Intraintrameduller çivi ile tedavi edilmiş distal tibia kırıklarının dizilim bozukluğu açısından incelenmesi. Evaluation of the distal tibial fractures treated with intramedullary nailing in terms of malalignment

Year 2018, , 968 - 979, 15.08.2018

Serdar Yüksel

https://doi.org/10.30569/adiyamansaglik.449026

Abstract

 

AMAÇ: Çalışmamızda
intramedüller çivileme ile tedavi edilmiş AO/OTA tip 43 A1, A2, A3 distal tibia
kırıklarının dizilim bozukluğu açısından sonuçlarını değerlendirmeyi
amaçladık. 
YÖNTEM : İntramedüller çivileme ile
tedavi edilmiş AO/OTA tip 43A1, A2, A3 distal tibia kırığı olan 55 hasta (38
erkek, 17 kadın, ortalama yaş 41.3±15.3, ortalama takip süresi 35.1±9 hafta);
retrospektif olarak değerlendirildi. Hastaların kırık kaynama durumu, kaynama
zamanı, komplikasyonlar ve kaynama durumları değerlendirildi. Klinik
değerlendirme için Olerud-Molander skoru kullanıldı. 
BULGULAR: Tüm hastalarda kaynama
sağlandı. Ortalama Olerud-Molander skoru 88.5 ± 8 idi. Ortalama varus
açılanması 0.6 ± 1.4°, ortalama valgus açılanması 2.1 ± 1.9°, ortalama
rekurvatum açılanması 0.7 ± 1.2°, ortalama prokurvatum açılanması 0.3 ± 0.7°,
ortalama rotasyon açısı ise 0.5 ± 1.4° olarak bulundu. İki hastada (%3.6)
varus, 6 hastada (%10.9) valgus, 1 hastada (%1.8) rekurvatum and 3 hastada
(%5.5) rotasyonda yanlış kaynama tespit edildi. 

 SONUÇ: İntramedüller çivileme ile
tedavi edilmiş distal tibia kırıklarında başarılı sonuçlar elde edilmiştir.
Bununla birlikte, dizilim problemleri, valgus dizilim bozukluğu nadir görülen
komplikasyonlar değildir(%10.9). Bu komplikasyonların engellenmesinde; cerrahi
tedavi esnasında dikkatli değerlendirme ve farklı teknikler
gerekebilmektedir. 

Keywords

Distal tibia kırığı, intrameduller çivileme

Evaluation of the distal tibial fractures treated with intramedullary nailing in terms of malalignment

Abstract

Background:
The
aim of the present study was to evaluate outcomes of distal tibia fractures
AO/OTA 43 A1, A2, A3 whom we have treated through intramedullary nailing
especially for alignment disorders.

Materials
and Methods: Fifty-five
patients with distal tibia fractures AO/OTA type 43A1, A2, A3 (38 males, 17
females, mean age 41.3±15.3
years, mean follow-up period 35.1±9
weeks) who were treated through intramedullary nailing were evaluated
retrospectively.  Fracture union status,
union time, complications and alignment disorders of the patients were
evaluated. Olerud-Molander score was used for clinical evaluation.

Results:
Union
was achieved in all patients. Mean Olerud-Molander score was 88.5 ± 8. Mean varus angle
was 0.6 ±
1.4°, mean valgus angle was 2.1 ±
1.9°, mean recurvatum angle was 0.7 ±
1.2°, mean procurvatum angle was 0.3 ±
0.7°, mean rotation angle was 0.5 ±
1.4°. Two patients (3.6%) had varus malunion; 6 patients (10.9%) had valgus
malunion, 1 patient (1.8%) had recurvatum malunion and 3 patients (5.5%) had
rotation malunion.

Conclusion:
Successful
results are obtained by intramedullary nailing treatment of distal tibia
fractures. However, alignment problems, valgus alignment disorder in particular
are not a rare complication (10.9%).  A
careful evaluation during surgical treatment and different techniques may help
to prevent this complication. 

Keywords

tibial fracture, fracture fixation, tibia

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