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İzole ulna cisim kırıklarında konservatif ve cerrahi tedavi yöntemlerinin karşılaştırılması

Yıl 2018, Cilt: 9 Sayı: 3, 199 - 204, 30.09.2018
https://doi.org/10.18663/tjcl.439538

Öz

Amaç: İzole ulna cisim kırıklarının
tedavisinde hem konservatif hem de cerrahi metodlar önerilmiştir. Çalışmanın amacı izole ulna cisim kırıklarının optimal
tedavisini ve kırık iyileşmesini etkileyen faktörleri araştırmaktır.

Gereç ve Yöntemler: Çalışmaya
2013-2016 yılları arasında hastanemize başvurmuş izole ulna cisim kırıklı 43
hasta alındı. Hastalar konservatif tedavi edilen ve cerrahi olarak tedavi
edilen olmak üzere 2 grupta incelendi. Sonuçların değerlendirilmesinde eklem
hareket açıklığı, kavrama gücü, fonksiyonel ve radyolojik sonuçlar kullanıldı. Ağrı vizuel analog skala (VAS) ile
değerlendirildi. Kavrama gücüne ise el dinamometresiyle hasta otururken ve
dirsek 90 derece fleksiyonda bakıldı. Fonksiyonel sonuçlara kol, omuz el
sorunları skorlaması (DASH Skoru) ile bakıldı.

Bulgular: Konservatif
tedavi edilen grupta 23 hasta, cerrahi tedavi edilen grupta 20 hasta
bulunmaktaydı. Her 2
grup
arasında yaş, cinsiyet dağılımı, kırık
paterni, yaralanma mekanizması ve kırık lokasyonu açısından fark saptanmadı.
Her 2 grup arasında VAS skoru, kavrama gücü, DASH skoru ve kaynama açısından da
fark saptanmadı. Konservatif tedavi edilen grupta kaynama süresi ortalama
12±1,04 haftayken cerrahi olarak tedavi edilen grupta kaynama süresi ortalama
17±1,16 haftaydı (p=0,586). Her 2 grup arasında dirsek ve el bileği eklem
hareket açıklığı ve komplikasyonlar açısından da fark saptanmadı.







Sonuç: Çalışmamızda
cerrahi olarak tedavi edilen hastaların konservatif olarak tedavi edilen
hastalardan fonksiyonel ve klinik olarak daha iyi sonuçlara sahip olmadığı ve
konservatif tedavi yöntemlerinin sonuçlarının başarılı olduğunu saptandı. İzole
ulna cisim kırıkları tedavi yönteminin belirlenmesinde prospektif, çok merkezli
ve daha geniş hasta serilerini kapsayan çalışmalara ihtiyaç vardır.

Kaynakça

  • 1. Handoll HH, Pearce P. Interventions for treating isolated diaphyseal fractures of the ulna in adults. Cochrane Database Syst Rev 2012; 13: CD000523. doi:10.1002/14651858.CD000523.pub4. Review.
  • 2. Atkin DM, Bohay DR, Slabaugh P, Smith BW. Treatment of ulnar shaft fractures: a prospective, randomized study. Orthopedics 1995; 18: 543–47.
  • 3. Corea JR, Brakenbury PH, Blakemore ME. The treatment of isolated fractures of the ulnar shaft in adults. Injury 1981; 12: 365-70.
  • 4. Du Toit FP, Grabe RP. Isolated fractures of the shaft of the ulna. S Afr Med J 1979; 56: 21-5.
  • 5. Sarmiento A, Latta LL, Zych G, McKeever P, Zagorski JP. Isolated ulnar shaft fractures treated with functional braces. J Orthop Trauma 1998; 12: 420-24.
  • 6. Pollock FH, Pankovich AM, Prieto JJ, Lorenz M. The isolated ulnar shaft fracture: treatment without immobilization. J Bone Joint Surg Am 1983; 65: 339-42.
  • 7. Chapman MW, Gordon JE, Zissimos AG. Compression plate fixation of acute fractures of the diaphyses of the radius and ulna. J Bone Joint Surg Am 1989; 71: 159-69.
  • 8. Boriani S, Lefevre C, Malingue E, Bettelli G. The Lefevre ulnar nail. Chir Organi Mov 1991; 76: 151-55.
  • 9. Gebuhr P, Hölmich P, Orsnes T, Soelberg M, Krasheninnikoff M, Kjersgaard AG. Isolated ulnar shaft fractures: comparison of treatment by a functional brace and long-arm cast. J Bone Joint Surg Br 1992; 74: 757–59.
  • 10. Coulibaly MO, Jones CB, Sietsema DL, Schildhauer TA. Results of 70 consecutive ulnar night stick fractures. Injury 2015; 46: 1359–66.
  • 11. Stern PJ, Drury WJ. Complications of plate fixation of forearm fractures. Clin Orthop Relat Res 1983; 175: 25–29
  • 12. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). Am J Ind Med 1996; 29: 602- 8
  • 13. Szabo RM, Skinner M. Isolated ulnar shaft fractures: retrospective study of 46 cases. Acta Orthop Scand 1990; 61: 350-52.
  • 14. Dymond IW. The treatment of isolated fractures of the distal ulna. J Bone Joint Surg Br 1984; 66: 408-10.
  • 15. Van Leemput T, Mahieu G. Conservative management of minimally displaced isolated fractures of the ulnar shaft. Acta Orthop Belg 2007; 73: 710–13.
  • 16. Mackay D, Wood L, Rangan A. The treatment of isolated ulnar fractures in adults: a systematic review. Injury 2000; 31: 565–70.
  • 17. Zych GA, Latta LL, Zagorski JB. Treatment of isolated ulnar shaft fractures with prefabricated functional fracture braces. Clin Orthop Relat Res 1987; 219: 194-200.
  • 18. Saka G,Saglam N,Kurtulmus T,Avcı CC,Akpınar F,Kovacı H,Celik A .New interlocking intramedullary radius and ulna nails for treating forearm diaphyseal fractures in adults: A retrospective study. Injury 2014; 45: 16-23.
  • 19. Leung F, Chow SP. A prospective, randomized trial comparing the limited contact dynamic compression plate with the point contact fixator for forearm fractures. J Bone Joint Surg Am 2003; 8: 2343-48.

