Dergiler / Ulusal Travma ve Acil Cerrahi Dergisi / 2008 / Cilt: 14 - Sayı: 1
The role of biological fixation with bridge plating for comminuted subtrochanteric fractures of the femur
- Sayfa
- 53–58
- DOI
- —
Özet
Parçal› subtrokanterik k›r›klar, yüksek enerjili yaralanma olmalar› ndan dolay› cerrahi tedavi sonras› yüksek kaynamama ve kötü kaynama riski tafl›rlar. Biyolojik tespit yumuflak doku kanlanmas›n› korurken, bu komplikasyonlar› azaltmay› hedefler. Bu çal›flmada amaç, parçal› subtrokanterik k›r›kl› olgular› n köprü plaklama sonras› geriye dönük olarak sonuçlar›n› de¤erlendirmektir. GEREÇ VE YÖNTEM 1996-2002 y›llar› aras›nda parçal› subtrokanterik k›r›kl› 10 olgu çal›flmaya dahil edildi. Tüm olgular erkekti, ortalama yafl 46±15,2 y›l (da¤›l›m 29-76) idi. AO/ OTA s› n› flamas› na göre alt› olguda C-3-1, dört olguda C-3-2 tip k›r›k mevcuttu. Tüm olgulara floroskopi kontrolünde biyolojik tespit kurallar› na uygun köprü plaklama uyguland›. Son kontrolde Sander’s kriterleri için, a¤r›, yürüme kapasitesi, fonksiyonel durum, hareket, günlük aktiveteler, radyolojik de¤erlendirme, k›r›k ve sa¤lam taraf femur boyun-cisim aç›lar› ölçüldü. BULGULAR Ortalama izleme süresi 62±20,9 ayd› (da¤›l›m 37-104). K›smi yüklenme ortalama 3,3±1,1 ayda (da¤›l›m 1,5-4,5), tam yüklenme ortalama 4,8±1 ayda (da¤›l›m 3-6) önerildi. Sander’s kriterlerine göre sekiz çok iyi (%80), bir iyi (%10) ve bir kötü (%10) sonuç saptand›. Femur boyun-cisim aç›lar› bak›m›ndan k›r›kl› ve sa¤lam taraflar aras›nda anlaml› fark saptanmad›. SONUÇ Parçal› subtrokanterik femur k›r›klar›n›n tedavisinde, köprü plaklama ile uygulanan biyolojik tespitin alternatif bir yöntem oldu¤unu düflünüyoruz.
Abstract
The surgical outcomes of comminuted subtrochanteric fractures result in high incidence of nonunion and malunion due to high energy trauma. Biological fixation offers decrease in these complications while preserving soft tissue vascularity. The aim of this study was to evaluate the results of patients treated with bridge plating for comminuted subtrochanteric femoral fractures retrospectively. METHODS Ten patients with comminuted subtrochanteric femoral fractures between 1996 and 2002 were included into this study.All patients were male and mean age was 46±15.2 years (range: 29-76 years) . Six patients had C-3-1 and four patients had C-3-2 type fractures according to AO/ OTA classification. Bridge plating under fluoroscopy control, according to biological fixation principles was carried out on all patients. Pain, walking capacity, functionality, motion, daily activities, radiological assessment for Sander’s criteria and shaft-neck angles of both fractured and the other sides were recorded for statistical analysis, at the last follow-up. RESULTS Mean follow-up period was 62±20.9 months (range: 37-104 months). Partial and full weight-bearing were recommended at an average period of 3.3±1.1 (range: 1.5- 4.5 months) and 4,8± 1 months (range: 3-6 months) respectively (range: 3-6 months) . There were eight excellent (80%), one good (10%) and one poor (10%) results according to Sanders’criteria. There was no statistically significant difference between the healthy and fractured sides with respect to femoral shaft-neck angles. CONCLUSION We have concluded that biological fixation applied with bridge plating offered an alternative method in the treatment of comminuted subtrochanteric femoral fractures.