Abdulkadir SARI, Mehmet Ümit ÇETİN, İsmail Bülent ÖZÇELİK, Abdulkadir POLAT, Fırat FİDAN

Gözden Kaçan Perilunat Karpal Dislokasyonda Dorsal Yaklaşım ve Geçici Tespit Prosedürünün Orta-Uzun Dönem Sonuçları

Amaç: Çalışmadaki amacımız, perilunat çıkıklı olgularda dorsal yaklaşımla açık redüksiyon, K-teli uygulaması ve skafolunat ligaman tamiri sonrası orta-uzun dönem fonksiyonel ve radyolojik sonuçlarımızı sunmaktır. Gereç ve Yöntem: 2014-2018 yılları arasında perilunat çıkık nedeniyle başvuran, en az 18 aylık takibi olan 11 hasta çalışmamıza dahil edildi. Bu olgularda, skafolunat açı, skafolunat gap, artroz ve avasküler nekroz varlığı değerlendirildi. Hastaların el bileği fleksiyon-ekstansiyon ve pronasyon- supinasyon hareket açıklığı gonyometre ile ölçüldü. Jamar dinamometresi ile el bileği kavrama gücü değerlendirildi. Olgular fonksiyonel olarak Kol, Omuz ve El Sorunları Anketi (DASH) skorlaması ve Herzberg klinik skorlama sistemine göre değerlendirildi. Bulgular: Ortalama yaş 41,1 (28-64), ortalama takip süresi 3,8 (1,5-6) yıldı. Ortalama skafolunat açı 49,1±8,7 (37,3-70,4) derece, skafolunat interval 2,0±0,5 (1,2-2,8) mm, fleksiyon-ekstansiyon arkı 131±17,5 (90-155) derece, pronasyon-supinasyon arkı 155,4±6,1 (140-160) derece olarak ölçüldü. DASH skoru ortalama 5,6±3,2 (0-10,9), Herzberg klinik skoru ortalama 89,1±9,4 (70-100) olarak bulundu. Sonuç: Perilunat çıkıklarda tedavinin erken dönemde ve uygun şekilde yapılması prognozdaki ana belirleyicidir. Bu yaralanmaların olası komplikasyonlar açısından minimum 18 aylık yakın takibi son derece önemlidir.

Mid-long Term Results of Dorsal Approach and Temporary Fixation Procedure in Overlooked Perilunate Carpal Dislocation

Aim: Our aim in this study is to present our mid-long term functional and radiological results after open reduction with dorsal approach, K-wire application and scapholunate ligament repair in cases with perilunate dislocation. Materials and Methods: Eleven patients who applied for perilunate dislocation between 2014 and 2018 and were followed up for at least 18 months were included in our study. The scapholunate angle, scapholunate gap, arthrosis, and avascular necrosis were evaluated in cases with isolated perilunate dislocations. The wrist flexion-extension and pronation-supination range of motion (ROM) of the patients were measured using a goniometer, and the wrist grip strength using a Jamar dynamometer. Functionally, the cases were evaluated according to the Disabilities of the Arm, Shoulder and Hand (DASH) scoring and the Herzberg clinical scoring system. Results: The mean age was 41.1 (28-64) years, the mean follow-up time was 3.8 (1.5-6) years. The mean scapholunate angle was 49.1±8.7 (37.3- 70.4) degrees, the mean scapholunate gap was 2.0±0.5 (1.2-2.8) mm, the mean flexion-extension ROM was 131±17.5 (90-155) degrees, and the mean pronation-supination ROM was 155.4±6.1 (140-160) degrees. Patients had a mean DASH score of 5.6±3.2 (0-10.9) and a mean Herzberg clinical score of 89.1±9.4 (70-100).

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