İntertrokanterik femur kırıklarında dinamik kalça çivisi ile proksimal femoral çivisi karşılaştırılması ve maliyet analizi
Amaç: Çalışmamız femur intertrokanterik kırıklarında dinamik kalça vidası (DHS) – proksimal femoral çivi antirotasyon (PFNA) uygulamalarının sonuçlarının karşılaştırılması ve bu konuda maliyet analizinin yapılması için planlanmıştır. Gereç ve yöntem: Mayıs-2009 Aralık-2012 tarihleri arasında intertrokanterik femur kırığı nedeniyle ameliyat olmuş 75 hasta retrospektif olarak değerlendirildi. Gruplar arasında redüksiyon kalitesi, ortalama yatış süresi, komplikasyon oranları, fonksiyonel sonuçlar ve tedavi masrafları açısından fark olup olmadığı değerlendirildi. Bulgular: Otuz hastaya DHS, Kırk beş hastaya PFNA uygulandı. Çalışmamızda takip süresi ortalama 21.55 (6-49) aydır. Fonksiyonel sonuçlar gruplar arasında anlamlı fark olmayacak şekilde birbirine yakındı. PFNA uygulanan hastaların DHS uygulanan hastalara göre hastanede yatış sürelerinin kısa; tedavi ve bakım masraflarının daha düşük olduğu görülmektedir. Sonuç:PFNA; DHS’ye oranla pahalı bir implant olsa da hastane toplam maliyeti değerlendirildiğinde aralarında anlamlı bir farklılık görülmemektedir. Bunun yanında benzer fonksiyonel sonuçları ile DHS intertrokanterik femur kırıklarında tercih edilebilir bir tedavi yöntemidir.
Comparison of dynamic hip screw and proximal femoral nail in intertrochanteric femur fractures and cost analysis
Purpose: The study was planned to compare the results of dynamic hip screw (DHS) and proximal femoral nailantirotation (PFNA) applications to femur intertrochanteric fractures and to implement a cost analysis.Materials and methods: A retrospective evaluaton was made of 75 patients who were treated for intertrochantericfemur fracture between May 2009 and December 2012. Evaluation was made of differences between the groupsin reduction quality, mean duration of hospitalization, complication rates, functional outcomes and treatmentcosts.Results: Thirty patients were treated with DHS and forty five patients with PFNA. The average follow-up periodwas 21.5 (12-49) months. Functional outcomes were similar, with no significant difference between the groups.Length of hospital stay was shorter in the PFNA group, the treatment and care costs were lower compared tothe DHS group.Conclusion: Although PFNA is a much more expensive implant than DHS, there is no significant differencebetween total hospital costs. Nevertheless, as DHS has similar functional results, it is still a preferrable treatmentmethod for intertrochanteric femur fractures.
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