SUPRAKONDİLER FEMUR KIRIKLARINDA RETROGRAD İNTRAMEDÜLLER ÇİVİLEME VE PLAK VİDA İLE TESPİT CERRAHİ SONUÇLARININ KARŞILAŞTIRILMASI
Amaç
Erişkinlerde görülen suprakondiler femur kırıkları eklem
yüzeyini ilgilendiren veya ilgilendirmeyen kırıklar
olup farklı cerrahi tespit seçenekleri bulunmasına
rağmen, tedavisi kolay olmayan bir kırık çeşididir. Bu
kırıklarda yapılan plak uygulamalarında geniş insizyonlar
sebebiyle yumuşak doku ve periost canlılığı
korunamayıp kaynamama gibi sonuçlarla karşılaşıldığından
dolayı cerrahlar tarafından retrograd intramedullar
çivileme metoduna bir yönelim meydana
gelmiştir.
Gereç ve Yöntem
Çalışmamızda retrograd intrameduller çivileme ve
plak ile tespit edilen iki grup hastada karşılaştırma yapıldı.
2005-2016 tarihleri arasında kliniğimizde tedavi
olan 20 hasta çalışmaya dahil edildi, bu hastaların 11’i
plak ile 9’u ise retrograd çivi ile tedavi edildi. Bu hastalarda
subjektif memnuniyet derecesi ameliyat sonrası
VAS, HSS, Neer skorları, artroz gelişimi, kuadriseps
kası gücü, uyluk atrofisi ve kısalık açısından araştırıldı
ve karşılaştırıldı.
Bulgular
Yapılan karşılaştırmalarda her iki tedavi grubu arasında
memnuniyet derecesi postoperatif VAS, HSS,
Neer skorları, artroz gelişimi, kuadriseps kası gücü,
uyluk kas atrofisi ve kısalık açısından istatiksel olarak
anlamlı bir fark saptanmadı.
Sonuç
Suprakondiler femur kırıklarında plak-vida ile tedavi
ve retrograd çivileme yöntemleri güvenilir tedavi yöntemleridirler,
her iki yöntemin avantaj ve dezavantajları
mevcut olup uzun vadede değerlendirildiğinde her
iki yönteminde suprakondiler femur kırıkları tedavisinde
başarılı olduğunu söyleyebiliriz.
COMPARISON OF SURGICAL RESULTS OF RETROGRADE INTRAMEDULLARY NAILING AND FIXING WITH PLATE SCREW IN SUPRACONDYLAR FEMUR FRACTURES
Objective
Supracondylar femur fractures in adults are fractures
that involve or do not involve the articular surface, and
although there are different surgical fixation options,
they
are a type of fracture that is not easy to treat. Since
the soft tissue and periosteum viability could not be
preserved due to wide incisions in plate applications
performed in these fractures, and results such as
nonunion were encountered, surgeons preferred the
retrograde intramedullary nailing method.
Material and Method
In our study, two groups of patients who were fixed
with retrograde intramedullary nailing and plate were
compared. Twenty patients who were treated in our
clinic between 2005 and 2016 were included in the
study, 11 of these patients were treated with plate
screws and 9 with retrograde nails. The subjective
satisfaction level of these patients was investigated
and compared in terms of postoperative VAS, HSS,
Neer scores, development of arthrosis, quadriceps
muscle strength, thigh atrophy, and shortness.
Results
In comparison, there was no statistically significant
difference between the two groups in terms of
subjective satisfaction level, postoperative VAS, HSS,
Neer scores, development of arthrosis, quadriceps
muscle strength, thigh atrophy, and shortness.
Conclusion
Plate and screw treatment and retrograde nailing
methods are reliable and good treatment methods in
supracondylar femur fractures, both methods have
advantages and disadvantages, but there is no major
difference between the two methods in terms of the
patient in the long run.
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