Antegrade Locked Nailing Of Adult Femoral Shaft Fractures And Non-Unions: A Retrospective Review Of 48 Cases Erişkin Femur Şaft Kırıklarının Ve Non-Unionlarının Antegrad Kilitli Çivileme Yöntemi İle T

Abstract

Keywords

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Erişkin Femur Şaft Kırıklarının Ve Non-Unionlarının Antegrad Kilitli Çivileme Yöntemi İle Tedavisi: 48 Olgunun Retrospektif Değerlendirilmesi

Abstract

Amaç: Bu makalede, akut femur cisim kırığı veya non-unionu nedeni ile antegrade kilitli intramedüller kilitli çivileme yapılan 48 olgunun fonksiyonel sonuçları retrospektif olarak değerlendirildi. Gereç ve Yöntem: Bu çalışmaya dahil edilen 48 hastaya toplam 52 antegrad kilitli intramedüller çivileme uygulandı. Akut femur cisim kırıklarının 27’sinde oymasız antegrad kilitli intramedüller çivileme uygulandı. Akut femur kırığı olan 4 ve non-union olan 21 hastada ise fiksasyon oymalı kilitli çivileme ile sağlandı. Olguların yaş ortalaması 40.2 (17-80) idi. Serimizdeki hastaların 16’sı bayan (%33.3) ve 32 ’si erkekti (%66.7). Bulgular: Hastaların takipleri ile elde edilen veriler, Thoresen kriterlerine göre; femoral aks deformitesi, femoral kısalık, diz eklemi hareket açıklığı ve ağrı veya ödem varlığı incelenerek değerlendirildi. Hastalar ortalama 21 ay (10-46 ay) takip edildi. Bir tanesi haricinde tüm olgularda kaynama görüldü (%98.07). Yüzeyel enfeksiyon üç hastada izlendi ve bunlardan bir olgunun takiplerinde derin enfeksiyon gelişti. Akut kırık grubundan gastrointestinal kanama öyküsü olan Winquist tip IV kırıklı bir hastaya, antikoagülan tedavi verilemediğinden, derin venöz trombüs izlendi. Non-union grubundan bir hastada ise, ameliyattan sonraki dördüncü günde pulmoner emboli gelişti. Sonuç: İntramedüller çivileme yöntemleri akut femur cisim kırıkları ve non-unionlarında etkili bir tedavi metodudur. Oymalı çivileme metodu, oymasız çivileme metodu ile karşılaştırıldığında daha az başarısızlık izlenirken, yöntem sağlam stabilizasyon sağlar.

Keywords

• femur, kırık tespiti, kırık iyileşmesi, intramedüller çivileme

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