İzole ulna cisim kırıklarında konservatif ve cerrahi tedavi yöntemlerinin karşılaştırılması

Abstract

Amaç: İzole ulna cisim kırıklarının tedavisinde hem konservatif hem de cerrahi metodlar önerilmiştir. Çalışmanın amacı izole ulna cisim kırıklarının optimal tedavisini ve kırık iyileşmesini etkileyen faktörleri araştırmaktır.

Gereç ve Yöntemler: Çalışmaya 2013-2016 yılları arasında hastanemize başvurmuş izole ulna cisim kırıklı 43 hasta alındı. Hastalar konservatif tedavi edilen ve cerrahi olarak tedavi edilen olmak üzere 2 grupta incelendi. Sonuçların değerlendirilmesinde eklem hareket açıklığı, kavrama gücü, fonksiyonel ve radyolojik sonuçlar kullanıldı. Ağrı vizuel analog skala (VAS) ile değerlendirildi. Kavrama gücüne ise el dinamometresiyle hasta otururken ve dirsek 90 derece fleksiyonda bakıldı. Fonksiyonel sonuçlara kol, omuz el sorunları skorlaması (DASH Skoru) ile bakıldı.

Bulgular: Konservatif tedavi edilen grupta 23 hasta, cerrahi tedavi edilen grupta 20 hasta bulunmaktaydı. Her 2 grup arasında yaş, cinsiyet dağılımı, kırık paterni, yaralanma mekanizması ve kırık lokasyonu açısından fark saptanmadı. Her 2 grup arasında VAS skoru, kavrama gücü, DASH skoru ve kaynama açısından da fark saptanmadı. Konservatif tedavi edilen grupta kaynama süresi ortalama 12±1,04 haftayken cerrahi olarak tedavi edilen grupta kaynama süresi ortalama 17±1,16 haftaydı (p=0,586). Her 2 grup arasında dirsek ve el bileği eklem hareket açıklığı ve komplikasyonlar açısından da fark saptanmadı.

Sonuç: Çalışmamızda cerrahi olarak tedavi edilen hastaların konservatif olarak tedavi edilen hastalardan fonksiyonel ve klinik olarak daha iyi sonuçlara sahip olmadığı ve konservatif tedavi yöntemlerinin sonuçlarının başarılı olduğunu saptandı. İzole ulna cisim kırıkları tedavi yönteminin belirlenmesinde prospektif, çok merkezli ve daha geniş hasta serilerini kapsayan çalışmalara ihtiyaç vardır.

Keywords

• İzole ulna cisim kırığı,konservatif tedavi,cerrahi tedavi

Comparison of conservative and surgical treatment methods in isolated ulna shaft fractures

Abstract

Aim: Conservative and surgical treatment options have been suggested for the treatment of isolated ulna shaft fractures. The aim the study is to research the optimal treatment option for isolated ulna fractures and factors affecting the fracture healing.

Material and Methods: The study included 43 patients who applied to our hospital in 2013-2016 with isolated ulna shaft fractures. Patients were divided into two groups: conservative treatment and surgical treatment. Joint range of motion, grip strength, functional and radiologic results were used for evaluating the results. Pain was evaluated by visual analogue scale (VAS). Grip strength was measured with a hand dynamometer while the patient was sitting and elbow was in 90-degree flexion. Functional tests were evaluated with the Disabilities of the Arm, Shoulder and Hand Score (DASH Score).

Results: 23 patients were in the conservative treatment group and 20 patients were included in the surgical intervention group. No difference was observed in terms of VAS score, grip strength, DASH score and bone union. Average bone union times for the two groups were as following: conservative treatment group, 12±1.04 weeks; surgical treatment group, 17±1.16 weeks (p=0,586). No difference was observed between the groups in terms of hand wrist joint range of motion and complications.

Conclusion: Our study showed that patients who were treated by surgical intervention had no functional and clinical superiority to patients with conservative treatment. There is a need for prospective and multicentre studies comprising a larger series of patients for defining the methodology for isolated ulna shaft fractures.

Keywords

• isolated ulnna shaft fracture,conservative treatment,surgical treatment

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