Comparison of Intramedullary Nail Fixation and Minimally Invasive Plate Osteosynthesis in Distal Tibial Fractures in Geriatric Patients

Year 2024, , 315 - 320, 30.09.2024

Uğur Onur Kasman

https://doi.org/10.31832/smj.1458009

Abstract

Introduction: Minimally invasive plate osteosynthesis (MIPO) and intramedullary nails are two accepted and effective methods in the treatment of tibial fractures. This study was aimed to evaluate the surgical treatment and complications of distal tibial fractures not related to the ankle joint with MIPO and intramedullary nails in the geriatric group retrospectively.
Materials and Methods: Between 2019 and 2020, 42 patients in the geriatric group with distal tibia fractures that did not extend to the ankle joint and who underwent surgical treatment were evaluated retrospectively. The patients were divided into two groups: those who underwent MIPO and those who underwent osteosynthesis with an intramedullary nail. Patients were evaluated according to Johner Wrush criteria.
Results:
This study enrolled 42 patients. The mean age of the patients was 70±3.4 years. 22 of these patients underwent osteosynthesis with intramedullary nailing. MIPO was performed in the treatment of 20 patients. Based on the Johner Wrush criteria, the intramedullary nail group evaluated 16 patients as very good, 5 as good, and 1 as bad. The MIPO group evaluated 15 patients as excellent, 3 as good, 1 as moderate, and 1 as poor.
Conclusion: In geriatric age groups, there was no significant difference in clinical outcomes or complications from surgical treatment of closed tibial distal fractures that do not extend to the ankle joint. Both surgical treatment methods can be applied effectively to geriatric patients.

Keywords

Fracture, Geriatric, Tibia

Geriatrik Hastalarda Distal Tibia Kırıklarının Cerrahi Tedavisinde İntramedüller Çivi ve Minimal İnvaziv Plak ile Osteosentezin Karşılaştırılması

Abstract

Amaç: Tibia kırıklarının tedavisinde minimal invaziv plak ile osteosentez ve intramedüller çivi kabul edilmiş ve etkili tedavi yöntemidir. Bu çalışmada geriatrik grupta ayakbileği eklemine uzanmayan distal tibia kırıklarının intramedüller çivi ve MIPO tedavi sonuçlarının ve komplikasyonlarının retrospektif olarak değerlendirilmesi amaçlanmıştır.
Gereç ve yöntemler: Geriatrik grupta ayak bileği eklemine uzanmayan distal tibia kırığı olan cerrahi tedavi yapılan hastalar retrospektif olarak değerlendirilmiştir. Çalışmaya dahil olma kriterleri geriatrik yaş grubunda olan ayak bileği eklemine uzanmayan distal tibia kırığı olan hastalar ve takip dosyalarında Johner Wrush kriterleri olan hastalar olarak belirlenmiştir.
Bulgular:
Çalışmaya 42 hasta dahil edildi. Hastaların ortalama yaşı 70 ± 3.4 yıl olarak belirlendi. 22 hastaya intramedüller çivi ile tespit yapıldı. 20 hastanın tedavisinde MIPO yapıldı. İntramedüller çivi yapılan grupta Johner Wrush kriterlerine göre 16 hasta çok iyi, 5 hasta iyi ve 1 hasta kötü olarak değerlendirildi. MIPO yapılan grupta 15 hasta çok iyi, 3 hasta iyi, 1 hasta orta ve 1 hasta kötü olarak değerlendirildi.
Sonuç: Geriatrik yaş grubunda ayak bileği eklemine uzanmayan distal tibia kırıklarının klinik sonuçları ve komplikasyonları açısından her iki tedavi grubunda anlamlı bir fark tespit edilmedi ve her iki cerrahi tedavi metodu geriatrik hastalarda etkili bir şekilde uygulanabilir.

Keywords

Geriatri, Kırık, Tibia kırıkları

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