İzole ulna cisim kırıklarında konservatif ve cerrahi tedavi yöntemlerinin karşılaştırılması

Year 2018, Volume: 9 Issue: 3, 199 - 204, 30.09.2018

Tolga Tolunay , Mehmet Orçun Akkurt

https://doi.org/10.18663/tjcl.439538

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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