Ahmet Adnan KARAASLAN, Nihat ACAR, ABDULLAH MERİÇ ÜNAL

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

Amaç: Par çalı tibia kırıklar ınnın tedavisinde kullanılan intramedüller çivinin kilitleme vidalarında deformasyon sıklıkla görülmektedir. Bu çalışmanın amacı tibia intramedüller çivileme sisteminde beş farklı proksimal kilitleme vidasının bükülme dirençlerini karşılaştırmaktır. Gereç ve Yöntemler: 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. Bulgular: 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) Sonuç: 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 kullanılması daha güvenli olabilir.

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

Purpose: Locking screw defor mation 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 scr ews were divided into five gr oups. 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, using 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.

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