sdü tıp fak derg

Medical Journal of Süleyman Demirel University

2602-2109

Süleyman Demirel Üniversitesi

10.17343/sdutfd.1219295

Surgery

Cerrahi

DİSTAL TİBİA KIRIKLARINDA FİBULAR FİKSASYON: KAYNAMA VE DİZİLİM AÇISINDAN GEREKLİ MİDİR?

DISTAL THIRD TIBIAL FRACTURE SURGERY WITH FIBULAR FIXATION: IS IT NECESSARY FOR UNION AND ALIGNMENT?

https://orcid.org/0000-0003-4994-5059

Turgut

Necmettin

BAŞKENT ÜNİVERSİTESİ, TURGUT NOYAN UYGULAMA VE ARAŞTIRMA MERKEZİ

https://orcid.org/0000-0001-6467-2111

İnce

Ahmet

Aydin State Hospital

https://orcid.org/0000-0001-9576-5994

Unal

Meric

Meddem Hospital

09 23 2023

30 3 308 315 01 01 2023 08 25 2023

1994

Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

AmaçDistal 1/3 tibia kırıklarının tedavi yönetimi tartışmalıdır.Bu çalışmanın amacı aynı zamanda yapılan fibularfiksasyonun kaynama oranlarını arttırıp arttırmadığınıve dizilim açısından gerekliliğini değerlendirmektir.Gereç ve YöntemBu çalışmaya distal 1/3 tibia kırığı nedeniyle tek birmerkezde Ocak 2016 ile Haziran 2020 arasında opereedilmiş 106 hasta alındı. Kırıklar plafond seviyesinden3-12 cm arası mesafede lokalize olarak belirlendi.Hastalar fibulanın durumuna göre üç gruba ayrıldı:Grup 1 (bir fibula kırığı var ancak fibular fiksasyon yapılmamış,47 vaka), Grup 2 (bir fibula kırığı var, eşzamanlı fibular fiksasyon yapılmış, 38 vaka) and Grup3 (intakt fibula, 21 vaka). Tüm fibular fiksasyon cerrahilerikilitli kompresyon plakları ile, tibial fiksasyon isekiltli kompresyon plakları veya intramedüller çivilemeile yapıldı. Primer sonuç ölçütleri kaynama ve dizilimolarak belirlendi. Yaş, cinsiyet, AO sınıflaması, fibulakırık seviyesi, açık kırık varlığı, implant tipi ve cerrahiyekadar geçen süre değerlendirildi.BulgularAçık kırık varlığı haricindeki değişkenlerin hem kaynamaoranlarını hem de dizilimi etkilemediği izlendi.Kaynama oranı eş zamanlı fibula fiksasyon grubundaaçık kırık varlığında anlamlı oranda daha düşük saptandı(p

ObjectiveThe management of distal third tibial fractures remaincontroversial. The aim of the present study was toevaluate whether concurrent fibular fixation changesunion rates and aids in alignment in the case of distalthird tibia fractures.Material and MethodThe study included 106 distal third tibia fractureoperation cases in which the distance from the fractureto the plafond was between 3-12 cm at a single centrebetween January 2016 and June 2020. The patientswere divided into three groups according to the statusof the fibula: Group 1 (without fibular fixation withthe presence of a fibula fracture, 47 cases), Group2 (concurrent fibular fixation with the presence of afibular fracture, 38 cases) and Group 3 (intact fibula,21 cases). All fibular fixation surgeries were performedwith locked plates (LCP) and tibial fixation with eitherLCP or intramedullary nailing (IMN). The primaryoutcome measures were union and alignment. Age,gender, AO classification, fibula fracture location,presence of an open fracture, implant type and timedelay for surgery were also assessed.ResultsNone of the variables except the presence of an openfracture was significant for the union rates or alignment.The union rate was significantly less if there was anopen fracture in the concurrent fibular fixation group(p

distal tibia fracture fibula fracture nonunion Gustilo Anderson classification intramedullary nailing concurrent fibular fixation

distal tibia kırığı fibula kırığı kaynamama Gustilo Anderson sınıflaması intramedüller çivileme eş zamanlı fibular fiksasyon

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