Proksimal Falanks Ve Orta Falanks Eklem İçi Kırıklarında Kirschner Teli Kullanımıyla Vida Kullanımının Fonksiyonel Ve Radyografik Sonuçlarının Karşılaştırılması

Abstract

El, insanın günlük hayatta en çok kullandığı ve fonksiyonel olmasını sağlayan en önemli uzvudur. Genel olarak da bilindiği gibi eklem içi kırıklar iyileşme süreci daha uzun olan ve ideal tedavi uygulanamazsa hastaların en çok ağrı ve hareket kısıtlılığı gibi sorunlar yaşadığı kırıklardır. Bunun için çeşitli tespit yöntemleri vardır. Bu kırıklar mini vidayla tespit, mini plakla tespit, K teliyle tespit, dinamik ve statik eksternal fiksatörle tespit şeklinde tedavi edilebilmektedir . Bu yöntemlerin hangisinin hangi açıdan daha üstün olduğu araştırılmaktadır. Bu yüzden bu çalışmanın konusu orta ve proksimal falanks eklem içi kırıklarında K teli kullanımının ve mini vida kullanımının fonksiyonel ve radyografik sonuçlarının karşılaştırılmasıdır. Amacımız bu kırıklarda hangi tedavinin daha etkili olduğunu bulmak ve bu hastaları daha erken rehabilite edip günlük hayatlarına ve iş hayatlarına en erken olacak şekilde kavuşturmaktır.

Keywords

• Kondil kırıkları
• bazis kırıkları
• mini vida
• açık redüksiyon

Proximal Phalanx and Middle Phalanx Intra-articular Fractures: Comparison of Functional and Radiographic Results of Kirschner Wire and Screw

Abstract

The hand is the most important part of the human being that is used the most in daily life and enables it to be functional. As it is generally known, intra-articular fractures are fractures that have a longer healing process and if ideal treatment cannot be applied, patients experience the most problems such as pain and limitation of movement. There are various fixation methods for this. These fractures can be treated with mini screw fixation, mini plate fixation, K wire fixation, dynamic and static external fixator fixation. It is being investigated which of these methods is superior in which aspect. Therefore, the subject of this thesis is to compare the functional and radiographic results of the use of K-wire and mini-screw in intra-articular fractures of the middle and proximal phalanx. Our aim is to find out which treatment is more effective in these fractures and to rehabilitate these patients earlier and return them to their daily lives and work lives as soon as possible.

Keywords

• Condyle fractures
• basis fractures
• mini screw
• open reduction

References

1. 1. T. T. Lögters, H. H. Lee, S. Gehrmann, J. Windolf, and R. A. Kaufmann, “Proximal Phalanx Fracture Management,” Hand (N Y), vol. 13, no. 4, pp. 376–383, Jul. 2018, doi: 10.1177/1558944717735947.
2. 2. A. H. Taghinia and S. G. Talbot, “Phalangeal and Metacarpal Fractures,” Clin Plast Surg, vol. 46, no. 3, pp. 415–423, Jul. 2019, doi: 10.1016/J.CPS.2019.02.011.
3. 3. “Green DP, Butler TE, Jr: Fractures and dislocations in the hand. In: Rockwood and Green’s Fractures in Adults, Bucholz RW, Beckman JD(eds), Vol.1, 4th ed., Lippincott, New York, 1996, s:607-744.”.
4. 4. “Kaplan İ, Eroğlu M: 1983-1989 yılları arasında 12803 kırığın analizi. XII. Milli Türk Ortopedi ve Travmatoloji Kongre Kitabı, Ege R. (ed), 1991, T.H.K. Basımevi, s: 193-6”.
5. 5. “Egol KA, Koval KA, Zukerman JD. Kırıklar ve Çıkıklar El Kitabı2013”.
6. 6. K. C. Chung and S. v. Spilson, “The frequency and epidemiology of hand and forearm fractures in the United States,” J Hand Surg Am, vol. 26, no. 5, pp. 908–915, 2001, doi: 10.1053/JHSU.2001.26322.
7. 7. D. Lamb, “Training in Hand Surgery,” Journal of Hand Surgery, vol. 15, no. 2, pp. 148–150, Apr. 1990, doi: 10.1016/0266-7681_90_90117-M/ASSET/0266-7681_90_90117-M.FP.PNG_V03.
8. 8. W. Y. Ip, K. H. Ng, and S. P. Chow, “A prospective study of 924 digital fractures of the hand,” Injury, vol. 27, no. 4, pp. 279–285, 1996, doi: 10.1016/0020-1383(95)00222-7.

