Opere edilmiş çocuk suprakondiler humerus kırıklarının orta-uzun dönem sonuçları
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Tarih
2016
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Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Opere Edilmiş Çocuk Suprakondiler Humerus Kırıklarının Orta-Uzun Dönem Sonuçları Giriş ve Amaç: Günümüzde Suprakondiler humerus kırıkları çocukların en sık maruz kaldığı kırıklardan biridir. Ortopedistlerin sıkça karşılaştığı ve karşılaşmaktan bir o kadar çekindiği bu kırıklar gerek dirseğin komplike nörovasküler anatomik yapısı gerekse ameliyat öncesi ve sonrası sık komplikasyon oranı ile ortopedinin en zor pratiklerindendir. Çalışmamızda kliniğimizde cerrahi olarak tedavi edilmiş olan suprakondiler humerus kırığı olgularında tedavinin orta-uzun dönemdeki sonuçlarını güncel literatür eşliğinde tartışarak sunmayı amaçladık. Gereç ve Yöntem: Çalışmamızda 2008-2015 tarihleri arasında suprakondiler humerus kırığı nedeni ile kliniğimizde cerrahi tedavi edilmiş hastalar telefon ile son kontrollere davet edildi. Davete uyarak polikliniğimize başvuran ; fizik muayeneleri, grafi kontrolleri ve ölçümleri yapılan 46 hasta değerlendirildi. Bulgular: Hastaların 23'ü (%50'si) erkek, 23'ü(%50'si) kız idi. Hastaların yaş ortalaması 6.52 idi. Hastaların 14'üne (%30) kapalı redüksiyon , 32'sine (%70) açık redüksiyon ve perkütan pinleme uygulandı. Hastaların taşıma açıları, eklem hareket açıklıkları, Baumann, humeroulnar ve lateral humerokapitellar açıları ölçüldü ve sağlam dirsekle mukayese edildi. Hastalar Flynn kriterleri ve Mayo dirsek performans skoruna göre değerlendirildi. Flynn kozmetik değerlendirmesine göre 29 hasta(%63) mükemmel, 10 hasta(%21.7) iyi, 2 hasta (%4.3) orta ve 5 hasta(%10.9) ise kötü olarak bulundu. Flynn fonksiyonel skorlamasında ise 42 hasta (%91.3) mükemmel, 1 hasta (%2.2) iyi, 1 hasta (%2.2) orta ve 2 hasta(%4.3) ise kötü olarak bulundu. Mayo dirsek Performans skorlarına göre değerlendirdiğimizde ise 29(%63) hasta çok iyi, 16 hasta(%34.8) iyi, 1(%2.2) hasta ise orta olarak bulundu. Sonuç: Suprakondiler humerus çocuk kırıkları ortpedinin en zor ve meşakkatli konularından biridir. Açık/Kapalı redüksiyon, Lateral/Medial Kirschner teli ile pinleme sonuçları birbirine yakındır. Cerrah kendini güvende hissettiği ve en iyi bildiği metodla redüksiyon sağlamaya çalışmalı ve en az komplikasyonla hastaları tedavi etmelidir.
