Tibia Kırıklarının İlizarov Yöntemi İle Tedavisi

Abstract

The Treatment of Acute Tibia Fractures using the ilizarov Method The results of 40 patients who had acute tibia fractures and treated with Ilizarov external fixation method in Ondokuz Mayis University Faculty of Medicine, Department of Orthopedics and Traumatology between July 1999 and January 2005 were presented along with a review of the literature. 30 (75%) of the patients were male and 10 (25%) were female. The mean age of patients operated for acute fractures was 36.2 (8-76) and the mean follow-up period was 38 months (18-62). Of all the acute tibial fracture cases treated with Ilizarov external fixator method, we have achieved complete union and had their frames removed. Clinical and functional data acquired during the management and follow-up of the patients were evaluated according to the ASAMI evaluation criteria developed by Paley et al. The results yielded by our acute tibial fracture patients were very good in 22 (58.8%), good in 10 (23.5%), and fair in 8 (17.7%). In our group, we have encountered 4 (6.5%) superficial infectio ns and 5 (8.1%) pin tract infections; all of which responded to antibiotherapy and daily dressing treatment. There were no other complications encountered in our group. On the light shed by the data of this study, it can be concluded that, Ilizarov surgery is the treatment method of choice for acute tibial fractures since it can provide closed reduction, it inflicts no further damage to bone and soft tissues, it does not increase the risk of infection, it provides stable and rigid fixation without compromising the nutrition of bone and soft tissues, it allows axial loading micromotion on the fracture line which is known to have positive effects on bone healing and consolidation, and prevents bending loading which have a deleterious effect on bone healing and consolidation, and it allows the physiologic use of the extremity throughout the treatment process. Ondokuz Mayıs Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı'nda, Temmuz 1999-Ocak 2005 tarihleri arasında, İlizarov yöntemi ile tedavi edilen 40 akut tibia kı-rıklı sonuçları literatür eşliğinde retrospektif olarak değerlendirildi. Hastaların 30'u (%75.0) erkek ve 10'u (%25.0) kadındı. Opere edilen akut tibia kırıklı hastaların yaş ortalaması 36.2 (8-76) yıl idi. Bu hastaların ortalama takip süresi 38 ay (16-62 ay) idi. Tedavi sonucunda tüm hastalarda tam kaynama sağlandı. Sonuçlar Paley ve ark.'nın ASAMI değerlendirme kriterlerine göre değerlendirildi. Hastaların 22'sinde (%58.8) çok iyi, 10'unda (%23.5) iyi ve 8'inde (%17.7) orta sonuç elde edildi. Hastaların dördünde (%10.0) açık yara bölgesinde yüzeyel enfeksiyon ve beş (%12.5) hastada antibiyotik tedavisi gerektiren tel dibi enfeksiyonu görüldü. Başka herhangi bir komplikasyona rastlanılmadı. Akut tibia kırıklarının problemli tiplerinin tedavisinde, İlizarov yönteminin kapalı redüksiyona olanak tanıması, kemik ve yumuşak dokulara ilave zarar vermemesi, enfeksiyon riskini arttırmaması, kemik ve yumuşak dokuların kanlanmasını bozmadan stabil tespit sağlayabilmesi, kırık iyileşmesi için gerekli olan aksiyel yüklenmelere izin verip konsolidasyona pozitif yönde katkısı olan kırık hattındaki mikrohareket sağlaması ve tedavi süresince ekstremitenin fizyolojik kullanımına izin vermesi gibi önemli avantajları olması nedeniyle, etkin bir tedavi metodu olduğu sonucuna varıldı.

Keywords

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