Treatment of adult tibial diaphysis fractures with reamed and locked intramedullary nailing

Halil Burc; Muhsin Dursun; Haldun Orhun; Volkan Gurkan; Volkan Gurkan; İlhan Bayhan; - -

TR EN

Tibia diyafiz kırıklarının oymalı kilitli intramedüller çivi ile tedavisi

Abstract

Amaç: Tibia diyafiz kırıklarının oymalı kilitli intramedüller çivi ile tedavi sonuçları değerlendirildi. Çalışma planı: Çalışmaya, tibia cisim kırığı nedeniyle oymalı kilitli intramedüller çivi ile tedavi edilen 73 erişkin hasta (68 erkek, 5 kadın; ort. yaş 31; dağılım 17-68) alındı. AO/ASIF sınıflamasına göre, 28 kırık tip A, 29 kırık tip B, 16 kırık tip C olarak değerlendirildi. Kırıklar, 12 hastada 1/3 proksimal, 50 hastada 1/3 orta, 11 hastada 1/3 distal diyafiz seviyesinde idi. Yirmi sekiz hastada (%38.4) kapalı kırık vardı. Gustilo-Anderson sınıflamasına göre, 30 hastada (%41.1) derece I, 10 hastada (%13.7) derece II, beş hastada (%6.9) derece IIIA açık kırık vardı. On yedi hastada (%23.3) açık, 56 hastada (%76.7) kapalı redüksiyonu takiben çivileme yapıldı. Kırık oluşumu ile ameliyat arasında geçen süre ortalama 3.4 gün (dağılım 2-11 gün); ortalama takip süresi 48 ay (dağılım 24-60 ay) idi. Hastalar hareket açıklığı, kaynama süresi ve komplikasyonlar açısından değerlendirildi. Fonksiyonel değerlendirmede Johner-Wrush ölçütleri kullanıldı. Sonuçlar: Tüm hastalarda ortalama 18.2 haftada (dağılım 8-52 hafta) kaynama elde edildi. Dört olguya kaynama gecikmesi nedeniyle dinamizasyon uygulandı. Bir hastaya grefonaj uygulandı. Dinamizasyon uygulanan bir hastada geçici duyu kaybı gelişti. Bir olguda radyografik kontrollerde distal kilit vidalarının çivi dışında görülmesi üzerine revizyon uygulandı. Diz ön ağrısı gelişen iki hastada (%2.7) sadece fleksiyon kısıtlılığı görülürken, diğer hastalarda hareket kısıtlılığına rastlanmadı. Johner-Wrush ölçütlerine göre, 45 olguda (%61.6) çok iyi, 28 olguda (%38.4) iyi sonuç elde edildi. Çıkarımlar: Tibia diyafiz kırıklarında oymalı kilitli intramedüller çivi tedavisi, komplikasyon oranı düşük, uygun bir tedavi seçeneğidir. Kontaminasyonu fazla olmayan açık kırıklarda güvenle uygulanabilir.

Keywords

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Treatment of adult tibial diaphysis fractures with reamed and locked intramedullary nailing

Abstract

Objectives: We evaluated the results of reamed and locked intramedullary nailing for tibial diaphysis fractures.
Methods: The study included 73 patients (68 males, 5 females; mean age 31 years; range 17 to 68 years) who were treated with reamed and locked intramedullary nailing for tibial diaphysis fractures. There were 28 AO/ASIF type A, 29 type B, and 16 type C fractures. The fractures involved the proximal 1/3 (n=12), middle 1/3 (n=50), and distal 1/3 (n=11) of the tibial diaphysis. Twenty eight fractures (38.4%) were closed. According to the Gustilo-Anderson classification, 30 patients (%41.1) had grade I, 10 patients (%13.7) had grade II, and five patients (%6.9) had grade IIIA open fractures. Intramedullary nailing was performed following open reduction in 17 patients (23.3%), and closed reduction in 56 patients (76.7%). The mean time to surgery was 3.4 days (range 2 to 11 days) and the mean follow-up was 48 months (range 24 to 60 months). The patients were evaluated with respect to range of motion, time to union, and complications. Functional results were assessed using the Johner-Wrush criteria.
Results: Union was achieved in all the patients within a mean of 18.2 weeks (range 8 to 52 weeks). Four patients required dynamization because of delayed union and grafting was performed in one patient. Transient sensorial deficit occurred in one patient after dynamization. One patient underwent revision surgery because of migration of the distal locking screws. The only limitation of range of motion was seen in flexion of two patients (2.7%) who developed anterior knee pain. According to the Johner-Wrush criteria, functional results were very good in 45 patients (61.6%), and good in 28 patients (38.4%).
Conclusion: Treatment of tibial diaphysis fractures with reamed and locked intramedullary nailing is an appropriate choice with a low complication rate. It can be safely used in moderately contaminated open fractures.

