İntertrokanterik femur kırıklarında dinamik kalça çivisi ile proksimal femoral çivisi karşılaştırılması ve maliyet analizi.

Öz

GİRİŞ ve AMAÇ: Çalışmamız femur intertrokanterik kırıklarında dinamik kalça vidası (DHS) – proksimal femoral çivi antirotasyon (PFNA) uygulamalarının sonuçlarının karşılaştırılması ve bu konuda maliyet analizinin yapılması için planlanmıştır.
YÖNTEM ve GEREÇLER: Mayıs-2009 Aralık-2012 tarihleri arasında intertrokanterik femur kırığı nedeniyle ameliyat olmuş 75 hasta retrospektif olarak değerlendirildi. Gruplar arasında redüksiyon kalitesi, ortalama yatış süresi, komplikasyon oranları, fonksiyonel sonuçlar ve tedavi masrafları açısından fark olup olmadığı değerlendirildi.
BULGULAR: Otuz hastaya DHS, Kırk beş hastaya PFNA uygulandı. Çalışmamızda takip süresi ortalama 21.55 (6-49) aydır. Fonksiyonel sonuçlar gruplar arasında anlamlı fark olmayacak şekilde birbirine yakındı. PFNA uygulanan hastaların DHS uygulanan hastalara göre hastanede yatış sürelerinin kısa; tedavi ve bakım masraflarının daha düşük olduğu görülmektedir.
TARTIŞMA ve SONUÇ: PFNA; DHS’ye oranla pahalı bir implant olsa da hastane toplam maliyeti değerlendirildiğinde aralarında anlamlı bir farklılık görülmemektedir. Bunun yanında benzer fonksiyonel sonuçları ile DHS intertrokanterik femur kırıklarında tercih edilebilir bir tedavi yöntemidir. 

Anahtar Kelimeler

• intertrokanterik
• dinamik kalça vidası
• proksimal femoral çivi

Comparison of dynamic hip screw and proximal femoral nail in intertrochanteric femur fractures and cost analysis

Öz

INTRODUCTION: The study was planned to compare the results of dynamic hip screw (DHS) and proximal femoral nail antirotation (PFNA) applications to femur intertrochanteric fractures and to implement a cost analysis.
METHODS: A retrospective evaluaton was made of 75 patients who were treated for intertrochanteric femur fracture between May 2009 and December 2012. Evaluation was made of differences between the groups in reduction quality, mean duration of hospitalization, complication rates, functional outcomes and treatment costs.
RESULTS: Thirty patients were treated with DHS and forty five patients with PFNA. The average follow-up period was 21.5 (12-49) months. Functional outcomes were similar, with no significant difference between the groups. Length of hospital stay was shorter in the PFNA group, the treatment and care costs were lower compared to the DHS group.
DISCUSSION AND CONCLUSION: Although PFNA is a much more expensive implant than DHS, there is no significant difference between total hospital costs. Nevertheless, as DHS has similar functional results, it is still a preferrable treatment method for intertrochanteric femur fractures.

Anahtar Kelimeler

• intertrochanteric
• dynamic hip screw
• proximal femoral nail

Kaynakça

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