İNTERTROKANTERİK FEMUR KIRIKLARININ TEDAVİSİNDE KULLANILAN İKİ FARKLI PROKSİMAL FEMUR ÇİVİSİNİN KLİNİK VE RADYOLOJİK SONUÇLARI

Year 2021, , 441 - 447, 13.09.2021

Mirza Zafer Dağtaş , Ömer Kays Unal

https://doi.org/10.17343/sdutfd.856822

Abstract

Amaç
Bu çalışmanın amacı iki farklı tipte proksimal femur
çivisi (PFÇ) kullanılarak internal fiksasyon uygulanan
intertrokanterik femur kırığı (İTK) olgularında fonksiyonel
ve radyolojik sonuçların karşılaştırılmasıdır.
Gereç ve Yöntem
Bu çalışmada 1 Ocak 2012 – 31 Aralık 2018 tarihleri
arasında kliniğimizde İTK nedeniyle ameliyat edilen
hastaların dosyaları retrospektif olarak incelendi. Olgular
uygulanan PFÇ tipine göre Profin ve İnterTan
olmak üzere iki gruba ayrıldı.
Bulgular
78 olgunun 41’i Profin, 37’si İnterTAN grubundaydı. Olguların
%47,4’ü erkek, yaş ortalaması 74,12 ± 8,91’di.
İnterTan grubu ile karşılaştırıldığında, Profin grubunda
skopi süresi ve mobilizasyona kadar geçen süre
istatistiksel olarak anlamlı düzeyde daha fazlaydı (sırasıyla,
p = 0,002, p = 0,037). Profin grubu ile karşılaştırıldığında,
İnterTan grubunda hastanede yatış süresi
istatistiksel olarak anlamlı düzeyde daha fazlaydı (p =
0,001). Operasyondan bir yıl sonra değerlendirilen femur
boyun açısı İnterTan grubunda istatistiksel olarak
anlamlı düzeyde daha fazlaydı (p <0.001). İnterTan
grubu ile karşılaştırıldığında, Profin grubunda varus
deformitesi sıklığı istatistiksel olarak anlamlı düzeyde
daha fazlaydı (%8,11’e karşın %61,0, p <0.001).
Gruplar arasında Harris kalça skoru bakımında istatistiksel
olarak anlamlı bir fark yoktu (p = 0,630). Harris
kalça skorunu etkileyen faktörleri belirlemek amacıyla
yapılan çoklu doğrusal regresyon analizi sonucunda,
komplikasyon gelişen (p<0,001) ve revizyon yapılan
hastalarda (p<0,001) Harris kalça skorunun diğerlerine
göre daha düşük olduğu saptandı.
Sonuç
Varus deformitesi Profin uygulanan olgularda daha
fazla sıklıkta gelişmiş olsa da, gruplar arasında fonksiyonel
sonuçlar, kırık kaynama süresi, komplikasyon
ve revizyon sıklığı açısından anlamlı fark yoktu. İTK
olgularında redüksiyon ve kırık tespiti iyi düzeyde
yapılırsa, seçilen implant tipinin çok önemli olmadığı
söylenebilir.

Keywords

İntertrokanterik femur kırığı, proksimal femoral çivi, Harris kalça skoru

CLINICAL AND RADIOLOGICAL RESULTS OF TWO DIFFERENT PROXIMAL FEMUR NAILS USED IN THE TREATMENT OF INTERTROCHANTERIC FEMUR FRACTURES

Abstract

Objective
The aim of this study was to compare the functional
and radiological results of intertrochanteric femoral
fractures (İTF) patients who underwent internal
fixation using two different types of proximal femoral
nails (PFN).
Materials and Methods
In this study, the files of patients who were operated
for İTF in our clinic between January 1, 2012 and
December 31, 2018 were retrospectively analyzed.
The cases were divided into two groups as Profin and
InterTan according to the type of PFN applied.
Results
41 of 78 cases were in Profin group and 37 were in
InterTAN group. 47.4% of the cases were male, the
mean age was 74.12 ± 8.91. When compared to the
InterTan group, the duration of fluoroscopy and time
to mobilization were significantly higher in the Profin
group (p = 0.002, p = 0.037, respectively). The duration
of hospital stay was statistically significantly higher in
the InterTan group compared to the Profin group (p =
0.001). The femoral neck angle evaluated one year
after the operation was statistically significantly higher
in the InterTan group (p <0.001). When compared with
the InterTan group, varus deformity was statistically
significantly more common in the Profin group (61.0%
versus 8.11%, p <0.001). There was no statistically
significant difference between the groups in terms
of Harris Hip Score (HHS) (p = 0.630). As a result
of multiple linear regression analysis performed to
determine the factors affecting the HHS, it was found
that the HHS was lower in patients with complications
(p <0.001) and revision (p <0.001) compared to the
others.
Conclusion
Although varus deformity was more frequent in
patients who underwent Profin, there was no
significant difference between the groups in terms of
functional results, time to union, complications, and
revision frequency. If reduction and fracture fixation is
done well in ITF cases, it can be said that the type of
implant chosen is not very important.

Keywords

Intertrochanteric femur fracture, proximal femoral nail, Harris hip score

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