Ayrışmış orta cisim klavikula kırıklarının ekspanse olabilen esnek kilitli intramedüller çivi ile tedavi sonuçları

Year 2015, , 13 - 17, 19.03.2015

Sinan Zehir Turgut Akgul Regayip Zehir

https://doi.org/10.3944/AOTT.2015.14.0070

Abstract

Amaç: Çalışmamızda yetişkin orta cisim klavikula kırıklarında ekspanse olabilen esnek kilitli intrame¬düller çivi uygulanan olguların sonuçları değerlendirmek amaçlanmıştır.

Çalışma planı: Tamamen ayrışmış ve en az iki cm kısalığı bulunan ve ekspanse olabilen esnek kilitli intramedüller çivi ile tespit yapılan 11 erkek ve 6 kadın hasta çalışmaya dahil edildi. Hastaların son takiplerinde erken ve geç dönem komplikasyonları ve Constant ve DASH skorlama sistemine göre fonksiyonel skorları değerlendirildi.

Bulgular: Ortalama ameliyat süresi 30.4 (25-42) dakika idi. Ortalama takip süresi 10.3 (8-19) ay, ortalama kaynama süresi ise 15.8 (9-20) hafta idi. Bir hastada yüzeyel enfeksiyon görüldü. Hiçbir hastada derin enfeksiyon görülmedi. Hiçbir hastada nörovasküler komplikasyon ile karşılaşılmadı. Hiçbir hastada implant migrasyonu ve irritasyonu ile karşılaşılmadı. Bir hastada uygulama hatasına bağlı olduğu düşünülen instabiliteye yol açmayan implant kırılması görüldü. Sağlam tarafla karşılaştı¬rıldığında hiçbir hastada anlamlı kısalık görülmedi. Hastaların son kontrollerinde ortalama Constant skoru 94.3 (86-97), DASH skoru ise 11.8 (7.3-17.4) idi.

Çıkarımlar: Ekspanse olabilen esnek kilitli intramedüller çivi ayrışmış orta diafiz klavikula kırıkların¬da minimal invaziv olarak uygulanabilen, düşük komplikasyon oranı olan ve iyi fonksiyonel sonuçlar elde edilmesini sağlayan bir yöntem olarak görülmektedir. Daha geniş serileri içeren karşılaştırmalı çalışmaların gerekliliği aşikardır.

Keywords

Klavikula; kırık; çivi; cisim.

Results of midshaft clavicle fractures treated with expandable, elastic and locking intramedullary nails

Abstract

Objective: The aim of the study was to present the results of osteosynthesis with elastic expandable intramedullary nail for clavicle fractures.

Methods: The study included 17 patients (11 males, 6 females; mean age 36.4 years, range: 21 to 54 years) who underwent surgery for a displaced clavicle fracture and had a shortening of more than 2 cm. The Constant Score and DASH (Disabilities of The Arm, Shoulder and Hand) scoring were used to determine the functional status of the patients.

Results: Mean operation time was 30.4 (range: 25 to 42) minutes and mean follow-up period was 10.3 (range: 8 to 19) months. Mean union time was 15.8 (range: 9 to 20) weeks. A superficial infection was treated with wound debridement and antibiotherapy in one patient. No patient suffered from neurovascular compromise, deep infection or implant irritation. Implant fracture developed at months after surgery in one patient treated for Type B1 clavicle fracture and healed without any other intervention. There was no statistically significant shortening (p>0.05). In the final follow-up, the mean Constant Score was 94.3 (range: 86 to 97), and mean DASH score was 11.8 (range: 7.3 to 17.4).

Conclusion: Expandable elastic locking intramedullary nail appears to provide minimal complication and high success rate for the surgical treatment of non-comminuted displaced clavicle shaft fractures. Additional studies with large series are necessary for further investigation.

Keywords

Clavicle, fracture, nail, shaft

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