Antegrade Locked Nailing Of Adult Femoral Shaft Fractures And Non-Unions: A Retrospective Review Of 48 Cases Erişkin Femur Şaft Kırıklarının Ve Non-Unionlarının Antegrad Kilitli Çivileme Yöntemi İle T

Yıl 2007, Cilt: 60 Sayı: 3, 123 - 129, 01.03.2007

Hakan Selek , Hakan Atalar Hakan Kınık Osman Yüksel Yavuz Ertan Mergen

Öz

Anahtar Kelimeler

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Erişkin Femur Şaft Kırıklarının Ve Non-Unionlarının Antegrad Kilitli Çivileme Yöntemi İle Tedavisi: 48 Olgunun Retrospektif Değerlendirilmesi

Öz

Amaç: Bu makalede, akut femur cisim kırığı veya non-unionu nedeni ile antegrade kilitli intramedüller
kilitli çivileme yapılan 48 olgunun fonksiyonel sonuçları retrospektif olarak değerlendirildi.
Gereç ve Yöntem: Bu çalışmaya dahil edilen 48 hastaya toplam 52 antegrad kilitli intramedüller
çivileme uygulandı. Akut femur cisim kırıklarının 27’sinde oymasız antegrad kilitli intramedüller çivileme
uygulandı. Akut femur kırığı olan 4 ve non-union olan 21 hastada ise fiksasyon oymalı kilitli
çivileme ile sağlandı. Olguların yaş ortalaması 40.2 (17-80) idi. Serimizdeki hastaların 16’sı bayan
(%33.3) ve 32 ’si erkekti (%66.7).
Bulgular: Hastaların takipleri ile elde edilen veriler, Thoresen kriterlerine göre; femoral aks deformitesi,
femoral kısalık, diz eklemi hareket açıklığı ve ağrı veya ödem varlığı incelenerek değerlendirildi.
Hastalar ortalama 21 ay (10-46 ay) takip edildi. Bir tanesi haricinde tüm olgularda kaynama görüldü
(%98.07). Yüzeyel enfeksiyon üç hastada izlendi ve bunlardan bir olgunun takiplerinde derin enfeksiyon
gelişti. Akut kırık grubundan gastrointestinal kanama öyküsü olan Winquist tip IV kırıklı bir
hastaya, antikoagülan tedavi verilemediğinden, derin venöz trombüs izlendi. Non-union grubundan
bir hastada ise, ameliyattan sonraki dördüncü günde pulmoner emboli gelişti.
Sonuç: İntramedüller çivileme yöntemleri akut femur cisim kırıkları ve non-unionlarında etkili bir
tedavi metodudur. Oymalı çivileme metodu, oymasız çivileme metodu ile karşılaştırıldığında daha
az başarısızlık izlenirken, yöntem sağlam stabilizasyon sağlar.

Anahtar Kelimeler

femur, kırık tespiti, kırık iyileşmesi, intramedüller çivileme

Kaynakça

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