Danis-Weber Tip A ve B lateral malleol kırıklarında plak-vida ve gergi bandı tekniği sonuçlarının karşılaştırılması

Yıl 2013, Cilt: 47 Sayı: 1, 27 - 31, 05.04.2013

Cetin Isik Osman Tecimel Ramazan Akmese Ahmet Firat Mesut Tahta Murat Bozkurt

Öz

Amaç: Çalışmada izole Danis-Weber Tip A ve B lateral malleol kırıklarında plak-vida ile gergi bandı tekniklerinin klinik ve radyolojik sonuçlarının karşılaştırılması amaçlandı.
Çalışma planı: Kasım 2005-Aralık 2010 tarihleri arasında, izole Danis- Weber tip A ve B lateral malleol kırığı tanısıyla 4 farklı merkez ve 6 ayrı klinikte opere olmuş 135 olgu (82 tip B, 53 tip A kırık) geriye dönük olarak değerlendirildi. Grup 1’de yer alan 81 (55 tip B, 26 tip A) hastada lateralden 1/3 tübüler plak ve vida tekniği; Grup 2’de yer alan 54 (27 tip B, 27 tip A) hastada ise gergi bandı tekniği ile cerrahi tespit uygulandı. Gruplar klinik ve radyolojik sonuçlarına göre karşılaştırıldı. İstatistiksel analizde Student-t testi kullanıldı.
Bulgular: Grup 1’de cerrahi insizyon skarı tip A’da ortalama 4.9 cm (4.5-5.4), tip B’de 6.8 cm (5.6-7.5) iken; Grup 2’de 4 cm (3.5-5.2) ve 5.3 cm (5.0-5.9) olarak ölçüldü. Radyolojik kaynama Grup 1’de ortalama 10 haftada (7-13) sağlanırken, Grup 2’de 9 haftada (7-12) sağlandı. Grup 1’de 12 hastada takiplerde implantlar çıkarılırken; Grup 2’de sadece bir hastada implantların çıkarılmasına gerek görüldü. AOFAS Skoru grup 1’de ortalama 90 (72-100) iken; Grup 2’de 92 (70-100) olarak ölçüldü.
Çıkarımlar: Danis-Weber Tip A ve B kırıklarında kullanılan her iki cerrahi teknik de, mükemmel sonuç vermektedir. Gergi bandı tekniği bu tip kırıklarda ucuz ve kabul edilebilir bir tedavi seçeneği olabilir.

Anahtar Kelimeler

Ayak bileği, cerrahi tedavi, kırık sabitlenmesi-internal, kırık sabitlenmesi-intramedüller, kemik vidaları.

The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures

Öz

Objective: The aim of this study was to compare the clinical and radiological results of plate-screw and tension band fixation in isolated Danis-Weber Type A and B lateral malleolar fractures.
Methods: A total of 135 cases of lateral malleolar fractures (82 Danis-Weber Type B and 53 Type A) operated on in 4 different centers and 6 orthopaedic clinics between November 2005 and December 2010 were reviewed retrospectively. Eigthy-one patients (55 Type B and 26 Type A) had lateral 1/3 tubular plate and screw fixation (Group 1), while the remaining 54 patients (27 Type B and 27 Type A) were operated on with tension band technique (Group 2). The clinical and radiological results of the groups were compared. Student t test was used in statistical analysis.
Results: The mean length of surgical incision scar was 4.9 cm (4.5-5.4 cm) for Type A fractures and 6.8 cm (5.6-7.5 cm) for Type B in Group 1 and 4.0 cm (3.5-5.2 cm) for Type A and 5.3 cm (5.0-5.9 cm) for Type B fractures in Group 2. Radiological union was obtained at mean of 10 weeks (7-13 weeks) in Group 1 and 9 weeks (7-12) in Group 2. The implant had to be removed in 12 patients in Group 1 and in one patient in Group 2. The mean AOFAS Score was 90 (72-100) and 92 (70-100) in Groups 1 and 2, respectively.
Conclusion: Both plate-screw and tension band techniques revealed excellent results in isolated DanisWeber Type A and B fractures. The tension band technique may be an alternative fixation method in the treatment of these fractures.

Anahtar Kelimeler

Ankle, operative therapy, fracture fixation-internal, fracture fixation-intramedullar, bone screws

Kaynakça

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