Outcomes of reduction and plate fixation in hand phalanx fractures

Yıl 2019, Cilt: 44 Sayı: Ek 1, 427 - 433, 29.12.2019

Çağrı Özcan

https://doi.org/10.17826/cumj.560382

Öz

Purpose: The aim of this study is to evaluate the radiological and functional results of open reduction, mini plate fixation in multifragmanter, shortness and followed by loss of reduction in the fractures of the phalanx,

Materials and Methods: Between 2008 and 2016, patients who underwent mini plate and screw fixation due to 28 phalangeal fractures in our hospital were evaluated retrospectively. 30 phalanges of 28 patients were included in the study. Quick Dash scores, Grip strength, Functional range of motion were examined. The duration of union, duration of stay, duration of surgery and complications were evaluated.

Results: The mean age of the patients was 37.3 (23-57) and the mean follow-up period was 23 (7-84) months. Quick Dash scores in the final follow-up of the patients were evaluated as 8.43 (0-27.5). The grip strength was 43 (25-60) kgW in the fracture and 47 (35-60) kgW in healthy. The total range of motion of the 3 joints of the patients (MP, PIP, DIP) was 240 ° (170 -270). The mean union time of the patients was 34.9 days (25-50). The mean duration of hospital stay was 1.45 days (1-3). The mean duration of surgery was 60.25 min (45-90). Functionally, 6 of 28 patients had joint stiffness and 1 rotation. Six patients were not satisfied with the surgery.18 patients complained of swelling of the fingers. 

Conclusion: The advantage of open reduction and plate fixation in phalangeal fractures is a rigid fixation and decreased labor loss in the early period. In the early postoperative period, starting hand movement is important for patients with limited mobility. Surgical treatment of multifragmanter, displacement and shortness phalangeal fractures provides an advantage in early period; Rotation and joint stiffness are the major problems that may be encountered after surgery.

Anahtar Kelimeler

Falanks, El kırıkları

El falanks kırıklarında açık redüksiyon ve plak ile fiksasyonun sonuçları

Öz

Amaç: Multifragmanter, kısalık oluşan ve takiplerinde redüksiyon kaybı görülen falanks kırıklarının açık redüksiyon, mini plak ile fiksasyonunun radyolojik ve fonksiyonel sonuçlarını degerlendirmektir.

Gereç ve Yöntem: 2008–2016 Yılları arasında hastanemizde 28 tane falanks kırığı sebebiyle mini plak ile fiksasyon yapılan hastalar retrospektif olarak incelenmiştir. 28 hastanın 30 falanksı çalışmaya dahil edilmiştir. Hastalar son kontrollerine geldiğinde Quick Dash skorları, kavrama kuvvetlerine, fonksiyonel eklem hareket açıklığına bakılmıştır. Hastaların kaynama süresi, yatış süresileri, cerrahi süre ve komplikasyonlar değerlendirilmiştir.

Bulgular: Hastaların ortalama yaşları 37.3(23–57) ortalama takip süresi 23 (7–84) aydır. Hastaların son kontrollerindeki Quick Dash skorları ortalama 8,43(0-27,5) olarak değerlendirilmiştir. Kavrama kuvveti kırık elde 43 (25-60) kgW, sağlıklı elde 47 (35-60) kgW olarak ölçüldü. Hastaların 3 ekleminin (MP, PİP, DİP) toplam hareket açıklığı 240°(170 –270) olarak ölçülmüştür. Hastaların ortalama kaynama süresi 34.9 gün (25-50) dür. Hastaların yatış süresi ortalama 1.45 Gün (1-3) dür. Cerrahi süresi ortalama 60.25 dk (45-90) dır. Klinik olarak 28 hastanın 6 tanesinde eklem sertliği 1 tanesinde rotasyon tespit edilmiştir. 6 hasta yapılan cerrahiden memnun olmadığı görülmüştür.18 hasta parmaklarında şişlik kalmasından şikayetçiydi. 

Sonuç: Falanks kırıklarında açık redüksiyon ve internal fiksasyon yapmanın avantajı rigit bir tespit erken dönemde iş gücü kaybının azalmasıdır. Hastalara cerrahi sonrası erken dönemde hareket başlanması hareket kısıtlılığı açısından önemlidir. Multifragmanter, deplase ve kısalık oluşan falanks kırıklarında cerrahi erken dönemde hareket verme avantajı sağlar. Rotasyon ve eklem sertliği cerrahi sonrası karşılaşabilecek sorunların başında gelmektedir.

Anahtar Kelimeler

Falanks, El kırıkları, Mini plak, Eklem sertliği

Kaynakça

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