Alper KURTOĞLU, Alauddin KOCHAİ, Erhan ŞÜKÜR, Erkan İNANMAZ, Uğur ÖZDEMİR, Yüksel Laçin AVAN, İhsan ÖZ, Zafer ŞEN, İsmail DALDAL, Orhan BAŞOĞLU, Amet Çağrı UYAR

Femur suprakondiler kırığının perkütan plak osteosentez ve retrograde intramedüler kilitli çivi ile tedavisinin karşılaştırması

Özet: Başlık: Femur suprakondiler kırığının perkütan plak osteosentez ve retrograde intramedüler kilitli çivi ile tedavisinin karşılaştırması. Amaç : Femur suprakondiler kırıklarının uygun cerrahisi tedavisi net olarak aydınlatılmış değildir. Bu bölge kırıkları sonrası implant yetmezliği, kaynama gecikmesi, kaynamama ve diz eklem sertliği en sık görülen komplikasyonlardandır. Bu çalışmanın amacı suprakondiler femur kırıkları için en sık kullanılan iki cerrahi tekniğinin radiyolojik ve klinik sonuçlarını karşılaştırmasıdır. Materyal Metod: Femur suprakondiler kırığı için kliniğimizde tedavi edilen 69 hasta çalışmaya alındı. Hastaların 45’i perkütan plak osteosentezi ( grup A) ile ve 24’ü retrograd intramedüler femur çivisiyle opera edilmiş. Hastalar ameliyat sonrası kaynama süresi, komplikasyon, eklem hareket açıklığı ve fonksiyonel sunuç açısından değerlendirildi. Hastaların fonksiyonel sonuçları diz eklem hareket açıklığı ve diz cemiyeti skoru ölçülerek değerlendirildi. Bulgular: Her iki grubun demografik sonuçları birbirleriyle aynıydı. Kaynama süresi perkütan plak ile osteosentez yapılan hastalarda ortalama olarak 7.2±2.1 iken retrograd intramedüler çivi ile tedavi edilenler için bu süre 6.5±2 idi. Iki grup arasında istatiksel açısından farklılık saptanmadı (p=0.125). Aynı zamandan her iki grup arasında eklem hareket açıklığı (p=0.371) ve diz cemiyet skoru açısından (p=0.371) da istatistiksel açısından anlamlı farklılık bulunmadı. Hastanın son değerlendirmelerinde alt ekstremite dizilim anormallik açısından da istatistiksel açısından farklılık saptanmadı (p=0.791). Çıkarım: Çalışmamızda hem perkütan plak fiksasyonu hem de retrograd inntramedüler çivi ile yapılan cerrahinin sonuçları birbirleri ile kaynama süresi, eklem hareket açıklığı ve diz cemiyeti skoru açısından aynıydı. Her iki cerrahi arasında komplikasyonlar bakımından da farklılık saptanmadı. Her iki cerrahi teknik femur suprakondiler kırıkları için güvenli bir şekilde uygulanabilir.

Anahtar Kelimeler:

Distal femur kırıkları, Perkütan plak osteosentez, İntramedüller çivi

Comparison of percutaneous plate osteosynthesis and retrograde interlocking femoral nail for femur supracondyler fractures

Objectives: There is not optimal treatment option for distal femur. Implant failure, delayed union, nonunion and knee stiffness are the most common problem occur after distal femur fractures. The aim of this study is to compare clinical and radiological outcomes of the most used two techniques. Materials and Methods: Sixty-nine patients with distal femur fractures were included in this study. 45 patients (group A) undergone locked-bridge plating and 24 patients (group B) undergone RIMN. Patients were evaluated in terms of duration of union, complications, range of motion and functional results. Functional results were evaluated according to the knee range of motion and Knee Society Score. Results: There were no significant differences between the two groups in terms of demographic characteristics. While the mean union time was 7.2±2.1 months in the percutaneous plate group, it was 6.5±2 months in the RIMN group; however, there was no statistically significant difference between the study groups in terms of duration of bone healing (p=0.125). There was no statistically significant difference in the range of motion between the two groups at the last follow-up (p=0.371). There was no statistically significant difference in the Knee Society Scores between the two groups (p=0.353) too and also there was no statistically significant difference in the incidence of alignment disorders at the last follow-up between the two groups (p=0.791). Conclusion: Both percutaneous plate osteosynthesis with RIMN to treat supracondylar-intercondylar femur fractures, both groups had similar results in terms of duration of union, range of motion, and Knee Society Scores. Furthermore, there were also similar complication rates in both groups. Both techniques can be used safely in the treatment of distal femoral fractures with satisfactory outcomes. Keywords: Distal femur fractures, Percutaneous plate osteosynthesis, Intramedullary nail

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