Vücut kitle indeksinin pilon kırıklarında radyolojik ve klinik sonuçlar üzerine etkisi

Year 2014, Volume: 48 Issue: 5, 570 - 575, 12.11.2014

Gultekin Sitki Cecen Deniz Gulabi Erman Yanik Gokhan Pehlivanoglu Halil Bekler Nurzat Elmali

https://doi.org/10.3944/AOTT.2014.14.0073

Abstract

Amaç: Bu çalışmada amacımız, Vücut Kitle İndeksi’nin (VKİ) pilon kırıklarında klinik ve radyolojik sonuçlara etkisini değerlendirmekti. Bu değerlendirmemizde, VKİ≥30 olarak tanımlanan obez hastaların fonksiyonel ve radyolojik sonuçlarının obez olmayan hastalara göre daha kötü olmayacağını varsaydık.

Çalışma planı: Çalışmaya, Ocak 2008-Mayıs 2011 tarihleri arasında tibia pilon kırığı geçirmiş olan 42 hastanın (33 erkek, 9 kadın; ortalama yaş: 42.67±12.29, dağılım: 18-67), retrospektif olarak incelenen sonuçları dahil edildi. Her hastanın postoperatif komplikasyon insidansı dahil olmak üzere postoperatif seyri ve hastanede kalış süresi tıbbi kayıtlardan belirlendi. Son kontrollerde klinik değerlendirme AOFAS skoruna, radyolojik değerlendirme ise Kellgren-Lawrence sınıflamasına göre yapıldı.

Bulgular: Yirmi dokuz hasta düşük enerjili travmaya, 13 hasta yüksek enerjili travmaya maruz kalmıştı. Ortalama VKİ 28.96±4.86 kg/m² olarak bulundu. Obez hasta sayısı 18, obez olmayan hasta sayısı 24’tü. Son kontrolde ortalama AOFAS skoru 36±20.71 olarak kaydedilirken, hastaların ortalama takip süresi 30.0±11.48 ay idi. Obez grupta yüzeysel enfeksiyon oranı istatistiksel olarak anlamlı derecede yüksek bulundu (p<0.05). Ameliyat süresi ve hastanede kalış süresinin de obez hastalarda istatistiksel olarak anlamlı derecede uzun olduğu saptandı (sırasıyla, p=0.001 ve p=0.041).

Çıkarımlar: Pilon kırığı nedeniyle ameliyat edilen, obez hastalarda klinik ve radyolojik sonuçlar açısından obez olmayan hastalara göre yüzeysel enfeksiyon dışında fark bulunmamıştır. Obez hastalar da, yaranın yakın takibi yapılarak normal kilolu hastalar gibi tedavi edilebilmektedir.

Keywords

AOFAS skoru; obez; pilon kırığı; VKİ.

Effect of BMI on the clinical and radiological outcomes of pilon fractures

Abstract

Objective: The aim of this study was to evaluate the effect of BMI on clinical and radiological outcomes of pilon fractures. We hypothesized that obese patients, defined as having a BMI of 30 or higher, would not have worse functional and radiological outcome compared to non-obese patients.

Methods: This study retrospectively reviewed 42 patients (33 males and 9 females; mean age: 42.67±12.29 years, range: 18 to 67 years) who sustained tibial pilon fractures between January 2008 and May 2011. Each patient’s postoperative course, including the incidence of postoperative complications, and the length of hospital stay was determined from medical charts. At the final follow-up, clinical assessment was made according to the AOFAS score and radiological evaluation was made according to the Kellgren-Lawrence classification.

Results: Twenty-nine patients had low-energy trauma, while 13 had high-energy trauma. Mean BMI was 28.96±4.86 kg/m2. There were 18 obese patients and 24 non-obese patients. Mean AOFAS score at the final follow-up was 68.36±20.71. The average follow-up time was 30.0±11.48 months. Superficial infection in the obese group occurred at a statistically significantly higher rate (p<0.05). Operation and hospitalization times occurred at a significantly higher rate in the obese group (p=0.001 and p= 0.041, respectively).

Conclusion: Body mass index does not affect the clinical and radiological outcomes of tibial pilon fractures, with the exception of superficial infection. Obese patients could be treated as non-obese patients with close monitoring of the wound.

Keywords

AOFAS score, BMI, obese, pilon fracture

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