İntramedüller K-Teli Tespiti: Pediatrik Distal Radius Kırıklarının Tedavisinde Uygulanabilir ve Etkin Bir Teknik

Year 2019, Volume: 6 Issue: 1, 37 - 40, 20.03.2019

Yusuf Erdem , Cagri Neyıscı

Abstract

Bu çalışmada, deplase
distal metafizyal ve diametafizyal radius kırıkğı olan 6 çocuğun tedavisinde
uyguladığımız intramedüller K-teli tespitinin, klinik ve radyolojik sonuçlarını
sunmayı amaçladık. Çalışmaya Ocak 2016-Haziran 2017 tarihleri arasında anstabil
distal radius kırığı tanısı ile polikliniğe başvuran 6 çocuk hasta dahil
edildi. Ortalama yaş 8 (dağılım 7-9) idi. Hastaların 3'ünde kırıklar 1.5-2 mm
çapında perkütan uygulanan K-teli ile transepifizyal, diğerlerinde ise hem
transepifizyal hem de transkortikal tespit edildi. Cerrahi sonrası kısa dönem
takip sonuçları değerlendirildi. Ortalama ameliyat süresi 20 dakika idi
(dağılım 15-25). Tüm vakalarda ameliyat sonrası 3 hafta boyunca ek olarak kısa
kol splint kullanıldı. Tüm vakalarda 6 hafta sonra K-telleri çıkarıldı.
Hastaların tümünde kemik kaynamasına ortalama 4 haftada (dağılım 3-6) ulaşıldı.
Ortalama 13 aylık takipte (dağılım 4-18), malunion veya distal radiusun erken
epifizyal kapanmasını da içeren herhangi bir komplikasyon saptanmadı. Bu
çalışmanın sonuçları, çocuklarda deplase radius distal kırıklarının perkütan
olarak fleksible intramedüller K-teli tespit tekniği ile redüksiyonunun ve
osteosentezinin, stabil yapının korunması konusunda kolay, minimal invazif ve
hızlı uygulama gibi birçok avantajı olduğunu göstermiştir. Bu yöntemin
pediatrik distal anstabil radius kırıklarında güvenilir bir tedavi seçeneği
olduğu açıktır.

Keywords

Anstabil Radius Kırığı, İntramedüller Tespit, Pediatrik

Intramedullary K-Wire Fixation: A Feasible and Effective Technique in Treatment of Pediatric Distal Radius Fractures

Abstract

In this research we
aimed to report the clinical and radiological results of a retrospective study
performed on 6 children with severely displaced distal radial metaphyseal and
diametaphyseal fractures, who were treated with percutaneous intramedullary
Kischner wire (K-wire) fixation. A total of 6 children with distal unstable
radius fractures, all of whom have visible physeal plate, were treated as an
inpatient at our clinic January 2016 to June 2017. The average age was 8 years
(range, 7–9 years). The fractures were fixed with two percutaneous
intramedullary K-wires of 1.5-2 mm in diameter either transepiphyseally in
three of them or both transepiphyseally and transcortically in the remaining
three. Operative and short follow-up outcomes were assessed. The average operation
time was 20 min (range, 15-25 min). Additional below-the-elbow splint was used
in all cases for 3 weeks postoperatively. K-wires were removed after 6 weeks in
all cases. Bone union was achieved at an average time of 4 weeks (range, 3-6
weeks) in all cases. No complication including malunion or early epiphyseal
closure of the distal radius was identified at mean follow-up of 13 months
(range, 4-18 months). Results of this study showed that reduction and
osteosynthesis of distal displaced radius fractures in children by percutaneous
flexible intramedullary K-wire fixation technique have many advantages
regarding the maintenance of the stable construct with easy, minimally invasive
and quick application. We thought that this method is a reliable treatment option
for pediatric distal unstable radius fractures.

Keywords

Intramedullary Fixation, Pediatric, Unstable Radius Fracture

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