AO 34C Patella Kırıkları İçin Gerilim Bandı Tel Tekniği: Kırık Alt Türü ile Erken Dönem Fonksiyonel Sonuçlar Arasındaki İlişki

Yıl 2025, Cilt: 6 Sayı: 2, 135 - 142, 20.05.2025

Mustafa Aydın , Begüm Aslantaş Kaplan , Murat Ali Başak , Ömer Levent Karadamar , Ali Aydilek , Enes Keles , Deniz Çankaya

https://doi.org/10.47482/acmr.1602909

Öz

Amaç: Patella kırıkları tüm iskelet yaralanmalarının yaklaşık %1'ini temsil eder ve sıklıkla ağrı, sınırlı diz hareketi, ekstansör zayıflığı ve ağırlık taşıma zorluğu ile sonuçlanır. Kötü sonuçlar genellikle hızlandırılmış patellofemoral artroz ile bağlantılıdır. Bu çalışma, gerilim bandı teli ile tedavi edilen OTA/AO Tip 34-C patella kırıklı hastaların klinik ve radyolojik sonuçlarını retrospektif olarak değerlendirdi. Kırık tipini ve tedavi sonuçlarını günlük yaşam aktiviteleri ile ilişkili olarak analiz ederek herhangi bir korelasyon belirlemeye çalıştık.
Yöntemler: 2017 ile 2024 yılları arasında gerilim bandı teli ile tedavi edilen ve düzenli takiplere katılan OTA/AO Tip 34-C kırıklı hastalar çalışmaya dahil edildi. Toplam 28 hasta kaydedildi ve yaş, cinsiyet, ASA skoru, AO kırık tipi ve kırık tarafı ile ilgili veriler toplandı. Ameliyat sonrası altıncı ayda KOOS, VAS ve diz hareket açıklığı (ROM) değerlendirildi. Sonuçlar: 28 katılımcının ortalama yaşı 45 ± 19,65 yıldı. Erkekler ve kadınlar arasında ROM, KOOS skorları veya VAS'ta anlamlı bir fark bulunmadı (p > 0,05). AO34-C3 kırıkları en yaygın olanıydı. En yüksek KOOS skorları ve en düşük VAS ağrı skorları AO Tip C1 kırıklarında kaydedilirken, AO34-C3 kırıkları en düşük KOOS skorlarına ve en yüksek VAS skorlarına sahipti. Ancak, OTA/AO kırık alt tiplerinin (C1, C2, C3) analizi, ROM, KOOS veya VAS skorlarında istatistiksel olarak anlamlı bir fark ortaya koymadı (p > 0,05). Benzer şekilde, kırık tarafıyla ilgili olarak anlamlı bir fark gözlenmedi (p > 0,05).
Sonuç: Bu çalışma, literatürde parçalanmış, yerinden oynamış patella kırıkları için orta ve uzun vadeli zayıf sonuçlar bildirilirken; istatistiksel olarak anlamlı olmasa da erken dönemde alt tipler arasındaki sonuçlardaki farklılıkların başka katkıda bulunan faktörleri öne sürdüğünü vurgulamaktadır. OTA/AO Tip C3 kırıklarının yaygınlığı, bu alt tip için kişiye özel tedavi protokollerinin önemini vurgulamaktadır.

Anahtar Kelimeler

patella kırığı , OTA/AO 34-C , KOOS , VAS , ROM

Etik Beyan

Bu çalışma için etik onay Üçüncü Basamak Hastane Yerel Etik Kurulu'ndan (28.06.2024, No: 2024/351) alınmıştır.

Proje Numarası

no

Tension Band Wiring of AO 34C Patella Fractures: Relationship Between Fracture Subtype and Early-Term Functional Results

Öz

Background: Patella fractures account for about 1% of skeletal injuries, leading to pain, limited knee motion, extensor weakness, and difficulty with weight-bearing. This study retrospectively assessed clinical and radiological outcomes of patients with OTA/AO Type 34-C patella fractures treated with tension band wiring, analyzing fracture type and treatment outcomes in relation to daily activities to identify potential correlations.
Methods: Between 2017 and 2024, 28 patients treated for OTA/AO Type 34-C fractures with tension band wiring and attending regular follow-ups were included. Data on age, gender, ASA score, AO fracture type, and fracture side were collected. At six months postoperatively, KOOS, VAS, and knee range of motion (ROM) were assessed.
Results: The 28 participants had an average age of 45 ± 19.65 years. No significant differences were found between males and females in ROM, KOOS scores, or VAS (p > 0.05). AO34-C3 fractures were the most common. AO Type C1 fractures had the highest KOOS scores and lowest VAS pain scores, while AO34-C3 fractures had the lowest KOOS scores and highest VAS scores. However, no significant differences were found in ROM, KOOS, or VAS scores across OTA/AO fracture subtypes (C1, C2, C3) or fracture side (p > 0.05).
Conclusion: This study highlights that while literature reports poor medium- and long-term outcomes for comminuted, displaced patella fractures, the early period differences in outcomes between subtypes, though not statistically significant, suggest other contributing factors. The prevalence of OTA/AO Type C3 fractures emphasizes the need for tailored treatment protocols for this subtype.

Anahtar Kelimeler

Patella fracture , OTA/AO 34-C subtype , early functional results , pain , range of motion

Etik Beyan

This study was approved by the Ethics Committee of Gülhane Faculty of Medicine (Decision No: 2024/351). Written informed consent was obtained from all participants prior to surgery.

Destekleyen Kurum

No specific funding was received for this study. All procedures and data collection were carried out independently by the authors without external financial support.

Proje Numarası

no

Teşekkür

No acknowledgments are made to any individual for this study.

Kaynakça

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