Total el bileği artroplastisinde komponent dizilimi: İlk vakalarında cerrahların başarı oranı

Öz

Amaç:Bu çalışmada cerrahların ilk el bileği artroplasti ameliyatlarında başarılı bir dizilim elde etmeleri olasılığının değerlendirilmesi amaçlandı.

Çalışma planı: Yedi kadavranın 14 el bileği üzerinde 14 deneyimsiz cerrah tarafından gerçekleştirilen total el bileği artroplastileri (ReMotion®) radyolojik olarak incelendi. Posteroanterior görünümdeki radial komponent dizilimi (RKD-PA), lateral görünümdeki (RKD-Lat), posteroanterior görünümdeki karpal komponent dizilimi (KKD-PA) ve lateral görünümdeki karpal komponent diziliminin (KKD-Lat) ölçümleri yapıldı.

Bulgular: Ortalama RKD-PA açısı 9.6º, RKD-Lat açısı 4.6º, KKD-PA açısı 4.4º ve KKD-Lat açısı 10.1º olarak kaydedildi. Yapılan artroplastilerin hiçbirinde tatmin edici dizilim sağlanamadı.

Çıkarımlar: Deneyimsiz cerrahların ilk total el bileği artroplastisi deneyimlerinde, özellikle karpal komponentte doğru bir komponent dizilimini sağlaması zor gözükmektedir. Bu nedenle, kemiğe tespitinden önce, protezin pozisyonunun röntgen görüntüleri ile doğrulanmasını tavsiye etmekteyiz.

 

Anahtar Kelimeler

• Deneyimsiz cerrah; dizilim; ilk el bileği artroplastisi

Component alignment in total wrist arthroplasty: success rate of surgeons in their first cases

Abstract

Objective:The aim of this study was to assess the probability of achieving a satisfactory alignment in the performance of a first wrist arthroplasty.

Methods: The total wrist arthroplasties (ReMotion®) of 14 wrists of 7 corpses performed by 14 inexperienced surgeons were reviewed radiologically. Radial component alignment in the posteroanterior view (RCA-PA), radial component alignment in the lateral view (RCA-Lat), carpal component alignment in the posteroanterior view (CCA-PA) and carpal component alignment in lateral view (CCA-Lat) were measured.

Results: Mean RCA-PA angle was 9.6º, mean RCA-Lat angle 4.6º, mean CCA-PA angle 4.4º and mean CCA-Lat angle 10.1º. None of the arthroplasties had a satisfactory alignment.

Conclusion: It is difficult for an inexperienced surgeon to achieve a correct component alignment in his/her first total wrist arthroplasty, especially in the carpal component. Therefore, we recommend that the position of the prosthesis is confirmed before securing it to the bone with the help of X-ray images.

Keywords

• Alignment
• first wrist arthroplasty
• inexperienced surgeon

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