Comparison of conservative and surgical treatment methods in isolated ulna shaft fractures

Yıl 2018, Cilt: 9 Sayı: 3, 199 - 204, 30.09.2018
https://doi.org/10.18663/tjcl.439538

Öz

Aim: Conservative and surgical treatment options have
been suggested for the treatment of isolated ulna shaft fractures. The aim the
study is to research the optimal treatment option for isolated ulna fractures
and factors affecting the fracture healing.

Material and Methods: The study included 43 patients who applied to our
hospital in 2013-2016 with isolated ulna shaft fractures. Patients were divided
into two groups: conservative treatment and surgical treatment. Joint range of
motion, grip strength, functional and radiologic results were used for evaluating
the results. Pain was evaluated by visual analogue scale (VAS). Grip strength
was measured with a hand dynamometer while the patient was sitting and elbow
was in 90-degree flexion. Functional tests were evaluated with the Disabilities
of the Arm, Shoulder and Hand Score (DASH Score).

Results: 23 patients were in the conservative treatment group and 20 patients
were included in the surgical intervention group. No difference was observed in
terms of VAS score, grip strength, DASH score and bone union. Average bone
union times for the two groups were as following: conservative treatment group,
12±1.04 weeks; surgical treatment group, 17±1.16 weeks (p=0,586). No difference
was observed between the groups in terms of hand wrist joint range of motion
and complications.







Conclusion: Our study showed that
patients who were treated by surgical intervention had no functional and
clinical superiority to patients with conservative treatment. There is a need
for prospective and multicentre studies comprising a larger series of patients
for defining the methodology for isolated ulna shaft fractures.

