Medial kelebek fragmanlı humerus cisim kırıklarında farklı internal tespit yöntemlerinin biyomekanik değerlendirmesi

Öz

Amaç: Bu çalışmanın amacı medial kelebek fragmanlı humerus cisim kırıklarında üç biyolojik tespit yönteminin biyomekanik dayanıklılıklarını karşılaştırmaktı. Çalışma planı: Yirmi bir adet sentetik kortikal shell humerusta AO 12B2 kırık şekline benzer biçimde kelebek fragmanlar oluşturuldu. Humeruslara kilitli köprü plaklama, antegrad intramedüller çivileme veya retrograd intramedüller çivileme uygulandı. Rotasyonel ve dört-nokta bükülme testinde elde edilen yer değiştirme eğrisi değerleri kaydedildi. Bulgular: Burulma testlerinde elde edilen ortalama yer değiştirme değerleri; köprü plaklama grubunda 37.38 (dağılım: 25.75-55.69) mm, antegrad çivileme grubunda 26.55 (dağılım: 21.25-41.81) mm ve retrograd çivileme grubunda 33.23 (dağılım: 27.50-46.45) mm olarak saptandı. Dört nokta bükülme testinde elde edilen ortalama yer değiştirme değerleri; köprü plaklama grubunda 3.27 (dağılım: 2.54-3.73) mm, antegrad çivileme grubunda 3.17 (dağılım: 2.69-3.55) mm ve retrograd çivileme grubunda 3.15 (dağılım: 2.10-4.03) mm idi. Gruplar arasında anlamlı fark saptanmadı (p>0.05). Çıkarımlar: Medial kelebek fragmanlı humerus cisim kırıklarının tespitinde köprü plaklama, antegrad intramedüller çivileme ve retrograd intramedüller çivileme sistemlerinin biyomekanik stabilite açısından birbirlerine üstünlüğü olmadığı saptandı.

Anahtar Kelimeler

• Antegrad intramedüller çivileme; humerus cisim kırığı; köprü plaklama; medial kelebek fragman; retrograd intramedüller çivileme.

Biomechanical evaluation of different internal fixation methods for humerus shaft fractures with medial butterfly fragment

Abstract

Objective: The aim of this study was to compare the biomechanical strength of three fixation methods in humerus shaft fractures with medial butterfly fragment.
Methods: An AO 12B2 fracture with butterfly fragment was created in 21 synthetic cortical shell humeri. Humeri were divided into 3 groups which underwent bridge plating, antegrade intramedullary nailing or retrograde intramedullary nailing. Rotational and four-point bending test displacement curves were obtained.
Results: Mean displacement values in the torsion tests were 37.38 (range: 25.75 to 55.69) mm in the bridge plating group, 26.55 (range: 21.25 to 41.81) mm in the antegrade nailing group, and 33.23
(range: 27.50 to 46.45) mm in the retrograde nailing group. Mean displacement values in the fourpoint bending test were 3.27 (range: 2.54 to 3.73) mm in the bridge plating group, 3.17 (range: 2.69
to 3.55) mm in the antegrade nailing group, and 3.15 (range: 2.10 to 4.03) mm in the retrograde nailing group. No significant difference was found among the groups (p>0.05).
Conclusion: The biomechanical stability of bridge plating, antegrade intramedullary nailing and retrograde intramedullary nailing appears to be similar in the fixation of humerus shaft fractures with medial butterfly fragment.

Keywords

• Antegrade intramedullary nailing
• bridge plating
• humerus shaft fracture
• medial butterfly fragment
• retrograde intramedullary nailing

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