Parçalı proksimal humerus kırıklarının tedavisinde çimentolu ile çimentosuz hemiartroplasti sonuçlarının karşılaştırılması

Year 2018, Volume: 10 Issue: 3, 263 - 267, 30.09.2018

Ercan Şahin , Mahmut Kalem , Murat Songür Baver Acar Hakan Kocaoğlu

https://doi.org/10.21601/ortadogutipdergisi.453456

Abstract

Amaç: Bu çalışmamızda parçalı proksimal humerus kırığı sonrasında
hemiartroplasti yapılan ileri yaş hastalarda çimentolu ve çimentosuz
uygulamalarımızın sonuçlarını karşılaştırmayı amaçladık.

Gereç ve Yöntem: 2008 ile 2014 yılları arasında, parçalı
proksimal humerus kırığı nedeniyle hemiartroplasti yapılan hastalar iki
üniversite hastanesinin bilgi sistemi kullanılarak retrospektif olarak
araştırıldı ve en az 2 yıllık takibi olan hastalar çalışmaya alındı. Son
takiplerinde muayene bilgileri olmayan, telefon ile ulaşılamayan ve patolojik
veya açık kırığı olan hastalar değerlendirmeye alınmadı. Hastaların demografik
bilgileri, kırık tipi, son takipte fonksiyonel sonuç, son takipte vizüel analog
skala skoru ve ameliyatından memnuniyeti, son takipte radyolojik değerlendirme,
ortalama takip süresi ve komplikasyonlar çimentolu ile çimentosuz uygulamalarda
karşılaştırılarak not edildi.

Bulgular: Çalışmamızın kriterlerini karşılayan toplam 22 hasta (12 erkek, 10
kadın)(ortalama yaş: 76,4 yıl, aralık: 67-88) 
çalışmaya dahil edildi. 8 hastada çimentosuz, 14 hastada ise çimentolu
hemiartroplasti yapılmış ve ortalama takip süresi 38 ay idi. Ortalama öne
elevasyon, eksternal rotasyon ve internal rotasyon derecesi çimentosuz
hemiartroplasti yapılan hastalarda daha iyi olmakla beraber her iki grup
arasında fonksiyonel açıdan anlamlı fark bulunamadı. Yine çimentosuz
hemiartroplasti gurubunda ortama vizüel analog skala skoru 0,87±1,12 iken
çimentolu grupta ortalama vizüel analog skala skoru 1,28±0,91 idi ve anlamlı
bir fark bulunamadı (p=0,33). Radyolojik değerlendirmede gruplar arasında
anlamlı fark yoktu. Çimentolu ve çimentosuz hemiartroplasti yapılan hasta
gruplarında 1’er hastada periprostetik kırık görülürken, çimentosuz grubunda 1
hastanın omuzunda sıkılık, çimentolu grubunda ise yine 1 hastada derin doku
enfeksiyonu saptandı.

Sonuç: Proksimal humerus kırığı sonrası hemiartroplasti yapılan
hastalarımızda çimentolu ve çimentosuz uygulamalarımızın fonksiyonel ve
radyolojik sonuçları en az 2 yıllık takiplerinde benzer olarak
bulunmuştur.  

Keywords

Proksimal humerus kırığı, hemiartroplasti, çimento, omuz

Comparison of cemented and uncemented hemiarthroplasty results in the treatment of comminuted displaced proximal humeral fractures

Abstract

Aim: In this study, we aimed to compare the results
of cemented and uncemented hemiarthroplasty results in elderly patients for the
treatment of comminuted proximal humerus fractures.

Material
and Method: Between 2008 and 2014, patients who
underwent hemiarthroplasty  due to comminuted
proximal humerus fracture were retrospectively investigated using the data
system of two university hospitals. Patients who were followed for at least 2
years were included. Demographic information of the patients, fracture type, functional
results at final follow-up, visual analog scale score and satisfaction status,
radiological results, mean follow-up time and complications were noted.

Results:
A total of 22 patients (12 males, 10 females) (mean age: 76.4 years, range:
67-88)(8 cemented hemiarthroplasty, 14 uncemented hemiarthroplasty) were
included. The mean follow-up time was 38 months. Although the mean forward
elevation, external rotation and internal rotation were better in patients who
underwent uncemented hemiarthroplasty, no significant difference was found
between the two groups. The mean visual analog scale score in uncemented hemiarthroplasty
group was 0.87 ± 1.12, whereas the mean visual analog scale score in cemented
group was 1.28 ± 0.91 and no significant difference was found (p = 0.33). At radiologic
evaluation, no significant difference was found. Periprosthetic fracture was
seen in 1 patient of both groups. We have seen 1 shoulder stiffness in
uncemented group and 1 deep tissue infection in cemented hemiarthroplasty group.

Conclusion:
The functional and radiological results of our cemented and uncemented HA patients
were similar for the treatment of comminuted proximal humerus fractures in at
least 2 years follow-up.

Keywords

Proximal humerus fracture, hemiarthroplasty, cemented, shoulder

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