Ahmet KARAARSLAN, Nihat ACAR, Meric UNAL

Tibia Intramedüller Çivileme Sisteminde Proksimal Kilitleme Vidalarının Dirençlerinin Karşılaştırılması: Biyomekanik Çalışma

Amaç: Parçalı tibia kırıklarınnın tedavisinde kullanılan intramedüller çivinin kilitleme vidalarında deformasyon sıklıkla görülmektedir. Bu çalışmanın amacı tibia intramedüller çivileme sisteminde beş farklı proksimal kilitleme vidasının bükülme dirençlerini karşılaştırmaktır.Metod: 50 adet vida üç farklı çapta(4.5 mm, 5 mm ,5.5 mm) ve 2 farklı yiv şeklinde( yivli ve yivsiz)olacak şekilde beş farklı gruba ayrıldı. 34 mm iç çapa sahip bir paslanmaz çelik tüp tibiayı temsil etmek üzere hazırlandı. Tüm vidalara uygulama sonrası üç nokta bükülme testi yapıldı. Sonuçlar: Yivsiz 4.5 mm ve yivli 5mm vida gruplarının ortalama değerleri yivsiz 5 mm, yivli 5.5 mm ve yivsiz 5.5 mm gruplarına gore anlamlı derecede düşük bulundu(p=0.000) Çıkarımlar: Proksimal kilitleme vidasının deformasyonundan kaçınmak için yivsiz 4.5 mm ve yivli 5 mm vidaların kullanılması uygun olmayabilir. Yivsiz 5 mm, yivli 5.5 mm ve yivsiz 5.5 mm vidaların güvenli bir şekilde kullanılması önerilebilir.

Anahtar Kelimeler:

Parçalı tibia kırığı, tibia çivisi, kilitleme vidası

Comparison of the Resistance of Proximal Locking Screws in Tibia Nailing System – A Biomechanical Study

Purpose: Locking screw deformation is common in nailing of comminuted tibia fractures. The aim is to compare five different proximal locking screws bending resistance in tibia nailing system.Methods: 50 screws were divided into five groups. A stainless steel tube which has a 34 mm internal diameter was prepared representing the proximal tibia. A 3-point bending tests were performed on locking screws for determining their yield points with 3 different dimensions (4.5 mm, 5 mm and 5,5 mm) and with 2 different screw thread (low threaded and unthreaded).Results: The mean yield point values of smooth 4.5 mm and threaded 5 mm low locking screws were statistically significant less than that of smooth 5 mm, low threaded 5.5 mm and smooth 5.5 mm,(P=0.000). Conclusions: To avoid proximal locking screw deformation, use of smooth 4,5 mm and low threaded 5 mm locking screws should be avoided in nailing of comminuted tibia fractures of unreliable persons. Smooth 5 mm, low threaded 5.5 mm and smooth screws 5.5 mm may be used safely.

Keywords:

Tibia comminuted fractures, tibia nail, locking screw,

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