Surgical Treatment Results of Pediatric Femoral Fractures by Indirect Reduction and Locking plates

Abstract

Purpose: The aim of this study is evaluation of surgical treatment results by using locking
plates and indirect reduction in femoral fractures of childhood.
Materyal and Methods: This prospective study include 17( 7 females and 10 males) patients.
All patients had isolated femoral fractures. Type of femoral fractures in this study classified as
long spiral, oblique and shaft fractures of unstable in long axis. Mean age of patients in this
study was 6.2(range 5-12) years. All patients in this study treated by indirect reduction and
surgically minimal invasive approach with locking plates. Standard anterior-posterior and
lateral radiographs used for radiographic evaluation. Angulations more than 10 degrees in
radiographs accepted as deformity after fracture union.
Results: Mean follow-up time was 10(range3-17) months and mean hospital stay was
4.3(range 2-6) days. We used minimal contact titanium locking plates in all patients. The
avarage length of plates include 10 holes(range 8-12). The avarage of screws using with plates
was 6,7(6-9). Distribution of screws classified as distal and proksimal according to fracture
line. Mean number of proksimal screws were 3,2(3-4) and distal screws were 3,4(3-5). Mean
of fracture union time was 5,4(range 5-7) weeks. There are not any complication and all
fractures healed. İmplants removed in 4 patients.
Conclusion: Unstable long axis femoral fractures of childhood , from 5 years to skeletal
maturation, treated succesful by indirect reduction and locking plates in this study. This
surgical modality have a less complication and high fracture union rates and may alternatively
used instead of titanium elastic nail. Early mobilization and less hospitalization make
excellent family adaptation.

Keywords

• Femur Fracture
• Locking plates
• Surgical Treatment

ÇOCUKLUK ÇAĞI FEMUR KIRIKLARININ TEDAVİSİNDE DOLAYLI REDÜKSİYON VE KİLİTLİ PLAK UYGULAMA SONUÇLARIMIZ

Abstract

Amaç: Bu çalışmada çocukluk çağı femur kırıklarında dolaylı redüksiyon ve kilitli plak uygulamalarının sonuçlarını değerlendirmek.

Materyal ve Metod: Bu prospektif çalışmaya izole femur kırığı olan 17 (7 kız 10 erkek) hasta dahil edildi. Çalışmaya alınan femur kırıkları, uzun spiral, oblik ve uzunluk instabil olan femur diafiz kırıkları idi. Çalışmaya alınan hastaların yaş ortalaması 6,2 (5-12) yıl idi.

Hastaların hepsine dolaylı redüksiyon ve kilitli plak uygulandı. Hastaların radyolojik sonuçları standart olarak çekilen ön arka ve yan grafiler ile değerlendirildi. Hastalarda kaynama sonrası çekilen grafide 10 dereceden fazla olan angulasyonlar deformite olarak belirlendi.

Bulgular: Hastaların ortalama takip süreleri 10 (3-17) ay ve hastanede kalma süreleri ortalama 4,3 (2-6 ) gün idi. Hastaların tamamına az yüzey temaslı kilitli titanyum plaklar kullanıldı. Hastalara kullanılan ortalama plak uzunluğu 10 (8-12) delikli idi. Plak ile beraber ortalama kullanılan vida sayısı 6,7 (6-9) adet idi. Vidaların kırık hattının proksimal ve distal olarak dağılımları, proksimal ortalama 3,2 (3-4) ve distal ortalama 3,4 (3-5) adet olarak belirlendi. Hastaların kaynama zamanı ortalama 5,4 (4-7) hafta idi. Hastaların hepsinde tam kaynama gerçekleşti ve komplikasyon görülmedi. Hastaların dört tanesinden implant çıkarımı yapıldı.

Sonuç: Çalışmamızın sonucunda 5 yaş ile iskelet olgunlaşmasına kadarki süreçte oluşan uzunluk instabil femur kırıklarında dolaylı redüksiyon ile kilitli plak uygulaması ile başarılı sonuçlar elde edilmektedir. Düşük komplikasyon oranı ve yüksek kaynama başarısı ile titanyum elastik çivisi yerine kullanılabilecek alternatif bir yöntemdir. Erken mobilizasyon ve kısa süreli hastane yatışı ile yüksek oranda aile uyumu sağlanabilmektedir.

Keywords

• Femur kırığı
• kilitli plak
• ÇOCUKLUK ÇAĞI

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