Açık Redüksiyona Uygun Olmayan Radius Distali Metafiz Kırıklarında Eksternal Fiksasyon ile Alçı Döküm Sonuçlarının Karşılaştırılması

Year 2021, Volume: 23 Issue: 2, 270 - 278, 31.08.2021

Kerim Öner Muhammet Salih Ayas

https://doi.org/10.24938/kutfd.895219

Abstract

Amaç: Kapalı redüksiyon ve alçı (KRA) ve köprü eksternal fiksasyon (EF) ile tedavi edilen distal radius eklem dışı metafizer kırıklarının radyografik ve fonksiyonel sonuçlarını karşılaştırmayı amaçladık.

Gereç ve Yöntemler: Bu retrospektif çalışmaya distal radius kırığı olan 65 hasta dahil edildi. Hastaların ortalama yaşı 55 idi. Hastalar KRA grubu ve köprü EF grubu olarak adlandırılan iki gruba ayrıldı. Tüm kırıklar AO/OTA tip A3 idi. Tüm hastalar, birinci yılın sonunda Cooney tarafından modifiye edilen Green ve O'Brien Skoru, Mayo Bilek Skoru ve Kol, Omuz ve El Engellilikleri (DASH) ile değerlendirildi.

Bulgular: Ortalama yaş KRA grubunda 54.32±8.61 yıl, köprü EF grubunda 56.65±8.31 yıl idi. Ortalama takip süresi KRA grubunda 24.06±8.67 ay, köprü EF grubunda 24.88±9.2 aydı. Birinci yılın sonunda yapılan değerlendirmede kırıklar radyolojik olarak karşılaştırıldığında, köprü oluşturan EF grubunda radyal eğim ve radyal uzunluk sonuçları KRA grubuna göre istatistiksel olarak anlamlı bulundu. Klinik muayene sırasında kırıkların hareket aralığı karşılaştırıldığında, köprü EF grubunda KRA grubuna göre istatistiksel olarak anlamlı bulundu. Green ve Mayo skorlarında gruplar arası skorlama açısından istatistiksel olarak anlamlı bulunmadı. DASH skoru KRA grubunda 10.88±2.99, köprü EF grubunda 5.73±2.57 idi ve istatistiksel olarak anlamlıydı (p<0.001).

Sonuç: Daha az invaziv bir teknik olması ve başarılı klinik sonuçlar sağlaması nedeniyle yumuşak dokusu açık cerrahiye izin vermeyen AO/OTA tip A3 radius kırıklarında birincil tedavi seçeneklerinden biri olarak köprüleyici EF tedavisi önerilebilir.

Keywords

DASH, distal radius kırığı, eklem dışı, eksternal fiksasyon, alçı

COMPARISON OF EXTERNAL FIXATION AND PLASTER CASTING RESULTS IN DISTAL RADIUS METAPHYSIS FRACTURES THAT ARE NOT SUITABLE FOR OPEN REDUCTION

Abstract

Objective: We aimed to compare the radiographic and functional results of extra-articular metaphyseal fractures of the distal radius treated with closed reduction and plaster casting (CRPC) and bridging external fixation (EF).

Material and Methods: This retrospective study included 65 patients with distal radius fractures. The mean age of the patients was 55 years. Patients were divided into two groups, which were called the CRPC group and bridging EF group. All fractures were AO/OTA type A3. All patients were evaluated with Green and O'Brien Score modified by Cooney, Mayo Wrist Score and The Disabilities of the Arm, Shoulder, and Hand (DASH) at the end of the first year.

Results: The mean age was 54.32±8.61 years in the CRPC group and 56.65±8.31 years in the Bridging EF group. The mean follow-up time was 24.06±8.67 months in the CRPC group and 24.88±9.2 months in the bridging EF group. When the fractures were compared radiologically during the evaluation at the end of the first year, radial inclination and radial length results in the bridging EF group were statistically significant compared to the CRPC group. When the range of motions was compared in the fractures during the clinical examination, they were statistically significant in the bridging EF group compared to the CRPC group. There was no statistical significance in Green and Mayo scores in terms of the scoring between the groups. DASH score was 10.88±2.99 in the CRPC group and 5.73±2.57 in the bridging EF group, and it was statistically significant (p<0.001).

Conclusion: Bridging EF treatment can be recommended as one of the primary treatment options in AO/OTA type A3 radius fractures, whose soft tissue does not allow open surgery, because it is a less invasive technique and provides successful clinical results.

Keywords

DASH, Distal radius fractures, External fixation, Plaster Casting, extra-articular

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