Stabil olmayan femur proksimal kırıklarında anti rotatuar lag vidası olan proksimal femoral çivi (PFN) ile bıçaklı LAG vidası olan proksimal femoral çivinin biyomekanik kıyaslanması

Year 2022, , 361 - 367, 31.12.2022

Burak Özturan , Tarık Sarı

https://doi.org/10.36516/jocass.1210389

Abstract

Giriş: Proksimal femur kırıkları tedavisinde kullanılan farklı lag vidalarının çivi sisteminin aksiyel yüklenmedeki dayanıklılığında değişikliğe neden olup olmadığı değerlendirildi.
Gereç ve Yöntemler: AO/OTA 31/A2 tipinde kırık oluşturulan 14 kemik modeli yedişerli olacak şekilde iki gruba randomize olarak ayrıldı. Birinci gruptaki kemik modelleri bıçaklı lag vidası olan proksimal femur çivisi ile fikse edilirken; ikinci gruptaki kemik modelleri anti-rotatuar lag vidası olan proksimal femur çivisi ile fikse edildi. Tüm kemik modellerinin femur başlarına femur mekanik aksına uygun olacak şekilde 5 mm/dk hızda siklik kuvvet aksiyel olarak uygulandı. Test implant yetmezliği gelişinceye veya model kırılıncaya kadar sürdürüldü.
Sonuç: PFN grupundaki kemikler en az 908 N en fazla 1195 N kuvvetle kırılırken ortalamaları 1050 N oldu; A-PFN grupundaki kemikler en az 847 N en fazla 1219 N kuvvetle kırılırken ortalamaları 1096 N oldu. İki gruptaki kemiklere aksiyel yüklenme sonrası kırık oluşturan kuvvetler arasında istatiksel olarak anlamlı bir fark görülmedi (p=0,95;p>0,05)
Tartışma: Stabil olmayan intertrokanterik femur kırıklarında (ITFK) proksimal femur çivilerinde doğru pozisyonda yerleştirme ve tam redüksiyon ile cut-out ve varus kollaps komplikasyonları ile karşılaşılmadı. Bu sonuçlar sonrasında her iki model çivi stabil olmayan ITFK’larda güvenle kullanılabileceği ön görülmektedir.

Keywords

PFN,, intertrokanterik femur kırığı,, Stabil olmayan

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