Danis-Weber Tip A ve B lateral malleol kırıklarında plak-vida ve gergi bandı tekniği sonuçlarının karşılaştırılması

Abstract

Amaç: Çalışmada izole Danis-Weber Tip A ve B lateral malleol kırıklarında plak-vida ile gergi bandı tekniklerinin klinik ve radyolojik sonuçlarının karşılaştırılması amaçlandı. Çalışma planı: Kasım 2005-Aralık 2010 tarihleri arasında, izole Danis- Weber tip A ve B lateral malleol kırığı tanısıyla 4 farklı merkez ve 6 ayrı klinikte opere olmuş 135 olgu (82 tip B, 53 tip A kırık) geriye dönük olarak değerlendirildi. Grup 1’de yer alan 81 (55 tip B, 26 tip A) hastada lateralden 1/3 tübüler plak ve vida tekniği; Grup 2’de yer alan 54 (27 tip B, 27 tip A) hastada ise gergi bandı tekniği ile cerrahi tespit uygulandı. Gruplar klinik ve radyolojik sonuçlarına göre karşılaştırıldı. İstatistiksel analizde Student-t testi kullanıldı. Bulgular: Grup 1’de cerrahi insizyon skarı tip A’da ortalama 4.9 cm (4.5-5.4), tip B’de 6.8 cm (5.6-7.5) iken; Grup 2’de 4 cm (3.5-5.2) ve 5.3 cm (5.0-5.9) olarak ölçüldü. Radyolojik kaynama Grup 1’de ortalama 10 haftada (7-13) sağlanırken, Grup 2’de 9 haftada (7-12) sağlandı. Grup 1’de 12 hastada takiplerde implantlar çıkarılırken; Grup 2’de sadece bir hastada implantların çıkarılmasına gerek görüldü. AOFAS Skoru grup 1’de ortalama 90 (72-100) iken; Grup 2’de 92 (70-100) olarak ölçüldü. Çıkarımlar: Danis-Weber Tip A ve B kırıklarında kullanılan her iki cerrahi teknik de, mükemmel sonuç vermektedir. Gergi bandı tekniği bu tip kırıklarda ucuz ve kabul edilebilir bir tedavi seçeneği olabilir.

Keywords

• Ayak bileği, cerrahi tedavi, kırık sabitlenmesi-internal, kırık sabitlenmesi-intramedüller, kemik vidaları.

The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures

Abstract

Objective: The aim of this study was to compare the clinical and radiological results of plate-screw and tension band fixation in isolated Danis-Weber Type A and B lateral malleolar fractures.
Methods: A total of 135 cases of lateral malleolar fractures (82 Danis-Weber Type B and 53 Type A) operated on in 4 different centers and 6 orthopaedic clinics between November 2005 and December 2010 were reviewed retrospectively. Eigthy-one patients (55 Type B and 26 Type A) had lateral 1/3 tubular plate and screw fixation (Group 1), while the remaining 54 patients (27 Type B and 27 Type A) were operated on with tension band technique (Group 2). The clinical and radiological results of the groups were compared. Student t test was used in statistical analysis.
Results: The mean length of surgical incision scar was 4.9 cm (4.5-5.4 cm) for Type A fractures and 6.8 cm (5.6-7.5 cm) for Type B in Group 1 and 4.0 cm (3.5-5.2 cm) for Type A and 5.3 cm (5.0-5.9 cm) for Type B fractures in Group 2. Radiological union was obtained at mean of 10 weeks (7-13 weeks) in Group 1 and 9 weeks (7-12) in Group 2. The implant had to be removed in 12 patients in Group 1 and in one patient in Group 2. The mean AOFAS Score was 90 (72-100) and 92 (70-100) in Groups 1 and 2, respectively.
Conclusion: Both plate-screw and tension band techniques revealed excellent results in isolated DanisWeber Type A and B fractures. The tension band technique may be an alternative fixation method in the treatment of these fractures.

Keywords

• Ankle
• operative therapy
• fracture fixation-internal
• fracture fixation-intramedullar
• bone screws

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