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Tibia diafiz kırıklarının tedavisinde intramedüller kilitli çivi ve plak-vida yöntemlerinin karşılaştırılması

Year 2004, Volume: 38 Issue: 2, 104 - 109, 11.09.2006

Abstract

Amaç: Tibia diafiz kırıklarının plak-vida ve intramedüller kilitli çivi ile tedavi sonuçları değerlendirildi; iki yöntemle ortaya çıkan kaynama süresi ve komplikasyonlar karşılaştırıldı.
Çalışma planı: Tibia diafiz kırığı olan 44 hasta (31 erkek, 13 kadın; ort. yaş 38; dağılım 14-64) çalışmaya alındı. Kırıklar 23 hastada sol, 20’sinde sağ tarafta, birinde iki taraflı idi. Yirmi beş hastanın 26 tibiasına intramedüller kilitli çivi, 19 hastada ise plak-vida ile osteosentez yapıldı. İntramedüller kilitli çivi uygulanan grupta ameliyata kadar geçen süre ortalama 9 gün, plak-vida uygulanan grupta 10 gün idi. Hastalar ameliyat süresi, hareket açıklığı, kaynama süresi ve komplikasyonlar açısından değerlendirildi. Ortalama izlem süresi 23 ay (dağılım 18-46 ay) idi.
Sonuçlar: Ameliyat süreleri, diz ve ayak bileği ortalama hareket açıklığı değerleri iki grupta birbirine yakın değerlerde bulundu. Kaynama süresi, intramedüller çivi grubunda ortalama beş ay, plak-vida grubunda 3.5 ay idi. Plak-vida grubunda hiçbir olguda kısalık görülmezken, intramedüller çivi uygulanan iki hastada kısalık (2 ve 2.5 cm) saptandı. İntramedüller çivileme ile tedavi edilen, tip III açık kırığı olan hastaların birinde osteomiyelit gelişti. Düz grafilerde, intramedüller çivi grubunda dört hastada, plak-vida grubunda üç hastada açılı kaynama görüldü; bu kırıkların hepsi tibianın distal 1/3’ünde idi.
Çıkarımlar: Çok parçalı olmayan tibia diafiz kırıklarında plak-vida osteosentezi tatminkar sonuç vermektedir. Çok parçalı kırıklarda periosteal dolaşımı daha az bozan, bunun sonucunda daha düşük oranda komplikasyona neden olan intramedüller kilitli çivi tercih edilmelidir.

A comparison between locked intramedullary nailing and plate-screw fixation in the treatment of tibial diaphysis fractures

Year 2004, Volume: 38 Issue: 2, 104 - 109, 11.09.2006

Abstract

Objectives: The results of treatment with plate-screw or locked intramedullary nailing were evaluated for tibial diaphysis fractures, with a comparison of time to union and complications.
Methods : The study included 44 patients (31 males, 13 females; mean age 38 years; range 14 to 64 years) with 45 tibial diaphysis fractures. The fractures were on the left side in 23 patients and on the right side in 20 patients. One patient had bilateral involvement. Twenty-six fractures were treated by intramedullary nailing and 19 fractures by plate-screw fixation after a mean time of nine days and 10 days from injury, respectively. The patients were evaluated with regard to operation time, range of motion, time to union, and complications after a mean follow-up of 23 months (range 18 to 46 months).
Results : The mean operation time and the mean range of motion of the ankle and knee were found similar in both groups. The mean time to union was five months with intramedullary nailing, and 3.5 months with plate-screw fixation. Length discrepancy occurred in only two patients (2 and 2.5 cm) in whom intramedullary nailing was performed. One patient treated by intramedullary nailing for a type III open fracture developed osteomyelitis. Plain radiographs showed angulation in four patients and in three patients following intramedullary nailing and plate-screw fixation,
respectively, all of whom had distal-third tibial fractures.
Conclusion : Plate-screw osteosynthesis yields satisfactory results in uncomminuted fractures of the tibial diaphysis, whereas locked intramedullary nailing is more appropriate in comminuted fractures because of better preservation of periosteal circulation, and thus lower complication rates.

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Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Hasan Bombaci This is me

Bulent Guneri This is me

Mucahit Gorgec This is me

Adnan Kafadar This is me

Publication Date September 11, 2006
Published in Issue Year 2004 Volume: 38 Issue: 2

Cite

APA Bombaci, H., Guneri, B., Gorgec, M., Kafadar, A. (2006). A comparison between locked intramedullary nailing and plate-screw fixation in the treatment of tibial diaphysis fractures. Acta Orthopaedica Et Traumatologica Turcica, 38(2), 104-109.
AMA Bombaci H, Guneri B, Gorgec M, Kafadar A. A comparison between locked intramedullary nailing and plate-screw fixation in the treatment of tibial diaphysis fractures. Acta Orthopaedica et Traumatologica Turcica. September 2006;38(2):104-109.
Chicago Bombaci, Hasan, Bulent Guneri, Mucahit Gorgec, and Adnan Kafadar. “A Comparison Between Locked Intramedullary Nailing and Plate-Screw Fixation in the Treatment of Tibial Diaphysis Fractures”. Acta Orthopaedica Et Traumatologica Turcica 38, no. 2 (September 2006): 104-9.
EndNote Bombaci H, Guneri B, Gorgec M, Kafadar A (September 1, 2006) A comparison between locked intramedullary nailing and plate-screw fixation in the treatment of tibial diaphysis fractures. Acta Orthopaedica et Traumatologica Turcica 38 2 104–109.
IEEE H. Bombaci, B. Guneri, M. Gorgec, and A. Kafadar, “A comparison between locked intramedullary nailing and plate-screw fixation in the treatment of tibial diaphysis fractures”, Acta Orthopaedica et Traumatologica Turcica, vol. 38, no. 2, pp. 104–109, 2006.
ISNAD Bombaci, Hasan et al. “A Comparison Between Locked Intramedullary Nailing and Plate-Screw Fixation in the Treatment of Tibial Diaphysis Fractures”. Acta Orthopaedica et Traumatologica Turcica 38/2 (September 2006), 104-109.
JAMA Bombaci H, Guneri B, Gorgec M, Kafadar A. A comparison between locked intramedullary nailing and plate-screw fixation in the treatment of tibial diaphysis fractures. Acta Orthopaedica et Traumatologica Turcica. 2006;38:104–109.
MLA Bombaci, Hasan et al. “A Comparison Between Locked Intramedullary Nailing and Plate-Screw Fixation in the Treatment of Tibial Diaphysis Fractures”. Acta Orthopaedica Et Traumatologica Turcica, vol. 38, no. 2, 2006, pp. 104-9.
Vancouver Bombaci H, Guneri B, Gorgec M, Kafadar A. A comparison between locked intramedullary nailing and plate-screw fixation in the treatment of tibial diaphysis fractures. Acta Orthopaedica et Traumatologica Turcica. 2006;38(2):104-9.