Yetişkin ön kol kırıklarının cerrahi tedavisi
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Tarih
2001
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info:eu-repo/semantics/openAccess
Özet
Amaç: Cerrahi tedavi uygulanılan yetişkin ön kol cisim kırıklarının etyolojisini ve cerrahi sonrası sonuçlarını incelemek. Hastalar ve Metod: Biyolojisinde düşme ve trafik kazasının ilk iki sırada yer aldığı 88 yetişkin hastanın 82'si kapalı, 6'sı açık ön kol cisim kırıklarına cerrahi tedavi uygulandı. Kapalı kırıkların tedavisinde semitubuler plak, DCP, düz plak, Mennen plağı ve intramedüller fıksasyon uygulandı. Açık kırıklarda ise eksternal fiksatör kullanıldı. Bulgular: 74'ü erkek, 14'ü kadın olan 88 hastanın yaş ortalamaları 18.4 (14-62 yıl) idi. Tüm olguların hastanede yatış süresi ortalama 18.0 gün, cerrahiye kadar geçen süre ise 7.8 (3 ila 10 gün) gündü. Ortalama 57.3 (6-107) ay takip edilen tüm olguların kaynama süresi 17.1, semitubuler plak kullanılan hastalarda ise 16.8 hafta idi. 70'i kapalı, 6'sı açık kırıklı 76 hastada Anderson ve arkadaşlarının kriterlerine göre %73.9 olguda mükemmel, %14.8 olguda başarılı olmak üzere toplam % 88.7 oranında başarılı sonuç elde edildi. Plak gevşemesi ve redüksiyon kaybı 5 (%5.7), geç kaynama l olguda (%1.1) izlenirken, beşi yüzeysel, biri derin olmak üzere 6 (%6.8) enfeksiyon tedavi sırasında görülen komplikasyonlardı. Sonuç: Literatürde başarılı sonuçları bildirilen kompresyonlu plak uygulaması bizim serimizde de başarılı izlendi. Yetersiz fıksasyon ve ince olması nedeni ile alçı içerisinde dahi kırılabildiği bildirilen semitubuler plağın bu komplikasyonu olgularımızdan birinde izlendi. Tip I ve Tip II açık kırıklarda açık redüksiyon internal fıksasyon yerine hastalarımızın sosyokültürel yapıları ve bu kırıkların çoğunun kontamine olması nedeni ile tercih ettiğimiz dinamik aksiyel eksternal fıksatörle başarılı sonuç elde ettik.
Purpose: To evaluate the forearm fractures that underwent surgical treatment in terms of etiology and surgical outcome. Patients and Methods: Eighty-eight adults with forearm fractures undenvent surgical treatment. Falls and traffic accidents were the most frequent two causes. Out of 88 fractures, the mode of treatment was closed in 82, open in 6. Semitubuler plate, DCP, plate plaque, Mennen's plate and intermedullary fixation were used in the treatment of close fractures. External fixators were used in cases with open fractures. Results: Seventy-four patients were male and 14 were female. The mean age of the patients was 18.4 (14-62 years). Fracture duration was 7.8 (3-10) days and the mean hospitalization period was 18.0 days. The mean postoperative follow-up was 51.3 (6-107) months. The mean time required for union was 17.1 weeks for all cases. This time was 16.8 weeks in cases with a semitubular plate. According to Anderson' criteria, the rate of perfect cases was 73.9, the rate of successful cases was %14.8 and the overall succes rate was %88.7. The complications were loosened plate and failed reduction (5.6%), delayed union (1.1%), superficial infection (5.6%), deep infection (1.1%) Conclusion: The successful outcome was reached by compression plating in the forearm fractures in adults. Due to insufficient fixation and thinness even in cast, a semitubuler plate was broken in one of our cases. Because of the social status of the patients and presence of contamination, we applied external fixation in Type I and II open fractures instead of open reduction and internal fixation.
Purpose: To evaluate the forearm fractures that underwent surgical treatment in terms of etiology and surgical outcome. Patients and Methods: Eighty-eight adults with forearm fractures undenvent surgical treatment. Falls and traffic accidents were the most frequent two causes. Out of 88 fractures, the mode of treatment was closed in 82, open in 6. Semitubuler plate, DCP, plate plaque, Mennen's plate and intermedullary fixation were used in the treatment of close fractures. External fixators were used in cases with open fractures. Results: Seventy-four patients were male and 14 were female. The mean age of the patients was 18.4 (14-62 years). Fracture duration was 7.8 (3-10) days and the mean hospitalization period was 18.0 days. The mean postoperative follow-up was 51.3 (6-107) months. The mean time required for union was 17.1 weeks for all cases. This time was 16.8 weeks in cases with a semitubular plate. According to Anderson' criteria, the rate of perfect cases was 73.9, the rate of successful cases was %14.8 and the overall succes rate was %88.7. The complications were loosened plate and failed reduction (5.6%), delayed union (1.1%), superficial infection (5.6%), deep infection (1.1%) Conclusion: The successful outcome was reached by compression plating in the forearm fractures in adults. Due to insufficient fixation and thinness even in cast, a semitubuler plate was broken in one of our cases. Because of the social status of the patients and presence of contamination, we applied external fixation in Type I and II open fractures instead of open reduction and internal fixation.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp
Kaynak
Adnan Menderes Üniversitesi Tıp Fakültesi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
2
Sayı
2
Künye
Midillioğlu, M. R., Ekşioğlu, F. (2001). Yetişkin ön kol kırıklarının cerrahi tedavisi. Adnan Menderes Üniversitesi Tıp Fakültesi Dergisi, 2(2), 5 - 9.
