Eşref TERZİ, Süleyman Nafiz BİLSEL, Aybars KIVRAK, Recep DİNÇER

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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