Ercan ŞAHİN, Mahmut KALEM, Murat SONGÜR, Baver ACAR, Hakan KOCAOĞLU

Parçalı proksimal humerus kırıklarının tedavisinde çimentolu ile çimentosuz hemiartroplasti sonuçlarının karşılaştırılması

Amaç: Bu çalışmamızda parçalı proksimal humerus kırığı sonrasında hemiartroplasti yapılan ileri yaş hastalarda çimentolu ve çimentosuz uygulamalarımızın sonuçlarını karşılaştırmayı amaçladık.Gereç ve Yöntem: 2008 ile 2014 yılları arasında, parçalı proksimal humerus kırığı nedeniyle hemiartroplasti yapılan hastalar iki üniversite hastanesinin bilgi sistemi kullanılarak retrospektif olarak araştırıldı ve en az 2 yıllık takibi olan hastalar çalışmaya alındı. Son takiplerinde muayene bilgileri olmayan, telefon ile ulaşılamayan ve patolojik veya açık kırığı olan hastalar değerlendirmeye alınmadı. Hastaların demografik bilgileri, kırık tipi, son takipte fonksiyonel sonuç, son takipte vizüel analog skala skoru ve ameliyatından memnuniyeti, son takipte radyolojik değerlendirme, ortalama takip süresi ve komplikasyonlar çimentolu ile çimentosuz uygulamalarda karşılaştırılarak not edildi.Bulgular: Çalışmamızın kriterlerini karşılayan toplam 22 hasta (12 erkek, 10 kadın)(ortalama yaş: 76,4 yıl, aralık: 67-88) çalışmaya dahil edildi. 8 hastada çimentosuz, 14 hastada ise çimentolu hemiartroplasti yapılmış ve ortalama takip süresi 38 ay idi. Ortalama öne elevasyon, eksternal rotasyon ve internal rotasyon derecesi çimentosuz hemiartroplasti yapılan hastalarda daha iyi olmakla beraber her iki grup arasında fonksiyonel açıdan anlamlı fark bulunamadı. Yine çimentosuz hemiartroplasti gurubunda ortama vizüel analog skala skoru 0,87±1,12 iken çimentolu grupta ortalama vizüel analog skala skoru 1,28±0,91 idi ve anlamlı bir fark bulunamadı (p=0,33). Radyolojik değerlendirmede gruplar arasında anlamlı fark yoktu. Çimentolu ve çimentosuz hemiartroplasti yapılan hasta gruplarında 1’er hastada periprostetik kırık görülürken, çimentosuz grubunda 1 hastanın omuzunda sıkılık, çimentolu grubunda ise yine 1 hastada derin doku enfeksiyonu saptandı. Sonuç: Proksimal humerus kırığı sonrası hemiartroplasti yapılan hastalarımızda çimentolu ve çimentosuz uygulamalarımızın fonksiyonel ve radyolojik sonuçları en az 2 yıllık takiplerinde benzer olarak bulunmuştur.

Anahtar Kelimeler:

Proksimal humerus kırığı, hemiartroplasti, çimento, omuz

Comparison of cemented and uncemented hemiarthroplasty results in the treatment of comminuted displaced proximal humeral fractures

Aim: In this study, we aimed to compare the results of cemented and uncemented hemiarthroplasty results in elderly patients for the treatment of comminuted proximal humerus fractures. Material and Method: Between 2008 and 2014, patients who underwent hemiarthroplasty due to comminuted proximal humerus fracture were retrospectively investigated using the data system of two university hospitals. Patients who were followed for at least 2 years were included. Demographic information of the patients, fracture type, functional results at final follow-up, visual analog scale score and satisfaction status, radiological results, mean follow-up time and complications were noted. Results: A total of 22 patients (12 males, 10 females) (mean age: 76.4 years, range: 67-88)(8 cemented hemiarthroplasty, 14 uncemented hemiarthroplasty) were included. The mean follow-up time was 38 months. Although the mean forward elevation, external rotation and internal rotation were better in patients who underwent uncemented hemiarthroplasty, no significant difference was found between the two groups. The mean visual analog scale score in uncemented hemiarthroplasty group was 0.87 ± 1.12, whereas the mean visual analog scale score in cemented group was 1.28 ± 0.91 and no significant difference was found (p = 0.33). At radiologic evaluation, no significant difference was found. Periprosthetic fracture was seen in 1 patient of both groups. We have seen 1 shoulder stiffness in uncemented group and 1 deep tissue infection in cemented hemiarthroplasty group. Conclusion: The functional and radiological results of our cemented and uncemented HA patients were similar for the treatment of comminuted proximal humerus fractures in at least 2 years follow-up.

Keywords:

Proximal humerus fracture, hemiarthroplasty, cemented, shoulder,

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