Keywords

Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Halil Burc This is me

Muhsin Dursun This is me

Haldun Orhun This is me

Volkan Gurkan This is me

İlhan Bayhan This is me

- - This is me

Publication Date

March 16, 2009

Submission Date

May 10, 2014

Acceptance Date

-

Published in Issue

Year 2009 Volume: 43 Number: 1

IZ

https://izlik.org/JA46HK89HX

Cite

RIS / Bibtex

APA

Burc, H., Dursun, M., Orhun, H., Gurkan, V., Gurkan, V., Bayhan, İ., & -, -. (2009). Treatment of adult tibial diaphysis fractures with reamed and locked intramedullary nailing. Acta Orthopaedica et Traumatologica Turcica, 43(1), 7-13. https://izlik.org/JA46HK89HX

AMA

1.Burc H, Dursun M, Orhun H, et al. Treatment of adult tibial diaphysis fractures with reamed and locked intramedullary nailing. Acta Orthopaedica et Traumatologica Turcica. 2009;43(1):7-13. https://izlik.org/JA46HK89HX

Chicago

Burc, Halil, Muhsin Dursun, Haldun Orhun, et al. 2009. “Treatment of Adult Tibial Diaphysis Fractures With Reamed and Locked Intramedullary Nailing”. Acta Orthopaedica et Traumatologica Turcica 43 (1): 7-13. https://izlik.org/JA46HK89HX.

EndNote

Burc H, Dursun M, Orhun H, Gurkan V, Gurkan V, Bayhan İ, - - (March 1, 2009) Treatment of adult tibial diaphysis fractures with reamed and locked intramedullary nailing. Acta Orthopaedica et Traumatologica Turcica 43 1 7–13.

IEEE

[1]H. Burc et al., “Treatment of adult tibial diaphysis fractures with reamed and locked intramedullary nailing”, Acta Orthopaedica et Traumatologica Turcica, vol. 43, no. 1, pp. 7–13, Mar. 2009, [Online]. Available: https://izlik.org/JA46HK89HX

ISNAD

Burc, Halil - Dursun, Muhsin - Orhun, Haldun - Gurkan, Volkan - Gurkan, Volkan - Bayhan, İlhan - -, -. “Treatment of Adult Tibial Diaphysis Fractures With Reamed and Locked Intramedullary Nailing”. Acta Orthopaedica et Traumatologica Turcica 43/1 (March 1, 2009): 7-13. https://izlik.org/JA46HK89HX.

JAMA

1.Burc H, Dursun M, Orhun H, Gurkan V, Gurkan V, Bayhan İ, - -. Treatment of adult tibial diaphysis fractures with reamed and locked intramedullary nailing. Acta Orthopaedica et Traumatologica Turcica. 2009;43:7–13.

MLA

Burc, Halil, et al. “Treatment of Adult Tibial Diaphysis Fractures With Reamed and Locked Intramedullary Nailing”. Acta Orthopaedica et Traumatologica Turcica, vol. 43, no. 1, Mar. 2009, pp. 7-13, https://izlik.org/JA46HK89HX.

Vancouver

1.Halil Burc, Muhsin Dursun, Haldun Orhun, Volkan Gurkan, Volkan Gurkan, İlhan Bayhan, - -. Treatment of adult tibial diaphysis fractures with reamed and locked intramedullary nailing. Acta Orthopaedica et Traumatologica Turcica [Internet]. 2009 Mar. 1;43(1):7-13. Available from: https://izlik.org/JA46HK89HX