Erkan ALTUN, Osman CİVAN, Mustafa ÜRGÜDEN

Tibia pilon kırıkları: Tek merkez deneyimi

Amaç: Bu çalışmanın amacı cerrahi tedavi uygulanan tibia pilon kırıklarının orta dönem klinik sonuçlarını incelemektir. Gereç ve Yöntemler: 2002-2012 yılları arasında, tibia pilon kırığı nedeni ile cerrahi olarak tedavi edilmiş 20 hasta çalışmaya dahil edilmiştir. Çalışmaya dahil edilen hastalar fonksiyonel açıdan Weber ve Amerikan Ortopedik Ayak ve Ayak Bileği Derneği (AOFAS) protokolüne göre değerlendirildi. Bulgular: Hastaların ortalama izlem süresi 31.55 (20-48 ay) aydı. Hastaların 9’u (%45) açık kırıktı. Ruedi Allgöwer Sınıflamasına gore 9 hastada tip 1, 9 hastada tip 2 (%45) ve 2 hastada tip 3 kırık mevcuttu. Kapalı kırıklar ile açık kırıkların kaynama süreleri karşılaştırıldığında, açık kırıklarda kaynama süreleri anlamlı bir şekilde uzun bulundu (p=0,004). Aşamalı tespit yaptığımız hasta grubunda yumuşak doku komplikasyonlarının direk tespit uygulanan hastalara göre oransal olarak daha az geliştiği görüldü ancak istatistiksel olarak anlamlı bir farka rastlanmadı (p=0,999). Sonuç: Pilon kırıklarının cerrahi tedavi aşamasında, yumuşak dokuya maksimum saygı ve özen gösterilmelidir. Bazı kırıkların kaderinin olay anında çizildiği ve tüm çabalara rağmen bazı hastalarda kötü sonuçların kaçınılmaz olduğu unutulmamalıdır.

Anahtar Kelimeler:

Pilon Kırıkları, Tibia Kırıkları, Kırıklar, Weber ve AOFAS, Travma

Tibial pilon fractures: Single center experience

Aim: This study aims to investigate the mid-term clinical outcomes of surgically treated Pilon Fractures (PF). Material and Methods: Twenty patients, surgically treated for PF between 2002 and 2012 were included in the study. Patients were evaluated functionally based on the Weber and American Orthopaedic Foot & Ankle Society (AOFAS) protocols. Results: Mean follow-up period was 31.55 (20–48) months. Nine (45%) of the 20 patients had open fractures. According to the Rüedi–Allgöwer Classification: type 1 in nine, type 2 in nine (45%) and type 3 fractures were observed in two patients. A comparison of the duration of union between closed and open fractures revealed that the union of open fractures took a significantly longer time (p= 0.004). Moreover, soft tissue complications developed to a proportionally lesser extent in patients who were applied staged fixation compared with those were applied direct fixation, although the difference was not statistically significant (p= 0.999). Conclusion: The surgical treatment phase of PF should comply with maximum care provided and attention paid to soft tissue. It should be remembered that the fate/outcome of certain fractures is determined at the time of the incident and that certain negative outcomes are inevitable in some patients despite the best efforts.

Keywords:

Pilon fractures, Tibial fractures, Fractures, Weber and AOFAS, Trauma,

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