9. 9. Green DP and Butler TE, “Fractures and dislocations in the hand. ,” in Rockwood and Green’s Fractures in Adults, Bucholz RW and Beckman JD, Eds., 4th ed.New York: Lippincott, 1996, pp. 607–744.
10. 10. D. Popova, T. Welman, S. v. Vamadeva, and G. S. Pahal, “Management of hand fractures,” Br J Hosp Med (Lond), vol. 81, no. 11, Nov. 2020, doi: 10.12968/HMED.2020.0140.
11. 11. S. P. Moura et al., “Epidemiology and Fracture Patterns of Traumatic Phalangeal Fractures,” Plast Reconstr Surg Glob Open, vol. 10, no. 8, p. E4455, Aug. 2022, doi: 10.1097/GOX.0000000000004455.
12. 12. S. Weum, S. Millerjord, and L. de Weerd, “The distribution of hand fractures at the university hospital of north Norway,” J Plast Surg Hand Surg, vol. 50, no. 3, pp. 146–150, Feb. 2016, doi: 10.3109/2000656X.2015.1137923.
13. 13. N. Kodama, Y. Takemura, H. Ueba, S. Imai, and Y. Matsusue, “Operative treatment of metacarpal and phalangeal fractures in athletes: early return to play,” J Orthop Sci, vol. 19, no. 5, pp. 729–736, Sep. 2014, doi: 10.1007/S00776-014-0584-5.
14. 14. C. M. Curtin and K. C. Chung, “Use of eight-hole titanium miniplates for unstable phalangeal fractures,” Ann Plast Surg, vol. 49, no. 6, pp. 580–586, Dec. 2002, doi: 10.1097/00000637-200212000-00005.
15. 15. K. J. Fischer, J. A. Bastidas, D. A. Provenzano, and M. M. Tomaino, “Low-profile versus conventional metacarpal plating systems: a comparison of construct stiffness and strength,” J Hand Surg Am, vol. 24, no. 5, pp. 928–934, 1999, doi: 10.1053/JHSU.1999.0928.
16. 16. Freeland AE, “External fixation for skeletal stabilization of severe open fractures of the hand,” Clin Orthop Relat Res, pp. 93–100, 1987.
17. 17. S. P. Chow et al., “A prospective study of 245 open digital fractures of the hand,” J Hand Surg Br, vol. 16, no. 2, pp. 137–140, 1991, doi: 10.1016/0266-7681(91)90162-H.
18. 18. T. v. Swanson, R. M. Szabo, and D. D. Anderson, “Open hand fractures: prognosis and classification,” J Hand Surg Am, vol. 16, no. 1, pp. 101–107, 1991, doi: 10.1016/S0363-5023(10)80021-8.
19. 19. R. F. McLain, C. Steyers, and M. Stoddard, “Infections in open fractures of the hand,” J Hand Surg Am, vol. 16, no. 1, pp. 108–112, 1991, doi: 10.1016/S0363-5023(10)80022-X.
20. 20. M. El-Saeed, A. Sallam, M. Radwan, and A. Metwally, “Kirschner Wires Versus Titanium Plates and Screws in Management of Unstable Phalangeal Fractures: A Randomized, Controlled Clinical Trial,” J Hand Surg Am, vol. 44, no. 12, pp. 1091.e1-1091.e9, Dec. 2019, doi: 10.1016/J.JHSA.2019.01.015.
21. 21. P. Kurzen, C. Fusetti, M. Bonaccio, and L. Nagy, “Complications after plate fixation of phalangeal fractures,” J Trauma, vol. 60, no. 4, pp. 841–843, Apr. 2006, doi: 10.1097/01.TA.0000214887.31745.C4.
22. 22. M. El-Saeed, A. Sallam, M. Radwan, and A. Metwally, “Kirschner Wires Versus Titanium Plates and Screws in Management of Unstable Phalangeal Fractures: A Randomized, Controlled Clinical Trial,” J Hand Surg Am, vol. 44, no. 12, pp. 1091.e1-1091.e9, Dec. 2019, doi: 10.1016/J.JHSA.2019.01.015.
23. 23. H. Zhu, Z. Xu, H. Wei, and X. Zheng, “Locking Plate Alone versus in Combination with Two Crossed Kirschner Wires for Fifth Metacarpal Neck Fracture,” Sci Rep, vol. 7, Apr. 2017, doi: 10.1038/SREP46109.
24. 24. K. C. Chung and S. v. Spilson, “The frequency and epidemiology of hand and forearm fractures in the United States,” J Hand Surg Am, vol. 26, no. 5, pp. 908–915, 2001, doi: 10.1053/JHSU.2001.26322.
25. 25. Stem PJ, “Fractures of the metacarpals and phalanges,” in Green’s Operative Hand Surgery, Green DP, Hotchkiss RN, and Pederson WC, Eds., 4th ed.Churchill- Livingstone.