Konservatif Tedavi ile Pediatrik Radius Distal Uç Kırıklarında Düşük Redüksiyon Kaybı

Yıl 2020, Cilt: 22 Sayı: 2, 263 - 270, 31.08.2020

İbrahim Deniz Canbeyli Caner Baysan Ozan Pehlivan

Öz

Amaç: Pediatrik distal radius kırıklarında konservatif tedavinin (kapalı redüksiyon ve alçı immobilizasyonu) sonuçlarını değerlendirmeyi amaçladık.

Gereç ve Yöntemler: Bu retrospektif çalışmaya distal radius kırığı olan ve acil servis şartlarında kapalı redüksiyon ve alçı immobilizasyonu uygulanan, yaşları 3 ila 16 arasında olan toplam 138 pediatrik hasta dahil edildi. Kapalı redüksiyon sırasında hastaların ortalama yaşı 11.47 ± 3.60 (aralık: 3-16) yıl idi. Hastaların yaş, cinsiyet, kırık sınıflandırması, taraf ve yaralanma mekanizmaları tarandı. Ayrıca, radius distal uç kırığı olan pediatrik hastaların 1., 2., 4. ve 6. hafta takiplerindeki deplasman ve açılanma verileri PACS entegre hastane bilgi yönetim sisteminden kaydedildi. Hastaların demografik özellikleri ve radyografik redüksiyon kaybı değerlendirildi.

Bulgular: Elli hasta kadın, seksen sekiz hasta erkekti. Otuz bir hastada (%22.5) redüksiyon kaybı vardı. 1., 2., 4. ve 6. hafta takip görüntülemelerinde Colles kırıklarının; SH Tip-2 ve Torus/Buckle kırıklarına göre AP (Sırasıyla p<0.001; <0.001; <0.001 ve <0.001) ve lateral plandaki (Sırasıyla p=0.013; <0.001; <0.001 ve <0.001) açılanmaları anlamlı olarak daha yüksekti. Tüm takip döneminde kadın ve erkek hastalar arasındaki varus-valgus deformitesi (Sırasıyla p=0.160; 0.283; 0.263 ve 0.744) ve AP angulasyonu (Sırasıyla p=0.996; 0.943; 0.816 ve 0.237) açısından anlamlı bir fark yoktu. Takip görüntülemelerinde yaş ile varus-valgus ve AP angulasyonu arasında bir korelasyon yoktu.

Sonuç: Kapalı redüksiyon ve alçı immobilizasyonunun, Colles, SH Tip II ve Torus/Buckle distal radius kırıkları için etkili bir tedavi yöntemi olduğunu gösterdik.

Anahtar Kelimeler

Pediatrik radius distal uç kırıkları, colles kırıkları, torus/buckle kırıkları, SH tip II kırıklar

LOW LOSS OF REDUCTION RATES IN PEDIATRIC DISTAL RADIUS FRACTURES WITH CONSERVATIVE TREATMENT

Öz

Objective: We aimed to assess the outcomes of conservative treatment (closed reduction and cast immobilization) in the management of pediatric distal radius fractures.

Material and Methods: A total of 138 pediatric patients aged 3 to 16 years who sustained a distal radius fracture and underwent closed reduction and cast immobilization in emergency department were included in this retrospective study. The mean age of patients at the time of close reduction was 11.47 ± 3.60 (range, 3-16) years. Age, gender, classification of fracture, side, and mechanism of injury were documented. In addition, displacement and angulation data were recorded from PACS integrated hospital information management system. We evaluated demographic characteristics of patients and radiographic loss of reduction.

Results: A total of 50 patients were female, whereas 88 patients were male. Thirty-one patients (22.5%) had loss of reduction. Colles fractures had significantly higher varus-valgus deformity (p<0.001; <0.001; <0.001 and <0.001, respectively) and AP angulation (p=0.013; <0.001; <0.001 and <0.001, respectively) than SH type-2 and Torus/Buckle fractures at the first, second, 4th, and 6th weeks follow-up views. There is no significant difference in terms of varus-valgus deformity (p=0.160; 0.283; 0.263 and 0.744, respectively) and AP angulation (p=0.996, 0.943, 0.816 and 0.237, respectively) at each follow-up period between female and male patients. We did not find any correlation between age and varus-valgus and AP angulation at the follow-up views.

Conclusion: We demonstrated that closed reduction and cast immobilization is an effective treatment method for colles, SH type II, and Torus/Buckle distal radius fractures.

Anahtar Kelimeler

Pediatric distal radius fractures, colles fractures, SH tip II kırıkları, Torus/Buckle fractures

Kaynakça

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