Comparıson Of Platıng And Tıtanıum Elastıc Naıl Fıxatıon For Surgıcal Treatment Of Pedıatrıc Both-Bone Forearm Fractures

Year 2018, , 64 - 68, 02.07.2018

Erdinç Genç , İsmet Yalkın Çamurcu , Erdal Eren

https://doi.org/10.30565/medalanya.364191

Cited By: 1

Abstract

Aim: Plate fixation and titanium elastic nailing are conventional surgical treatment modalities for both-bone forearm fractures in children. The purpose of this study is to assess the functional and radiographic results of these techniques and compare with literature. 

Patient and Methods: We evaluated data of 36 children retrospectively. Twelve of the patients (group 1; 1 girls, 11 boys, age range 9-15 years) were treated by open reduction plate fixation and 24 of the children (group 2; 3 girls, 21 boys, age range 9-14 years) were treated by closed reduction intramedullary nailing. Mean total time from fracture until the surgery was 4.3 and 6.1 days in group 1 and 2, respectively. We compared the groups according to union duration, the number and the severity of the complications and clinical outcomes according to Price criteria.

Results: Mean follow-up duration was 22.0 months in group 1 and 19.7 months in group 2. Mean age was 13.0±1.2 years and 11.7±1.6 years in group 1 and 2, respectively. According to Price criteria, we obtained no poor outcomes in both groups. The rate of excellent outcome was 75% and 87.5 % in group 1 and 2, respectively. Union was obtained in 7.6 weeks and 6.7 weeks in group 1 and 2, respectively; this difference was statistically significant (p<0.001). The rate of major complication was 8.3% in group 1. There were none in group 2. 

Conclusion: According to our results, a favorable technique for pediatric both-bone forearm fractures requiring surgical treatment may be titanium elastic nailing because of better clinical outcomes and fewer and less severe complications. 

Keywords

titanium elastic nail, pediatrics, plate, bothbone forearm

Pediatrik Önkol Çift Kırıklarında Plak Osteosentez Ve Titanyum Elastik Çivi Tedavilerinin Karşılaştırılması

Abstract

 Amaç: Bu çalışmanın amacı cerrahi tedavi gerektiren çocukluk çağı önkol çift kırıklarında yaygın kullanılan iki yöntem olan plak osteosentez ve titanyum elastik çivi kullanımın fonksiyonel ve radyografik sonuçlarının değerlendirilmesi ve literatürdeki verilerle karşılaştırılmasıdır. 

Hastalar ve Yöntem: Düzenli takipleri yapılan 36 hasta geriye dönük olarak değerlendirildi. Bu hastaların 12’sine (grup 1; 1 kız, 11 erkek; yaş dağılımı 9-15 yaş) açık redüksiyon plak-vida osteosentez, 24’üne (grup 2; 3 kız, 21 erkek; yaş dağılımı 9-14 yaş) kapalı redüksiyon intramedüller çivileme yapıldı. Yaralanmadan cerrahi müdahaleye kadar geçen ortalama süre grup 1’de 4.3 gün, grup 2’de 6.1 gün idi. Gruplar kaynama süresi, komplikasyon sayısı ve ciddiyeti ve Price kriterlerine göre değerlendirilen klinik sonuçlarına göre karşılaştırıldı. 

Bulgular: Hastaların takip süresi Grup 1’de 22.0 ay, Grup 2’de 19.7 aydı. Hastaların ortalama yaşı Grup 1’de 13.0±1.2, Grup 2’de 11.7±1.6 idi. Price kriterlerine göre her iki grupta da kötü sonuç saptanmadı. Grup 1’de mükemmel sonuç oranı %75 iken Grup 2’de mükemmel sonuç oranı %87.5 olarak saptandı. Grup 1’de kaynama süresi 7.6 hafta, Grup 2’de kaynama süresi 6.7 hafta olarak gözlendi; bu fark istatistiksel olarak anlamlı idi (p<0.001). Grup 1’de major komplikasyon oranı %8.3 olarak saptanırken Grup 2’de major komplikasyon saptanmadı. 

Sonuç: Sonuçlarımıza göre cerrahi tedavi gerektiren çocukluk çağı ön kol çift kırıklarında öncelikli tedavi yöntemi olarak gerek klinik sonuçlarının daha iyi olması gerekse komplikasyon sayısı ve ciddiyetinin daha az olması nedeniyle titanyum elastik çivi uygulaması tercih edilebilir.

Keywords

titanyum elastik çivi, pediatri, plak, önkol kırıkları

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