Distal tibia kırıklarında minimal invasiv plak osteosentez sonuçları

Year 2017, Volume: 42 Issue: 3, 518 - 525, 30.09.2017

Osman Çiloğlu , Fırat Seyfettinoğlu , Hakan Çiçek , Ahmet Yılmaz , Fatma Feride Görgülü Ümit Tuhanioğlu , Hasan Ulaş Oğur

https://doi.org/10.17826/cutf.290352

Cited By: 1

Abstract

Amaç: Bu çalışmanın amacı distal tibia kırığı nedeniyle minimal invaziv yöntem ve biyolojik fiksasyon prensipleri ile plak kullanarak osteosentez uyguladığımız olgularda klinik, radyolojik sonuç ve komplikasyonların değerlendirilmesidir.

Gereç ve Yöntem: Bu çalışmada distal tibia kırığı nedeniyle minimal invaziv yöntem ve biyolojik fiksasyon prensipleri ile ameliyat olan 58 hasta (35 erkek, 23 bayan, ortalama yaş 32) ortalama 28 aylık  takibleri sonucunda değerlendirildi. Hastaların kırıkları AO/OTA  sınıflamasına göre değerlendirildi. Buna göre 16 hastada A1 (%27.6), 13 hastada A2 (%22.4), 14 hastada B1 (%24.1), 11 hastada B2 (%19), 4 hastada ise C1 (%6.9) tipi kırık mevcuttu. Tüm hastalarda kırıkların kaynama sonuçları, aktiviteye dönüşleri, ayak bileği hareket açıklıkları, enfeksiyon ve komplikasyonlar Johner ve Wruhs kriterlerine göre değerlendirildi.

Bulgular: Hastalarda kırıkların ortalama kaynama süresi 13 hafta (11-24 arası) idi. Tüm olgularımızda kaynama elde edilirken bir hastada gecikmiş kaynama görüldü. Hiçbir olgumuzda enfeksiyon ve yara yeri problemi görülmedi. İki olguda kaynama sonrasında 5 derece varus deformitesi tespit edildi. Dört olgumuzda diğer ayağa kıyasla 5 derece, 4 olguda ise 10 derece dorsifleksiyon kaybı görüldü. Sonuç olarak Johner ve Wruhs değerlendirme kriterlerine göre 48 hasta mükemmel (%82.75), 10 hasta (%17.25) iyi olarak değerlendirildi.

Sonuç: Yumuşak doku azlığı, zayıf vaskülarizasyon gibi nedenlerden dolayı komplikasyonla karşılaşma oranının yüksek olduğu distal tibia kırıklarında, minimal invaziv yöntem ve biyolojik plaklama prensipleri ile başarılı sonuçlar alınabilmektedir.

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Keywords

Distal Tibia Kırığı, Biyolojik fiksasyon, Minimal invaziv cerrahi

Outcome of minimal invasive plate osteosynthesis in distal tibia fractures

Abstract

Purpose: The aim of this study was to evaluate clinical, radiological and complication results in cases of osteosynthesis using plate by minimally invasive methods and biologic fixation principles due to distal tibia fracture.

Materials and Methods: In this study, 58 patients (35 males, 23 females, mean age 32 ) who underwent surgery by minimally invasive method and biologic fixation principles due to distal tibial fracture were included. Patients were followed for an average of 28 months . Fractures were classified according to AO/OTA classification. 16 patients were classified as A1 (27.6%), 13 patients classified as A2 (22.4%), 14 patients classified as B1 (24.1%), 11 patients classified as B2 (19%) and 4 patients were classified as C1 (%6.9)  according to AO classification. All patients fractures, union results, return to activity, ankle range of motion, infection and complication were evaluated according to the criteria of Johner and Wruhs.

Results: Mean union time of fractures was 13 weeks (11-24). In all our cases, union was achieved. Delayed union was observed in only one patient. There was no infection or wound problem in any of our cases. In four cases, dorsiflexion loss was seen at 5 degrees compared to the other foot and 10 degrees at 4 other cases.  48 patients were evaluated excellent (82.75%) and 10 patients (17.25%) were evaluated good according to Johner and Wruhs evaluation criteria.

Conclusion: Successful clinical and radiologic results can be obtained by using the minimally invasive methods and biological fixation principles in distal tibia fractures which has high complication rates due to soft tissue weakness and weak vascularization.

Keywords

Distal tibia fractures, Biological fixation method, Minimal invasive surgery

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