Distal Femur Kırıkları için Retrograd Intramedüller Çivileme Sonuçlarının Değerlendirilmesi: 3. Basamak Travma Merkezi Retrospektif Çalışması

Abstract

Amaç: Distal femur kırıkları modern anatomik plak ve çiviler ile tedavi edilebilmektedir. Bu çalışmanın amacı retrograd intramedüller çivi (RİÇ) ile tedavi edilen erişkin kişilerde deplase distal femur kırıklarının klinik ve radyolojik sonuçlarının incelenmesidir. Gereç ve Yöntemler: Çalışmaya, Ocak 2013 ile Nisan 2018 arasında 3. seviye bir travma merkezinde distal femur kırığı nedeniyle RİÇ ameliyatı geçiren tüm hastalar dahil edildi. Hastalar kırık paternine göre açık kırık ve kapalı kırık olmak üzere iki gruba ayrıldı. Distal femur kırığı nedeniyle RİÇ tedavisi yapılan hastaların ameliyat süreci ve ameliyat sonrası dönemdeki klinik, radyolojik ve fonksiyonel özellikleri analiz edildi. Bulgular: Çalışmaya 30 hasta dahil edildi. 21 (%70) hasta erkekti. Hastaların ortanca yaşı 39 (aralık, 18-58) yıl idi. Etkilenen femurların 17 (%56,7)'si sol taraflıydı. Kırık etiyolojisi 19 (%63,3) hastada trafik kazası ve düşme, 11 (%36,7) hastada ise ateşli silah yaralanmasıydı. Hastaların 17 (%56,7)'si kapalı kırık, 13 (%43,3)'ü açık kırıktı. İki grup arasında ameliyat süresi (p=0,086), floroskopi süresi (p=0,805), kan kaybı (p=0,967) açısından ve ameliyat sonrası dönemde hastanede yatış süresi (p=0,967), klinik ağrı ve fonksiyon skoru (p=0,341; p=0,902) ve kaynama zamanı (p=0,385) açısından istatistiksel olarak anlamlı fark bulunmadı. Sonuç: RIN fazla kan kaybını engelleyen ve ameliyat süresini de kısaltabilen minimal invaziv bir cerrahi yöntemdir. Distal femur kırıklarının tedavisinde akla getirilmesi gereken etkili ve güvenilir bir cerrahi seçenektir.

Keywords

• Distal Femur Kırıkları
• Travma
• İntramedüller Çivi
• Retrograd

Evaluating the Results of Retrograde Intramedullary Nailing for Distal Femur Fractures: A Level 3 Trauma Center Retrospective Study

Abstract

Aim: Distal femur fractures can be treated with modern anatomic plates and nails. This study aimed to examine the clinical and radiological results of displaced distal femur fractures in adult people who had been treated with a retrograde intramedullary nail (RIN). Material and Methods: The study included all patients who underwent RIN surgery for distal femur fracture between January 2013 and April 2018 in a level 3 trauma center. Patients were divided into two groups based on fracture pattern: open fracture and closed fracture. The preoperative and postoperative clinical, radiological and functional characteristics of patients who had RIN for a distal femur fracture were analyzed. Results: Thirty patients were included in the study. 21 (70%) patients were male. The median age of the patients was 39 (range, 18-58) years. 17 (56.7%) of the affected femur were left-sided. The etiology of the fractures was traffic accident and fall in 19 (63.3%) patients and gunshot injury in 11 (36.7%) patients. Of the patients, 17 (56.7%) were closed fractures and 13 (43.3%) were open fractures. There were no significant differences between two groups related to the surgery time (p=0.086), fluoroscopy time (p=0.805), blood loss (p=0.967), and hospitalization time (p=0.967), clinical pain and function scores (p=0.341, p=0.902), and union time (p=0.385) at the postoperative period. Conclusion: RIN is a minimally invasive method that may prevent excessive blood loss and decrease the duration of surgery time. It is an effective and reliable surgical intervention that should be considered for the treatment of distal femur fractures.

Keywords

• Distal Femur Fractures
• Trauma
• İntramedullary Nail
• Retrograde

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