Çocuk Suprakondiler Humerus Kırıklarında Lateral ve Çapraz Pinleme Sonuçlarının Karşılaştırılması

Öz

Amaç: Suprakondiler humerus kırıkları (SHK), gelişimini tamamlamamış iskelette meydana gelir. Çocuklarda görülen dirsek kırıklarının %60-65’ini oluştururlar ve en sık 4-7 yaş grubunda görülürler. Bu çalışmanın amacı, pediatrik SHK’ların kapalı cerrahisinde kullanılan lateral ve çapraz pinleme yöntemlerinin radyolojik ve fonksiyonel sonuçlarını karşılaştırmaktır. Gereç ve Yöntem: Bu çalışma, Gartland tip 2 ve 3 kırığı olan 46 hasta üzerinde yürütülmüştür. Sadece lateral pinleme uygulanan hastalar Grup 1’i, hem lateral hem de medial pinleme (çapraz pinleme) uygulanan hastalar ise Grup 2’yi oluşturmuştur. Ameliyat sonrası, 3. haftada ve 12. haftada anteroposterior ve lateral dirsek grafileri çekilmiş ve radyolojik açılar ölçülerek kaydedilmiştir. Dirsek eklemi hareket açıklığı (EHA) ameliyattan bir yıl sonra ölçülmüştür. Bulgular: Hastaların yaş ortalaması 6,28 ± 0,44 yıldı. Baumann açısındaki azalma Grup 1’de 2,61 ± 0,36° ve Grup 2’de 2,64 ± 0,38° idi. Taşıyıcı açıda azalma Grup 1’de 0,80 ± 0,14° ve Grup 2’de 1,36 ± 0,26° idi. Lateral kapitellohumeral açıdaki (LKHA) artış Grup 1’de 5 ± 0,74° ve Grup 2’de 6,72 ± 0,93° idi. Dirsek eklemi hareket açıklığı (EHA) Grup 1’de 132,85 ± 0,76° ve Grup 2’de 132 ± 1,01° idi. Yapılan ölçümlere göre, lateral ve çapraz pin konfigürasyonları arasında radyolojik ve klinik sonuçlar açısından istatistiksel olarak anlamlı bir fark bulunmamıştır. Sonuç: İyatrojenik ulnar sinir hasarı olasılığı göz önüne alındığında, lateral pinleme daha güvenli bir yöntem olarak değerlendirilebilir.

Anahtar Kelimeler

• Çapraz pinleme
• pediatrik travma
• perkütan pinleme
• suprakondiler humerus

Comparison of Lateral and Cross Pinning Results in Pediatric Supracondylar Humerus Fractures

Öz

Objective: Supracondylar humerus fractures (SHF) occur in the immature skeleton. They account for 60-65% of elbow fractures in children, with the most common age group being 4-7 years. The aim of this study is to compare the radiological and functional outcomes of lateral and cross pinning methods used in the closed surgery of pediatric SHF. Material and Method: This study was conducted on 46 patients with Gartland type 2 and 3 fractures. Group 1 who underwent only lateral pinning, and Group 2 patients who underwent both lateral and medial pinning. Anteroposterior and lateral elbow radiographs were taken postoperatively, at 3 weeks, and at 12 weeks, and radiological angles were measured and recorded. Elbow joint ROM was measured one year after the operation. Results: The mean age of the patients was 6.28 ± 0.44 years. The decrease in Baumann angle was 2.61 ± 0.36° in Group 1 and 2.64 ± 0.38° in Group 2. The decrease in carrying angle was 0.80 ± 0.14° in Group 1 and 1.36 ± 0.26° in Group 2. The increase in The lateral capitellohumeral angle (LCHA) was 5 ± 0.74° in Group 1 and 6.72 ± 0.93° in Group 2. The elbow joint range of motion (ROM) was 132.85 ± 0.76° in Group 1 and 132 ± 1.01° in Group 2. Based on the measurements, there was no statistically significant difference in radiological and clinical outcomes between lateral and cross pin configurations. Conclusion: Considering the possibility of iatrogenic ulnar nerve injury, lateral pinning may be considered a safer method.

Anahtar Kelimeler

• Cross pinning
• pediatric trauma
• percutaneous pinning
• supracondylar humerus

Etik Beyan

Approval for the study was obtained from the Kayseri City Hospital Clinical Research Ethics Committee on 12/12/2023. Decision no: 977/2023.

Kaynakça

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