DLT çivisi uygulanan intertrokanterik femur kırıklarının tedavi sonuçları
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Tarih
2015
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info:eu-repo/semantics/openAccess
Özet
Amaç: İntramedüller çiviler proksimal femur kırıklarında yaygın olarak uygulanmaktadır. Bu çalışmada, intertrokanterik femur kırığı nedeni ile DLT çivisi uygulanan 49 hastanın klinik ve radyolojik sonuçları değerlendirilmiştir. Yöntemler: Hastaların 22 (%44,9)si erkek, 27(%55,1)si kadındı. Yaş ortalaması 74.291.98 (28-99) yıl, ortalama takip süresi 14.353.43 (9-24) ay idi. Kırık 37 (%75,6) hastada basit düşme, 6 (%12,2) hastada trafik kazası, 6 (%12,2) hastada yüksekten düşme sonucu gelişti. Hastaların 25 (%51,0)inde sağ, 24 (%49,0)ünde sol intertrokanterik kırık mevcuttu. Orthopaedic Trauma Association sınıflamasına göre 21 (%42,9) hasta 31A1, 21 (%42,9) hasta 31A2, 7 (%14,2) hasta 31A3 idi. Ek patoloji olarak hastaların 1 (%2,0)inde klavikula kırığı, 3 (%6,1)ünde radius alt uç kırığı ve 1 (%2,0)inde aynı taraf total diz protezi mevcuttu. Operasyon sonrası radyolojik değerlendirmede direk grafi, fonksiyonel değerlendirmede Harris kalça skorlama sistemi kullanıldı. Bulgular: Hastalara ortalama 2.020.18 (1-7) günde cerrahi uygulandı. Ortalama hastanede kalış süresi 6.230.29 (4-15) gün idi. Tip apeks mesafesi ortalama 19.610.52 (13-28) mm idi. Ortalama kaynama süresi 11.741.82 (8- 15) hafta idi. Üç (%6,1) hastada implant yetmezliği gelişti ve bu hastalara parsiyel kalkar destekli kalça protezi uygulandı. Ortalama Harris kalça skoru 88.021.21(42-97) idi ve buna göre hastaların 29 (%59,2)u mükemmel, 17 (%34,7)u iyi, 3 (%6,1)i kötü sonuçtu. Sonuç: Düşük komplikasyon oranı ve güçlü tespit sağ- layan DLT çivisi intertrokanterik kırıkların tedavisinde başarılı ve güvenli bir uygulamadır.
Objective: Intramedullary nails frequently use in proximal femur fractures. In this study, 49 patients with intertrochanteric fractures were evaluated clinical and radiological results treated with dyna locking trochanteric (DLT) nail retrospectively. Methods: Twenty-two (44.9%) patients were male and 27 (55.1%) patients were female. Mean age was 74.29±1.98 (28-99) years and Followed up for a mean of 14.35±3.43 (9-24) months. Thirty-seven (75.6%) of the fractures resulted from simple falls while 6 (12.2%) caused from traffic accidents and 6 (12.2%) fall down from height. There were 24 (49.0%) left and 25 (51.0%) right lower extremities fractured. According to Orthopaedic Trauma Association classification system; 21 (42.9%), 21 (42.9%) and 7 (14.2%) fractures were classified as 31A1, 31A2, and 31A3 respectively. One (2.0%) patient had claviculae fracture, 3 (6.1%) patients had radius distal fracture and 1 (2.0%) patient had total knee arthroplasty. After surgery, X-ray was used for radiological results and functional outcomes were evaluated according to the Harris hip scoring system. Results: The average waiting time for the surgery was 2.02±0.18 (1-7) days and hospitalization time was 6.23±0.29 (4-15) days. Mean fracture healing time was 11.74±1.82 (8-15) weeks. Three patients had screw cut-out in the follow-up time and performed hemiarthroplasty. The average Harris hip score was 88.02±1.21 (42- 97) points and included 29 (59.2%) excellent cases, 17 (34.7%) good and 3 (6.1%) poor. Conclusion: DLT nail is a safe and successful method because of low complication rates, and capability of detection.
Objective: Intramedullary nails frequently use in proximal femur fractures. In this study, 49 patients with intertrochanteric fractures were evaluated clinical and radiological results treated with dyna locking trochanteric (DLT) nail retrospectively. Methods: Twenty-two (44.9%) patients were male and 27 (55.1%) patients were female. Mean age was 74.29±1.98 (28-99) years and Followed up for a mean of 14.35±3.43 (9-24) months. Thirty-seven (75.6%) of the fractures resulted from simple falls while 6 (12.2%) caused from traffic accidents and 6 (12.2%) fall down from height. There were 24 (49.0%) left and 25 (51.0%) right lower extremities fractured. According to Orthopaedic Trauma Association classification system; 21 (42.9%), 21 (42.9%) and 7 (14.2%) fractures were classified as 31A1, 31A2, and 31A3 respectively. One (2.0%) patient had claviculae fracture, 3 (6.1%) patients had radius distal fracture and 1 (2.0%) patient had total knee arthroplasty. After surgery, X-ray was used for radiological results and functional outcomes were evaluated according to the Harris hip scoring system. Results: The average waiting time for the surgery was 2.02±0.18 (1-7) days and hospitalization time was 6.23±0.29 (4-15) days. Mean fracture healing time was 11.74±1.82 (8-15) weeks. Three patients had screw cut-out in the follow-up time and performed hemiarthroplasty. The average Harris hip score was 88.02±1.21 (42- 97) points and included 29 (59.2%) excellent cases, 17 (34.7%) good and 3 (6.1%) poor. Conclusion: DLT nail is a safe and successful method because of low complication rates, and capability of detection.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Dicle Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
42
Sayı
4
