Pediatrik Femur Boyun Kırıklarının Klinik ve Radyolojik Sonuçları

Year 2017, Volume: 1 Issue: 2, 83 - 88, 15.07.2017

Ahmet Issın İsmet Yalkın Çamurcu Mehmet Nuri Konya , Vedat Şahin

https://doi.org/10.30565/medalanya.320251

Abstract

Amaç: Bu çalışmanın
amacı, pediatrik femur boyun kırıklarının klinik ve radyolojik sonuçlarını
değerlendirmek ve sonuçları literatürle karşılaştırmaktır.

Yöntemler: 2005-2012
tarihleri arasında femur boyun kırıklıkları tanısıyla tedavi edilen hastaları
retrospektif olarak taradık. Takiplerini aksatmayan ve minimum 1 yıllık takip
süresi olan 14 hasta (6 kız çocuk, 8 erkek çocuk) kayıtlardan bulundu. Kırığın
nedeni ve uygulanan tedavi tipi kayıtlardan araştırıldı. Kırık tipini
belirlemede Delbet-Colonna sınıflaması kullanıldı. Son kontrolde, femur
boyun-şaft açısı ve etkilenen kalçanın hareket açıklığı ölçüldü. Nihai sonuç
Ratliff’in değerlendirme kriterlerine göre skorlandı. Avasküler nekrozlar (AVN)
Ratliff’in AVN sınıflama sistemine göre sınıflandırıldı.

Bulgular: Hastaların
ortalama yaşı 9.9 olup ortalama takip 35 aydı. Delbet-Colonna sınıflamasına
göre;  hastalardan 1’i tip 1 (%7.1), 4’ü
tip 2 (%28.6), 8’i tip 3 (%57.2) ve 1’i tip 4’dü (%7.1). 14 kırığın 8’i kaymış
kırıktı (%57.2) ve 6’sı kaymamış kırıktı (%48.2). Ratliff değerlendirme
kriterlerine göre, 14 hastanın 11’inin iyi (%78.6), 1’inin orta (%7.1) ve
2’sinin (%14.3) kötü sonucu vardı. Ratliff AVN sınıflamasına göre, 2 hastada
tip 3 (%14.3) ve 1 hastada tip 1 (%7.1) AVN vardı.

Sonuç: Sonuçlarımıza
göre, pediatrik femur boyun kırıklarının tedavisinde anatomik redüksiyon
(kapalı veya açık) ve stabil internal tespiti öneriyoruz.

Keywords

femoral boyun kırıkları, pediatri, yaralanmalar, avasküler nekroz

Clinical and Radiographic Outcomes of Pediatric Femoral Neck Fractures

Abstract

Aim: The aim of this
study was to evaluate the clinical and radiological results of pediatric
femoral neck fractures and compare the results with the literature.

Methods: We retrospectively
reviewed patients with the diagnosis of femoral neck fracture who were treated
between 2005 and 2012. 14 patients (6 girls, 8 boys) were found in compliance
with the follow-up and with a minimum follow-up of 1 year. Causes of the
fracture and types of the treatment were investigated from our medical records.
Delbet-Colonna classification was used to determine the type of the fractures.
At the last follow-up, femoral neck shaft angle (FNSA) and range of motion
(ROM) of the affected hip were measured. Outcome was scored according to
Ratliff’s assessment criteria. Avascular necrosis (AVN) was classified
according to Ratliff’s AVN classification system.

Results: The mean age of
patients was 9.9 years and the mean follow-up was 35 months. According to
Delbet-Colonna classification; 1 patient was type I (7.1%), 4 were type II
(28.6%), 8 were type III (57.2%) and 1 was type IV (7.1%). Eight of 14
fractures were displaced (57.2%) and six were non-displaced (42.8%). Eleven of
14 patients had good (78.6 %), 1 had fair (7.1%) and 2 had poor (14.3%) results
according to Ratliff’s assessment criteria. According to Ratliff’s AVN
classification, 2 patients had Type-III (14.2 %) and 1 had Type-I AVN (7.1 %).

Conclusion: According to our
results, we recommend anatomical reduction (close or open) and stable internal
fixation for the treatment of pediatric femoral neck fractures.

Keywords

femoral neck fracture, pediatrics, injuries, avascular necrosis

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