İleri yaşlardaki trokanterik kırıklarda parsiyel endoprotez uygulamalarımız

Özet

SSK Tepecik Hastanesi 1. Ortopedi ve Travmatoloji Kliniğinde 1988-1995 yılları arasında intertrokanterik kırık tanısı ile başvuran 46 hastaya parsiyel endoprotez uygulandı. Hastalarımızın yaş ortalaması 76,6'dır. Ortalama izlenim süremiz 29 aydı. Hastaların hepsinde posterior girişim uygulanmış ve özellikle Osborne insizyon tercih edilmiştir. 32 hastamızda sementli özel yapım düz stemli "Moore" protez, 4 hastada sementli "Thompson" protez, 10 hastamızda da geçme başlı düz stemli endoprotez uygulandı. Hastalarımız ortalama 2,4 günde yatakta oturdular. Hiç yürümeyen hastalar dışında ortalama 5,6 günde yürüdüler. Merle D'Aubigne kriterlerine göre yapılan değerlendirmelerde toplam % 72,4 vakada iyi ve üstünde sonuç alınmıştır. Genel sağlık durumu kötü, nörolojik sekelli, senil demanslı ve düşkün hastaların tedavisinde parsiyel endoprotez uygulaması alternatif tedavi yöntemi olarak düşünülmelidir.

Abstract

HEMIARTHROPLASTY FOR INTERTROCHANTERIC FRACTURES IN ELDERLY PATIENTS Purpose: The effectiveness of the hemiarthroplasty in the treatment of intertrochanteric fractures of the elderly patients is discussed. Material: During 1988-1995, 46 patients who diagnosed as intertrochanteric fractures were treated by hemiarthroplasty at 1st Orthopaedics and Traumatology Clinic of SSK Tepecik Training Hospital. Mean age of them was 76.6 years and mean follow-up period was 29 months. Method: We preferred posterior Osborne incision. For 32 patients, a special design straight stem Moore prostheses with cement were applied; 4 patients were treated with Thompson prostheses with cement. The remaining 10 patients underwent surgery with prostheses which had a straight stem and modular head system. Results: At an average of 2.4 days the patients started to sit in bed, except the one who could not walk and they started to walk at an average of 5.6 days. According to Merle D'Aubigne criteria, results are accepted as excellent and good at 72.4% of the cases. Discussion: Treatment of intertrochanteric fractures by hemiarthroplasty could be accepted as a bold application by anyone. But hemiarthroplasty application allows to early mobilisation and walking in elderly and medical compromised patients. Fast clinical recovery is possible. Conclusion: For elder and medical compromised patients, hemiarthroplasty in the treatment of intertrochanteric fractures could be a good alternative treatment option.