Mid-Long term results of surgically treated pediatric humerus supracondylar fractures Abstract: Supracondylar humerus fractures are one of the most common fractures of children. These fractures are one of the hardest issues of Orthopeaedic Surgeons who don't like to face with due to the complicated neurovasculer anatomy of the elbow and too much complication rate of them pre and post operatively. In our study we compared the surgically treated supracondylar fractures of humerus with healthy elbow and aimed to see the functional and cosmetic mid-long term results in the light of the literature. Material and Methods: The surgically treated patients who had pediatric supracondylar fracture of humerus invited to our clinic for last examination by telephone. 46 patients who had accepted our invitation and examined in our outpatient clinics ; evaluated clinically and radiologically. Results: Twenty three (%50) of the patients were male and 23 (%50) of them were female. The mean age of the patients were 6.52. 14 (%30) of the patients were treated with closed reduction however , 32 (%70) of them were terated with open reduction. Patients' elbows' carrying angles, range of motions , Baumann's angles, humeroulnar angles and lateral humerocapitellar angles were measured and compared with the healthy sides. Patients were evaluated with Flynn's Criteria and Mayo Elbow Perfomance Scores. 29 patients (%63) were perfect, 10 patients (%21.7) were good, 2 patients (%4.3) were moderate and 5 patients (%10.9) were bad for Flynn's cosmetic scores ; 42 patients (%91.3) were perfect, 1 patient (%2.2) was good, 1 patient (%2.2) was moderate and 2 patients (%4.3) were bad for Flynn's functional scores. 29(%63) patients were very good, 16 patients (%34.8) were good and 1(%2.2) patient was moderate for Mayo Elbow Performance Score. Conclusion: The pediatric supracondylar humerus fractures are one of the most complicated and hard topics of Orthopaedics and Traumatology. Results of the treatment with Open/Closed reduction, Lateral/Medial pinning with Kirschner wires are close to each other. The final word is ; the surgeon has to choose the way that he/she best knows , try the best possible reduction of the fracture and treat the patients with the lowest complication.
Mid-Long term results of surgically treated pediatric humerus supracondylar fractures Abstract: Supracondylar humerus fractures are one of the most common fractures of children. These fractures are one of the hardest issues of Orthopeaedic Surgeons who don't like to face with due to the complicated neurovasculer anatomy of the elbow and too much complication rate of them pre and post operatively. In our study we compared the surgically treated supracondylar fractures of humerus with healthy elbow and aimed to see the functional and cosmetic mid-long term results in the light of the literature. Material and Methods: The surgically treated patients who had pediatric supracondylar fracture of humerus invited to our clinic for last examination by telephone. 46 patients who had accepted our invitation and examined in our outpatient clinics ; evaluated clinically and radiologically. Results: Twenty three (%50) of the patients were male and 23 (%50) of them were female. The mean age of the patients were 6.52. 14 (%30) of the patients were treated with closed reduction however , 32 (%70) of them were terated with open reduction. Patients' elbows' carrying angles, range of motions , Baumann's angles, humeroulnar angles and lateral humerocapitellar angles were measured and compared with the healthy sides. Patients were evaluated with Flynn's Criteria and Mayo Elbow Perfomance Scores. 29 patients (%63) were perfect, 10 patients (%21.7) were good, 2 patients (%4.3) were moderate and 5 patients (%10.9) were bad for Flynn's cosmetic scores ; 42 patients (%91.3) were perfect, 1 patient (%2.2) was good, 1 patient (%2.2) was moderate and 2 patients (%4.3) were bad for Flynn's functional scores. 29(%63) patients were very good, 16 patients (%34.8) were good and 1(%2.2) patient was moderate for Mayo Elbow Performance Score. Conclusion: The pediatric supracondylar humerus fractures are one of the most complicated and hard topics of Orthopaedics and Traumatology. Results of the treatment with Open/Closed reduction, Lateral/Medial pinning with Kirschner wires are close to each other. The final word is ; the surgeon has to choose the way that he/she best knows , try the best possible reduction of the fracture and treat the patients with the lowest complication.
Açıklama
YÖK Tez No: 435497
Anahtar Kelimeler
Ortopedi ve Travmatoloji, Orthopedics and Traumatology, Cerrahi tedavi, Surgical treatment, Humeral kırıklar, Humeral fractures, Humerus, Humerus, Kırık fiksasyonu, Fracture fixation, Kırıklar-kemik, Fractures-bone, Ortopedi, Orthopedics, Yaralar ve yaralanmalar, Wounds and injuries, Çocuklar, Children, Humerus kırıkları, Travma, Kirschner Teli, Humeral Fractures, Trauma, Kirschner Wires
