Eklem dışı distal femur kırıklarının tedavisinde retrograd intramedüller çivileme

Abstract

Amaç: Bu çalışmadaki amacımız, eklem dışı distal femur kırıklarının tedavisinde retrograd intramedüller çivileme (RİMÇ) ve köprü plaklama yöntemlerini karşılaştırmaktı.

Çalışma planı: 2007-2012 yılları arasında eklem dışı distal femur kırığına köprü plaklama uygulanan 15 hasta (13 erkek, 2 kadın; ortalama yaş: 36, dağılım: 17-55) ve RİMÇ uygulanan 13 hasta (11 erkek, 2 kadın; ortalama yaş: 31.1, dağılım: 17-49) geriye dönük olarak incelendi. Fonksiyonel sonuçlar Sanders kriterleri kullanılarak değerlendirildi. Ortalama takip süresi plak grubunda 31.3 dağılım: 20-46) ay, çivi grubunda 26.7 (dağılım: 18-62) ay idi.

Bulgular: Ortalama kaynama süresi plak grubunda 25.7 (dağılım: 12-72) hafta, çivi grubunda 22.3 (dağılım: 12-52) hafta idi. Kaynamama plak grubunda 2 hastada, çivi grubunda 1 hastada; kaynama gecikmesi plak grubunda 3 hastada, çivi grubunda 2 hastada; dizilim bozukluğu (>10°) plak grubunda 2 hastada, çivi grubunda 1 hastada; implant yetmezliği ise plak grubunda 1 hastada görüldü. Plak grubunda 12 hastada, çivi grubunda 10 hastada mükemmel/iyi fonksiyonel sonuç elde edildi. Gruplar arasında kaynama süresi, komplikasyonlar ve fonksiyonel sonuçlar açısından anlamlı bir fark saptanmadı (p>0.05).

Çıkarımlar: Eklem dışı distal femur kırıklarının tedavisinde köprü plaklama ve RİMÇ yöntemlerinin sonuçları benzerdir ve Gustilo-Anderson Tip 3B ve C açık kırıklar hariç tüm kırıklarda uygulanabilir.

Keywords

• Eklem dışı distal femur kırığı; köprü plaklama; retrograd intramedüller çivileme.

Comparison of retrograde intramedullary nailing and bridge plating in the treatment of extra-articular fractures of the distal femur

Abstract

Objective: The aim of this study was to compare retrograde intramedullary nailing (RIMN) and bridge plating for the treatment of extra-articular distal femur fractures.

Methods: The study retrospectively examined 15 patients (13 males and 2 females; mean age: 36 years, range: 17 to 55 years) who underwent bridge plating and 13 patients (11 males and 2 females; mean age: 31.1 years, range: 17 to 49 years) who underwent RIMN for the treatment of extra-articular distal femur fractures between 2007 and 2012. Functional results were evaluated using the Sanders criteria. The mean follow-up time was 31.3 (range: 20 to 46) months and 26.7 (range: 18 to 62) months in the plate and the nail groups, respectively.

Results: Mean duration until union was 25.7 (range: 12 to 72) weeks in the plate group and 22.3 (range: 12 to 52) weeks in the nail group. Nonunion was observed in 2 patients in the plate group and in 1 in the nail group, delayed union in 3 patients in the plate and 2 in the nail groups, malalignment (>10°) in 2 patients in the plate group and 1 in the nail group and implant failure in 1 patient in the plate group. Excellent/good functional results were obtained in 12 and 10 patients in the plate and the nail groups, respectively. No significant difference was found between the groups in terms of duration of union, complications and functional results (p>0.05).

Conclusion: Bridge plating and RIMN have similar results in the treatment of extra-articular distal femur fractures. Both methods can be applied to all fractures, with the exception of Gustilo-Anderson Type 3B and C open fractures.

Keywords

• Bridge plating
• extra-articular distal femur fracture
• retrograde intramedullary nailing

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