İnstabil çocuk önkol diyafiz kırık cerrahisinde açık ya da kapalı redüksiyonun klinik ve radyolojik sonuçlara etkisi
Küçük Resim Yok
Tarih
2015
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Stabil olmayan çocuk önkol diyafiz çift kırıklarının cerrahisinde, kırık redüksiyonu her iki kemiği açık, her iki kemiği kapalı ve bir kemiği açık diğeri kapalı yapılan hastaların klinik ve radyolojik sonuçları değerlendirildi. Yöntem : İnstabil önkol 1/4 orta cisim kırığı nedeniyle intramedüller çivileme yöntemiyle tedavi edilen 63 çocuk geriye dönük değerlendirildi. Hastaların 13’üne (Grup A; 3 kız, 10 erkek; ort. yaş 10; dağılım;5 -15) her iki kemiğe açık yerleştirme; 27’sine (Grup B; 4 kız, 23 erkek; ort. yaş 11; dağılım;5 -16) her iki kemiğe kapalı yerleştirme; 23’üne (Grup C; 3 kız, 20 erkek; ort. yaş 11; dağılım;7 -14) bir kemiğe açık diğerine kapalı redüksiyon uygulandı. Gustilo - Anderson sınıflamasına göre 15 hastada tip1, iki hastada tip 2 açık kırık vardı. Yaralanmadan cerrahiye kadar geçen süre grup A’da 4, grup B’de 2, grup C’de 2 gündü. Hastalarda Kirschner teli kullanıldı. Hastaların hepsinde hem radius hem ulna tespit edildi. Ortalama takip süresi grup A’da 38, grup B’de 34, grup C’de 39 aydı. Bulgular: Grup A’da ortalama 47 , grup B’de 45, grup C’de 46 günde kaynama sağlandı. Çivilerin çıkarılma süreleri grup A’da ortalama 53, grup B’de 82, grup C’de 67 gündü. Gruplar arasında yaş, yaralanmadan cerrahiye kadar geçen süre, tel çıkarma ve takip süresi, cinsiyet, taraf, etiyoloji, komplikasyon dağılımlarında istatiksel anlamlı farklılık saptanmadı (p>0.05). Epifiz hasarı, redüksiyon kaybı, refraktür, derin enfeksiyon, kaynamama, nörovasküler yaralanma, Kirschner teli migrasyonu, sinostoz, angular ya da rotasyonel deformite ve ane stezi komplikasyonu gelişmedi. Sonuç : Çocuklarda instabil önkol diyafiz kırıklarının Kirschner teliyle intramedüller tespitinde açık veya kapalı kırık redüksiyonunun fonksiyonel ve radyolojik sonuçlar üzerine etkisi olmadığını istatistiksel olarak gösteril di.
Objective : Clinical and radiological results were evaluated of surgery to paediatric unstable forearm diaphyseal double -bone fractures, treated as both bones open, both bones closed and one open, one closed. Method : 63 children treated with intramedu llar nailing for an unstable forearm mid 1/4 fracture were retrospectively evaluated. Group A comprised 3 females, 10 males (mean age 10 years) and underwent open reduction on both bones. Group B comprised 4 females, 23 males (mean age 11 years) and underwent closed reduction on both bones. Group C comprised 3 females, 20 male (mean age 11 years,) and underwent open reduction on one bone and closed reduction on the other. The Gustilo -Anderson classification showed 15 patients Type 1 and 2 patients Type 2 op en fractures. Mean time to surgery was 4, 2, 2 days for Groups A,B, C. K -wires were used on all patients. Fixation was applied to both the radius and ulna. Mean follow-up periods were 38, 34, 39 months for Groups A, B, C. Results : Union was achieved on mean Day 47, 45, 46 in Groups A,B, C. Nails were removed on mean Day 53, 82 and 67 respectively. No statistically significant difference was determined between the groups in terms of age, time to surgery, nail removal and follow -up period, gender, side, etiol ogy or complications (p>0.05). No significant complications developed. Conclusion : In intramedullar fixation of paediatric unstable forearm diaphyseal fractures with K -wire, open or closed fracture reduction showed no statistical effect on the functional a nd radiological results.
Objective : Clinical and radiological results were evaluated of surgery to paediatric unstable forearm diaphyseal double -bone fractures, treated as both bones open, both bones closed and one open, one closed. Method : 63 children treated with intramedu llar nailing for an unstable forearm mid 1/4 fracture were retrospectively evaluated. Group A comprised 3 females, 10 males (mean age 10 years) and underwent open reduction on both bones. Group B comprised 4 females, 23 males (mean age 11 years) and underwent closed reduction on both bones. Group C comprised 3 females, 20 male (mean age 11 years,) and underwent open reduction on one bone and closed reduction on the other. The Gustilo -Anderson classification showed 15 patients Type 1 and 2 patients Type 2 op en fractures. Mean time to surgery was 4, 2, 2 days for Groups A,B, C. K -wires were used on all patients. Fixation was applied to both the radius and ulna. Mean follow-up periods were 38, 34, 39 months for Groups A, B, C. Results : Union was achieved on mean Day 47, 45, 46 in Groups A,B, C. Nails were removed on mean Day 53, 82 and 67 respectively. No statistically significant difference was determined between the groups in terms of age, time to surgery, nail removal and follow -up period, gender, side, etiol ogy or complications (p>0.05). No significant complications developed. Conclusion : In intramedullar fixation of paediatric unstable forearm diaphyseal fractures with K -wire, open or closed fracture reduction showed no statistical effect on the functional a nd radiological results.
Açıklama
Anahtar Kelimeler
Anestezi, Tıbbi Araştırmalar Deneysel, Ortopedi, Pediatri
Kaynak
Abant Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
4
Sayı
1
