Kabul Edilemez Angulasyonu Olan Çocuk Önkol Kırıkları: Remodelizasyon Etkili mi?

Year 2024, Volume: 46 Issue: 1, 125 - 130, 16.01.2024

Murat Danışman , Abdulsamet Emet , İsmail Aykut Koçyiğit , İbrahim Mehmet Göymen , Saygın Kamacı

https://doi.org/10.20515/otd.1391592

Abstract

Bu çalışmanın amacı literatüre göre aslında kabul edilemez angulasyona sahip olan hastalarda, remodelizasyon sonrası kalan deformiteyi ve bunun pronasyon/supinasyon kısıtlılığı ile ilişkisini incelemektir. 2014-2019 yılları arasında kapalı redüksiyon ve alçı ile tedavi edilmiş 45 hasta çalışmaya dahil edildi. Alçı çıkarılması sırasında çekilen radyografiler (T1) ve son kontroldeki remodelizasyon sonraki grafiler (T2) üzerinden radius ve ulnanın angulasyonları ölçülerek ön-arka veya yan grafilerde maksimum angulasyon miktarı belirlendi. Ortalama takip süresi 61.6 aydı (36-90 ay). Hastalar alçının çıkarıldığı gün (T1) çekilen radyografilerdeki angulasyona göre 2 gruba ayrıldı (Grup 1: kabul edilebilir angulasyon; Grup 2: kabul edilemez angulasyon). Grup 1'de T1'de maksimum angulasyon değerlerinin ortalaması 8.2 (±2.6) iken, Grup 2'de 15.4 (±4.1) idi (p=0.002). T2'de ortalama rezidü angülasyon değeri Grup 1'de 3.5 (±1.8) iken, Grup 2'de 6.8 (±3.1) idi (p=0.002). Grup 1'de 19 hastanın 7'sinde, Grup 2'de ise 26 hastanın 13'ünde pronasyon veya supinasyonda 10'den fazla kısıtlılık olduğu saptandı (p=0.382). Konservatif tedavi edilen çocuk önkol kırıkları kabul edilemez angulasyon derecelerinde olsa bile yüksek oranda normal derecelere iyileşme potansiyeline sahip olup, hastalarda oluşan pronasyon/supinasyon kısıtlılığı rezidü angulasyon dereceleri ile direkt ilişkili değildir.

Keywords

Radius ve ulna kırığı, Kırığın kapalı redüksiyonu, Anormal kaynama, Kemik remodelizasyonu.

Pediatric Forearm Fractures with Unacceptable Angulation: Is Remodeling Effective?

Abstract

The aim of this study is to examine the remaining deformity after remodeling and its relationship with pronation/supination limitation in patients with unacceptable angulation according to the literature. 45 patients who had forearm fractures treated with closed reduction and plaster cast between 2014 and 2019 were included in the study. The maximum angulation amount was determined on anteroposterior or lateral radiographs by measuring the angulation of the radius and ulna on the radiographs taken during plaster removal (T1) and on the radiographs after remodeling (T2) at the last follow-up. The average follow-up period was 61.6 months (36-90 months). The patients were divided into 2 groups according to the angulation in the radiographs taken on the day the cast was removed (T1): Group 1 (acceptable angulation), and Group 2 (unacceptable angulation). While the average of maximum angulation values at T1 in Group 1 was 8.2 (±2.6) it was 15.4 (±4.1) in Group 2 (p = 0.002). While the mean residual angulation value at T2 was 3.5 (±1.8) in Group 1, it was 6.8 (±3.1) in Group 2 (p = 0.002). It was determined that 7 of 19 patients in Group 1 and 13 of 26 patients in Group 2 had a limitation of more than 10° (p = 0.382). Conservatively treated pediatric forearm fractures have the potential to heal to normal degrees at a high rate after remodeling, even if they have unacceptable angulation degrees, and the pronation/supination limitation in these patients is not directly related to the residual angulation degrees.

Keywords

Radius and ulna fracture, Closed fracture reduction, Malunion, Bone remodeling.

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