Outcomes of the distal intraarticular humeral fractures treated by olecranon osteotomy

Yıl 2009, Cilt: 36 Sayı: 4, 241 - 247, 01.12.2009

Erhan Yılmaz Mehmet Bulut

Öz

Objectives: To evaluate the management and outcome of intraarticular fractures of the distal humerus treated by open reduction and internal fixation using the olecranon osteotomy technique. Materials and methods: Twenty-one patients with intraarticular fractures of the distal humerus were treated by open reduction and internal fixation. The mean age of the patients was 41.6 years and the mean follow-up period was 25.3 months. All fractures were type C according to the AO/ASIF fracture classification system. Chevron type olecranon osteotomy was performed within 12- 24 h after the injury in all cases but 4 of them. Physical and radiological examination of patients with the appropriate range checks were made. Results: All fractures united within average duration of 3.2 months. Excellent or good results were found in patients less than 50 years-old, in women, when passing time from injury to surgery was within 12 hours and when early mobilization was achieved. The complications were seen as 2 (9.6%) transient neuropraxia of the ulnar nerve, 2 (9.6%) failure of fixation, 1 (4.8%) heterotopic ossification and 1 (4.8%) olecranon non-union. Fracture type (C1) and time from occurrence of injury to surgery (

Anahtar Kelimeler

Distal humerus, intraarticular fracture, surgical treatment, olecranon osteotomy, early mobilization.

onuçları

Öz

Amaç: Distal humerusun eklem içi kırıklarında olekranon osteotomisi yöntemiyle açık redüksiyon ve internal tesbit yapılan hastalarda tedavi sonuçlarının degerlendirilmesi. Gereç ve yöntem: Distal humerusta eklem içi kırıgı olan 21 hastaya olekranon osteotomisi yapılarak açık redüksiyon ve internal tesbit uygulandı. Hastaların ortalama yası 41.6 yıl ortalama takip süresi 25.3 ay idi. Kırıkların tamamı AO/ASIF kırık sınıflandırma sistemine göre tip-C idi. Chevron tipi olekranon osteotomisi yapılan hastaların dördü hariç digerleri yaralanmadan sonraki ilk 12-24 saat içerisinde ameliyata alındı. Uygun aralıklarla hastaların fizik muayene ve radyolojik kontrolleri yapıldı. Bulgular: Kırıkların tamamı ortalama 3.2 ayda kaynadı. Bayanlarda, 50 yasın altında, yaralanmayla ameliyata alınma arasındaki süre 12 saatin altında olan ve erken hareket baslanan hastalarda mükemmel ve iyi sonuçlar elde edildi. Komplikasyon olarak 2 (9.6%) hastada geçici unlar sinir nöropatisi, 2 (9.6%) hastada tesbit yetersizligi, 1 (4.8%) hastada heterotopik ossifikasyon, 1 (4.8%) hastada da olekranonda kaynamama görüldü. Kırıgın tipi (C1) ve yaralanmayla ameliyata alınma arasında geçen zaman (12 saat) mükemmel ve iyi fonksiyonel sonuçlar elde etmede ana belirleyici faktörlerdi. Sonuçlar: Dikkatli ve titiz cerrahi teknik, stabil internal tesbit, cerrahi tecrübe ve ameliyat sonrası erken kontrollü hareket distal humerusun eklem içi kırıklarının basarılı sonuçları için kritik faktörlerdir.

Anahtar Kelimeler

Distal humerus, eklem içi kırık, cerahi tedavi, olekranon osteotomisi, erken hareket

Kaynakça

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