, 32'si erkekti. Ameliyat sırasındaki ortalama yaş 31.50 ± 9.75 yıl (aralık, 19-60 yıl) idi. Mallet kırığı erken cerrahi tedavisi uygulanan 30 hasta ve cerrahi tedavisi gecikmiş 18 hasta çalışmaya dahil edildi. İki grup arasında distal interfalangeal eklem aktif fleksiyonu ve Crawford kriterleri (sırasıyla p=0.085, p=0.907) açısından anlamlı fark olmamasına rağmen komplikasyon oranları (p=0.045) ve ekstansiyon gecikmesi açısından istatistiksel olarak anlamlı fark saptandı. Sonuç: Gecikmiş dönem kapalı ekstansiyon-blok pinleme tekniği, erken dönem kapalı ekstansiyon-blok pinleme tekniği ile karşılaştırıldığında, mallet kırıklarının tedavisinde tatmin edici fonksiyonel sonuç vermiştir.

Anahtar Kelimeler:

Mallet kırığı, kapalı cerrahi, Ishiguro tekniği, gecikmiş cerrahi

Extension Block Pinning of Mallet Fractures: Comparison Between Early and Delayed Surgery

Objective: The objective of this study was to compare the outcomes of individuals who had acute mallet fracture treatment early versus those who underwent delayed surgical treatment. Methods: This was a retrospective cohort study in which all patients were skeletally mature and underwent closed extension pinning surgery for Doyle Type 4B mallet fractures. Crawford criteria were used to evaluate extension lag, loss of DIP joint flexion, and pain outcomes following surgery. All patients were evaluated clinically and radiographically. Results: There were 16 females and 32 males with total of 48 patients in this study. The mean age at the time of surgery was 31.50 ± 9.75 years (range, 19-60 years). A total of 30 patients with early surgical treatment of mallet fractures and 18 patients with delayed surgical therapy were included in the study. There was no significant difference in the active flexion of the DIPJ, Crawford criteria (p=0.085, p=0.907, respectively), except for complication rates (p=0.045). Conclusions: When compared to the early closed extension-block pinning technique, the delayed closed extension-block pinning technique yielded a satisfactory functional outcome in the treatment of mallet fractures.

Keywords:

closed surgery, delayed surgery, Ishiguro technique, Mallet fracture,

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ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez