Management of Femoral Fractures in Aging Adult Polio Population: A Retrospective Review of 13 Cases

Objective: Polio survivors have common sequelae of lower extremity paralysis characterized by flaccid muscle tone, limited ambulation, asymmetric involvement, retarded growth, and disuse osteoporosis. Such patients at risk of disuse osteoporosis are also at risk of sustaining osteoporotic fractures. This study aims to evaluate the effectiveness of extramedullary internal fixation devices in achieving better results in osteoporotic poliorelated femoral fractures. Methods: Retrospective evaluation was made of a total of 13 adult polio patients treated with extramedullary internal fixation devices for unilateral proximal and diaphyseal femoral fractures. The functional status of all patients was evaluated with the Vignos grade of disability. Results: All patients (mean age 62 years; range 47–88 years) were treated with extramedullary internal fixation devices (locked plate in eight diaphyseal fractures; dynamic condylar screw (DCS) and plate in three, and dynamic hip screw (DHS) and plate in two proximal femoral fractures). The mean follow-up period was 48.6 months (range 26–62 months). Bony union was confirmed at a mean of 3.7 months (range, 3–5 months) in all patients. Massive pulmonary embolism was seen in one patient. No cases of non-union, implant cutout or any other complications developed. Conclusion: Post-polio patients are at high risk of fractures. Extramedullary internal fixation devices provide effective stability for bony union and good functional results in poliorelated femoral fractures.

Yaşlanan Erişkin Polio Popülasyonunda Femur Kırıklarının Tedavisi: 13 Olgunun Geriye Dönük Değerlendirilmesi

Amaç: Polio geçiren hastalarda azalmış kas tonusu, sınırlı ambulasyon, asimetrik tutulum, gecikmiş büyüme ve kullanmama osteoporozu ile karakterize alt ekstremite paralizisinin genel sekelleri vardır. Kullanmama osteoporozu riski taşıyan bu hastalar aynı zamanda osteoporotik kırık geçirme riski altındadırlar. Bu çalışmanın amacı, ekstramedüller internal fiksasyon cihazlarının polio ilişkili osteoporotik femoral kırıklarda daha iyi sonuçlar elde etmedeki etkinliğini değerlendirmektir. Gereç ve Yöntem: Toplam 13 yetişkin polio hastası geriye dönük olarak değerlendirildi. Tek taraflı proksimal ve diyafizer femur kırığı için ekstra medüller internal fiksasyon cihazları ile tedavi edildi. Tüm hastaların fonksiyonel durumları Vignos sakatlık derecesi ile değerlendirildi. Bulgular: Tüm hastalar (ort. yaş 62; dağılım 47–88) ekstra-medüller iç fiksasyon cihazları ile tedavi edildi. Sekiz diyafizer kırığa kilitli plak uygulandı. Proksimal femur kırıklarının üçü kayan kondil vidası ile ve ikisi kayan kalça vidası ile tedavi edildi. Ortalama takip süresi 48.6 aydı (dağılım 26–62 ay). Kemik kaynama süresi tüm hastalarda ortalama 3.7 ayda (dağılım, 3–5 ay) tespit edildi. Bir hastada masif pulmoner emboli görüldü. Kaynamama, materyal yetmezliği veya başka herhangi bir komplikasyon görülmedi. Sonuç: Polio geçirmiş olan hastalar yüksek kırık riski taşır. Ekstra medüller internal fiksasyon cihazları, polio ile ilişkili femur kırıkları için uygun stabiliteyi ve iyi fonksiyonel sonuçları sağlar.

Kaynakça

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Kaynak Göster

Southern Clinics of Istanbul Eurasia
  • ISSN: 2587-0998
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2017

1.1b380

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