Asetabulum Arka Duvar Ve Arka Kolon Kırıklarında Kalkaneus Plağı Kullanımı, Teknik Özellikler ve Ameliyat Sonuçları

Abstract

Öz Amaç: Bu çalışmada asetabular arka duvar ve arka kolon kırıklarının tespitinde kalkaneus plaklarının kullanımının etkinliği değerlendirildi. Yöntemler: Kalkaneus plağı kullanılarak asetabulum arka duvar kırığı tespiti yapılan 28 hasta retrospektif olarak değerlendirildi. Kliniğimizde 2020-2023 yılları arasında 28 asetabulum arka duvar kırığı tedavi edildi. Cerrahi teknik, ameliyat sonrası sonuçlar, komplikasyonlar, hasta demografisi, kırık paternleri ve ameliyat öncesi durumlar değerlendirildi. Bulgular: Hastaların yaş ortalaması 33,04 (19-49) olup, bunların 20'si erkek, 8'i kadındı. Hastaların 17'sinde (%60,7) sağ asetabulum kırığı ve 11'inde (%39,3) sol asetabulum kırığı tespit edildi. Ortalama takip süresi 22 aydı. 28 hastanın 22'si (%78,6) travmadan önce çalıştığı işe dönmüştür. İşe dönüş süresi ortalama 6,3 aydır (2-14 ay). Enfeksiyon, dislokasyon ve çıkık gibi komplikasyonlar heterotopik ossifikasyon kaydedildi. Brooker sınıflandırmasına göre 4 hastada heterotopik ossifikasyon vardı. Sonuçlar: Kalkaneus plakları asetabulum arka duvar ve kolon kırıklarının tespitinde iyi sonuçlar göstermektedir. Avantajları, geleneksel tespit yöntemlerinin yerine uygulanabilir olma potansiyellerini göstermektedir. Bu bulguları doğrulamak için daha çok sayıda hasta ve daha uzun takip süreleri ile çalışma yapılması önerilmektedir. Anahtar Kelimeler: Asetabulum kırığı, kalkaneus plağı, cerrahi tedavi, arka duvar

Keywords

• Asetabulum kırığı
• kalkaneus plağı
• cerrahi tedavi
• arka duvar

İngilizce

Abstract

Abstract Objective: This study aims to evaluate the effectiveness of using calcaneus plates in the fixation of acetabular back wall and back column fractures. Methods: A retrospective analysis was conducted on patients who underwent acetabular posterior wall fracture operation using calcaneus plates. Between 2020-2023, we have treated 28 acetabular posterior wall fractures in our clinic.The primary focus was on the surgical technique, postoperative results,complications,patient demographics, fracture patterns, and preoperative conditions were documented. Results:The mean age of the patients was 33.04 (19-49), of which 20 were male and 8 were female. 17 (60.7%) patients had right acetabular fractures and 11 (39.3%) had left acetabular fractures. The mean follow-up period was 22 months.22 (78.6%) of 28 patients who worked before the trauma, returned to work. The mean time to return to work was 6.3 months (2-14 months). Complications such as infection, dislocation and heterotopic ossification were recorded. According to the Brooker classification 4 patients had heterotopic ossification. Conclusion: Calcaneus plates show good results in the fixation of acetabular posterior wall and column fractures. Their advantages indicate their potential to replace conventional fixation methods. Studies with a larger number of patients and longer follow-up periods are recommended to confirm these findings. Key words: Acetabular fracture, calcaneus plates, surgical treatment, posterior wall

Keywords

• Acetabular fracture
• calcaneus plates
• surgical treatment
• posterior wall

References

1. 1. Rommens PM. Is there a role for percutaneous pelvic and acetabular reconstruction? Injury 2007;38(4):463-77.
2. 2. Tornetta P. Displaced acetabular fractures: indications for operative and nonoperative management. J Am Acad Orthop Surg 2001;9(1):18-28.
3. 3. Kınık H. Asetabulum Kırıkları. TOTBID Dergisi 2002;1(2):45-59.
4. 4. Schäffler A, Freude T, Stuby F, Höntzsch D, Veltkamp J, Stöckle U, et al. Surgical Treatment of Acetabulum Fractures with a New Acetabulum Butterfly Plate. Z Orthop Unfall 2016;154(5):488-92.
5. 5. Klinger DL. Acetabular Fractures. AORNJ 1995;61(1):157-78; 181-6.
6. 6. Thompson VP, Epstein HC. Traumatic dislocation of the hip. JBJS 1951; 33A:746–777.
7. 7. Matta JM: Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg 1996;78(1):1632-45.
8. 8. Mayo KA. Open reduction and internal fixation of fractures of the acetabulum. Results in 163 fractures. Clin Orthop Relat Res 1994;(305):31-7.

9. 9. Rowe CR, Lowell JD. Prognosis of fractures of the acetabulum. J Bone Joint Surg 1961;43-A:30–59.
10. 10. Larson, C.B, Fracture dislocations of the hip. Clin. Orthop. 92: 147, 1973
11. 11. Judet R, Judet J, Letournel E. Fractures Of The Acetabulum: Classification And Surgical Approaches For Open Reduction. J Bone Joint Surg Am 1964;46:1615-46.
12. 12. Ruesch PD, Holdener H, Ciaramitaro M, Mast JW. A prospective study of surgically treated acetabular fractures. Clin Orthop Relat Res. 1994 Aug;(305):38-46.
13. 13. 13.Aşık M, Eralp L, Long term results of surgical therapy in acetabular fractures Acta Orthop TraumatolTurc2000;34:245-253
14. 14. Matta JM, Mehne DK, Roffi R. Fractures of the acetabulum. Early results of a prospective study. Clin Orthop Relat Res 1986;205:241-50.
15. 15. Helfet DL, Schmeling GJ. Somatosensory evoked potential monitoring in the surgical treatment of acute, displaced acetabular fractures. Results of a prospective study. Clin Orthop Relat Res Relat Res 1994;(301):213-20. 16. Stibolt RD Jr, Patel HA, Huntley SR, Lehtonen EJ, Shah AB, Naranje SM. Total hip arthroplasty for posttraumatic osteoarthritis following acetabular fracture: A systematic review of characteristics, outcomes, and complications. Chin J Traumatol. 2018 Jun;21(3):176-181. doi: 10.1016/j.cjtee.2018.02.004. Epub 2018 Apr 26. PMID: 29773451; PMCID: PMC6033725.
16. 17. Johnson EE, Kay RM, Dorey FJ. Heterotopic ossification prophylaxis following operative treatment of acetabular fracture. Clin Ort. Relat Res 1994;(305):88-95.
17. 18. McLaren AC. Prophylaxis with indomethacin for heterotopic bone. After open reduction of fractures of the acetabulum. J Bone Joint Surg Am 1990;72(2):245-247
18. 19. Moed BR, Maxey JW. The effect of indomethacin on heterotopic ossification following acetabular fracture surgery. J Orthop Trauma 1993;7(1):33-38
19. 20. Matta JM, Siebenrock KA. Does indomethacin reduce heterotopic bone formation after operations for acetabular fractures? A prospective randomised study. J Bone Joint Surg Br 1997;79(6):959-963
20. 21. Erdoğan F, Poursani RS, Öğüt T, Tenekecioğlu Y. Results of the conservative and surgical treatment of displaced acetabular fractures. Acta Orthop Traumatol Turc 1998;32:111-5