Kondiler destek plağı uygulaması sonrası femoral suprakondiler varus yanlış kaynamalarının retrograd kilitli intramedüller çivi ile tedavisi

Yıl 2014, Cilt: 48 Sayı: 4, 388 - 395, 03.09.2014

Chi-chuan Wu

https://doi.org/10.3944/AOTT.2014.3264

Öz

Amaç: Bu çalışmanın amacı, kondiler destek plağı (KDP) uygulaması sonrası femoral suprakondiler kırıklarda meydana gelen varus yanlış kaynamalarının tedavisinde retrograd kilitli intramedüller çivi kullanımını değerlendirmek idi.

Çalışma planı: Çalışmaya KDP uygulaması sonrası femoral suprakondiler kırıklarında görülen varus yanlış kaynamaları retrograd kilitli çivi ile tedavi edilen 32 ardışık erişkin hasta katıldı. Sonuçlar iyileşme süresi, alt ekstremite dizilimi ve diz fonksiyonlarına göre değerlendirildi.

Bulgular: Otuz iki hastadan takipleri tamamlanan 27’sinin ortalama takip süresi 2.8 (dağılım: 1.1-5.6) yıl idi. Osteotomi yapılan bölgelerin ortalama 4.0 (dağılım: 3.5-5.0) ayda iyileştiği görüldü. Cerrahi sonrası ortalama varus diz deformitesi 19.6° (dağılım: 14°-26°) olarak ölçüldü. Cerrahiden hemen sonraki ortalama varus diz deformitesi 0.4° (dağılım: 2° valgus-3° varus) idi (p<0.001). Son takipte, ortalama varus diz deformitesi 1.5° (dağılım: 1° valgus-3° varus) olarak kaydedildi (p<0.001). Hastaların tatmin edici derecedeki diz fonksiyonları %0’dan %93’e gelişim gösterdi. Hiçbir hastada ciddi bir komplikasyona rastlanmadı.

Çıkarımlar: Femoral suprakondiler kırıklarda KDP tedavisi sonrası gelişen varus yanlış kaynamalarının retrograd kilitli çivi yöntemi ile tedavisinin mükemmel bir alternatif olduğu görülmektedir. Basit olmasının yanı sıra, bu teknikle yüksek derecede tatmin edici sonuçlar alınmaktadır.

Anahtar Kelimeler

Femoral suprakondiler; kondiler destek plağı; retrograd kilitli çivi; varus yanlış kaynaması.

Correction of femoral supracondylar varus malunions after condylar buttress plating by using retrograde locked intramedullary nailing

Öz

Objective: The aim of this study was to evaluate the use of retrograde locked intramedullary nailing for the treatment of varus malunion occurring following condylar buttress plating (CBP) for femoral supracondylar fractures.

Methods: The study included 32 consecutive adult patients treated with retrograde locked nailing for varus malunion of femoral supracondylar fractures following CBP. Patient results were evaluated based on healing time, lower extremity alignment and knee functions.

Results: Average follow-up was 2.8 (range: 1.1 to 5.6) years for the 27 of the 32 patients who completed follow-up. All osteotomy sites healed at an average of 4.0 (range: 3.5 to 5.0) months. Average preoperative varus knee deformity was 19.6° (range: 14° to 26°). Immediate postoperative varus knee deformity was an average of 0.4° (range: valgus 2° to varus 3°) (p<0.001). At the final follow-up, the varus knee deformity was an average of 1.5° (range: valgus 1° to varus 3°) (p<0.001). Satisfactory knee function in patients improved from 0% to 93% (p<0.001). There were no serious complications.

Conclusion: Retrograde locked nailing appears to be an excellent alternative for the treatment of varus malunion of femoral supracondylar fractures after CBP treatment. It is a simple technique with high satisfaction rates.

Anahtar Kelimeler

Condylar buttress plate, femoral supracondylar, retrograde locked nail, varus malunion

Kaynakça

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