Klavikula orta diyafiz parçalı kırıklarının köprüleme plaklama yöntemi kullanılarak kilitli plak ile tedavisi

Öz

Amaç: Bu çalışmanın amacı minimal cerrahi diseksiyonla uygulanan köprü plaklama tedavisi sonrası klavikula orta diyafiz parçalı kırıklarının kaynamasını ve fonksiyonel sonuçlarını değerlendirmekti.

Çalışma planı: Retrospektif olarak yapılan çalışmaya klavikula orta diyafiz parçalı kırıkları 2004 ile 2010 yılları arasında tedavi edilen 17’si erkek ve 6’sı kadın toplam 23 hasta alındı. Tüm kırıklar minimal cerrahi diseksiyonla köprü plaklama tekniği kullanılarak opere edildi. Hastaların fonksiyonel değerlendirilmesi için Constant omuz skorlama sisteminden yararlanıldı.

Bulgular: Ortalama takip süresi 22 (dağılım: 6-68) ay olarak ölçülürken, ortalama 13 (dağılım: 8-20) haftalık bir dönemden sonra bütün kırıklarda kaynama görüldü. Hiçbir hastada implant yetmezliği, yüzeysel ya da derin enfeksiyon gözlenmedi. Yine hiçbir hastada iatrojenik nörovasküler hasar yoktu. Sağlam tarafla karşılaştırıldığında iki hastada klavikula uzunluklarının farklı oldu[u saptandı. Hastaların eklem hareket açıklığı normal idi. Ortalama Constant skoru 89.6 (dağılım: 72-100) olarak hesaplandı.

Çıkarımlar: Klavikula orta diyafiz kırıklarının köprüleme plak tekniği ile kilitli plaklar kullanılarak cerrahi tedavisi yüksek hasta konforu sağlar, erken mobiliteye izin verir ve aynı zamanda düşük komplikasyon oranına sahiptir.

Anahtar Kelimeler

• Kırık; klavikula; köprüleme; orta şaft.

Treatment of comminuted mid-diaphyseal clavicle fractures by plate fixation using a bridging technique

Abstract

Objective: The aim of this study was to determine the healing and functional results of the treatment of comminuted mid-diaphyseal clavicular fractures using a bridging plate technique with minimal surgical dissection.

Methods: This retrospective study included 23 patients (17 males and 6 females) with comminuted mid-diaphyseal clavicular fractures treated between 2004 and 2010. All fractures were operated on using a bridging plate technique with minimal surgical dissection. Patients were evaluated for function using the Constant shoulder scoring system.

Results: Mean follow-up was 22 (range: 6 to 68) months and healing occurred in all patients after a mean of 13 (range: 8 to 20) weeks. No implant failures or superficial or deep infections were observed. Iatrogenic neurovascular damage was not observed in any patient. Two patients had clavicle length discrepancy in comparison with the healthy side. Range of motion was normal in all patients. The mean Constant score was 89.6 (range: 72 to 100) points.

Conclusion: The surgical treatment of mid-diaphyseal fractures with the bridging plate technique using locking plates provides good patient comfort, allows early mobility and has a low complication rate.

Keywords

• Bridging
• clavicle
• fracture
• midshaft

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