Comparison of retrograde intramedullary nailing and percutaneous plate osteosynthesis methods in distal femur fractures

Year 2017, Volume: 42 Issue: 3, 490 - 498, 30.09.2017

Osman Çiloğlu , Muhsin Dursun Tuğhan Kalkan Hakan Çiçek , Fırat Seyfettinoğlu , Hasan Ulaş Oğur

https://doi.org/10.17826/cutf.289945

Cited By: 1

Abstract

Purpose: The aim of this study is to make prospective randomized comprehensive analysis of treatment results between the retrograde interlocking femoral nail and the percutan plate osteosynthesis in distal femoral fractures.

Material and Methods: Forty seven patients (34M, 13F) underwent surgical treatment in our clinic with distal femoral fractures were evaluated. While 23 patients underwent retrograde interlocking femoral nailing, 24 patients underwent percutan plate osteosynthesis. Patients fractures were classified according to the AO Classification. The patients had open fractures were classified according to Gustilo Anderson. The patients were evaluated about functional fracture healing, union time and complication rates.

Results: The mean union times were 25.3±5.7 weeks to 22.3±9 weeks. There were 8 excellent, 6 good, 7 moderate, 2 fair results in retrograde nail group and 12 excellent, 9 good, 3 moderate results in percutanous plate group. The mean joint range of motion was 102.6±16.5° in the retrograde nail group and 115.8±18.3°  in the percutan plate group. 

Conclusion: Although union times are similar in both groups , percutan plate osteosynthesis is significantly superior than retrograde interlocking femoral nails about functions. Percutan plate osteosynthesis is significantly superior than retrograde interlocking femoral nail about complications.

Keywords

femoral fractures, fracture fixation, intamedullary method, osteosynthesis

Distal femur kırıklarında retrograd intramedüller çivi ve perkutan plak osteosentez yöntemlerinin karşılaştırılması

Abstract

Amaç:  Distal femur kırıklarında retrograde kilitli intramedüller çivi uygulaması ile minimal invazif perkutan plakla osteosentez uygulamasının prospektif randomize olarak karşılaştırmalı analizi amaçlandı.

Gereç ve Yöntem: Distal femur kırığı nedeniyle kliniğimizde cerrahi tedavi uygulanan 47 hasta (34 E, 13K) değerlendirmeye alındı.  Hastaların ortalama yaşı 40 (22- 69 arası) idi. 23 hastaya retrograde kilitli intramedüller çivi , 24 hastaya ise perkutan plakla osteosentez uygulandı. Hastaların kırıkları AO sınıflamasına göre sınıflandırıldı. Açık kırığı olan hastalar Gustilo Anderson sınıflamasına göre sınıflandırıldı. Hastalar fonksiyonel kırık iyileşmesi, kaynama süresi ve komplikasyonlar açısından değerlendirildi.

Bulgular: Ortalama kaynama süreleri retrograd çivi yapılanlarda 26 hafta, perkutan plak yapılanlarda 22 hafta idi. Retrograd çivi yapılan hastalarda 8 mükemmel, 6 iyi, 7 orta, 2 kötü sonuç elde edilirken perkutan plak yapılan hastalarda 12 mükemmel, 9 iyi, 3 orta sonuç elde edildi. Retrograd çivi yapılan hastaların ortalama diz eklem hareket açıklığı 100 derece idi. Perkutan plak yapılan hastaların ortalama diz eklem hareket açıklığı 115 dereceydi. 

Sonuç: Kaynama süreleri açısından her iki grupta da sonuçlar benzer olsa da perkutan plakla osteosentez fonksiyonel açıdan (retrograd kilitli intramedüller çiviye göre anlamlı olarak üstündür. Komplikasyonlar açısından da perkutan plakla osteosentez retrograd kilitli intramedüller çiviye göre anlamlı olarak üstündür.

Keywords

femur kırığı, kırık tespiti, intramedüller yöntem, plak osteosentez

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