Kaynakça

  • 1. Handoll HH, Pearce P. Interventions for treating isolated diaphyseal fractures of the ulna in adults. Cochrane Database Syst Rev 2012; 13: CD000523. doi:10.1002/14651858.CD000523.pub4. Review.
  • 2. Atkin DM, Bohay DR, Slabaugh P, Smith BW. Treatment of ulnar shaft fractures: a prospective, randomized study. Orthopedics 1995; 18: 543–47.
  • 3. Corea JR, Brakenbury PH, Blakemore ME. The treatment of isolated fractures of the ulnar shaft in adults. Injury 1981; 12: 365-70.
  • 4. Du Toit FP, Grabe RP. Isolated fractures of the shaft of the ulna. S Afr Med J 1979; 56: 21-5.
  • 5. Sarmiento A, Latta LL, Zych G, McKeever P, Zagorski JP. Isolated ulnar shaft fractures treated with functional braces. J Orthop Trauma 1998; 12: 420-24.
  • 6. Pollock FH, Pankovich AM, Prieto JJ, Lorenz M. The isolated ulnar shaft fracture: treatment without immobilization. J Bone Joint Surg Am 1983; 65: 339-42.
  • 7. Chapman MW, Gordon JE, Zissimos AG. Compression plate fixation of acute fractures of the diaphyses of the radius and ulna. J Bone Joint Surg Am 1989; 71: 159-69.
  • 8. Boriani S, Lefevre C, Malingue E, Bettelli G. The Lefevre ulnar nail. Chir Organi Mov 1991; 76: 151-55.
  • 9. Gebuhr P, Hölmich P, Orsnes T, Soelberg M, Krasheninnikoff M, Kjersgaard AG. Isolated ulnar shaft fractures: comparison of treatment by a functional brace and long-arm cast. J Bone Joint Surg Br 1992; 74: 757–59.
  • 10. Coulibaly MO, Jones CB, Sietsema DL, Schildhauer TA. Results of 70 consecutive ulnar night stick fractures. Injury 2015; 46: 1359–66.
  • 11. Stern PJ, Drury WJ. Complications of plate fixation of forearm fractures. Clin Orthop Relat Res 1983; 175: 25–29
  • 12. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). Am J Ind Med 1996; 29: 602- 8
  • 13. Szabo RM, Skinner M. Isolated ulnar shaft fractures: retrospective study of 46 cases. Acta Orthop Scand 1990; 61: 350-52.
  • 14. Dymond IW. The treatment of isolated fractures of the distal ulna. J Bone Joint Surg Br 1984; 66: 408-10.
  • 15. Van Leemput T, Mahieu G. Conservative management of minimally displaced isolated fractures of the ulnar shaft. Acta Orthop Belg 2007; 73: 710–13.
  • 16. Mackay D, Wood L, Rangan A. The treatment of isolated ulnar fractures in adults: a systematic review. Injury 2000; 31: 565–70.
  • 17. Zych GA, Latta LL, Zagorski JB. Treatment of isolated ulnar shaft fractures with prefabricated functional fracture braces. Clin Orthop Relat Res 1987; 219: 194-200.
  • 18. Saka G,Saglam N,Kurtulmus T,Avcı CC,Akpınar F,Kovacı H,Celik A .New interlocking intramedullary radius and ulna nails for treating forearm diaphyseal fractures in adults: A retrospective study. Injury 2014; 45: 16-23.
  • 19. Leung F, Chow SP. A prospective, randomized trial comparing the limited contact dynamic compression plate with the point contact fixator for forearm fractures. J Bone Joint Surg Am 2003; 8: 2343-48.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Özgün Makale
Yazarlar

Tolga Tolunay

Mehmet Orçun Akkurt

Yayımlanma Tarihi 30 Eylül 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 9 Sayı: 3

Kaynak Göster

APA Tolunay, T., & Akkurt, M. O. (2018). İzole ulna cisim kırıklarında konservatif ve cerrahi tedavi yöntemlerinin karşılaştırılması. Turkish Journal of Clinics and Laboratory, 9(3), 199-204. https://doi.org/10.18663/tjcl.439538
AMA Tolunay T, Akkurt MO. İzole ulna cisim kırıklarında konservatif ve cerrahi tedavi yöntemlerinin karşılaştırılması. TJCL. Eylül 2018;9(3):199-204. doi:10.18663/tjcl.439538
Chicago Tolunay, Tolga, ve Mehmet Orçun Akkurt. “İzole Ulna Cisim kırıklarında Konservatif Ve Cerrahi Tedavi yöntemlerinin karşılaştırılması”. Turkish Journal of Clinics and Laboratory 9, sy. 3 (Eylül 2018): 199-204. https://doi.org/10.18663/tjcl.439538.
EndNote Tolunay T, Akkurt MO (01 Eylül 2018) İzole ulna cisim kırıklarında konservatif ve cerrahi tedavi yöntemlerinin karşılaştırılması. Turkish Journal of Clinics and Laboratory 9 3 199–204.
IEEE T. Tolunay ve M. O. Akkurt, “İzole ulna cisim kırıklarında konservatif ve cerrahi tedavi yöntemlerinin karşılaştırılması”, TJCL, c. 9, sy. 3, ss. 199–204, 2018, doi: 10.18663/tjcl.439538.
ISNAD Tolunay, Tolga - Akkurt, Mehmet Orçun. “İzole Ulna Cisim kırıklarında Konservatif Ve Cerrahi Tedavi yöntemlerinin karşılaştırılması”. Turkish Journal of Clinics and Laboratory 9/3 (Eylül 2018), 199-204. https://doi.org/10.18663/tjcl.439538.
JAMA Tolunay T, Akkurt MO. İzole ulna cisim kırıklarında konservatif ve cerrahi tedavi yöntemlerinin karşılaştırılması. TJCL. 2018;9:199–204.
MLA Tolunay, Tolga ve Mehmet Orçun Akkurt. “İzole Ulna Cisim kırıklarında Konservatif Ve Cerrahi Tedavi yöntemlerinin karşılaştırılması”. Turkish Journal of Clinics and Laboratory, c. 9, sy. 3, 2018, ss. 199-04, doi:10.18663/tjcl.439538.
Vancouver Tolunay T, Akkurt MO. İzole ulna cisim kırıklarında konservatif ve cerrahi tedavi yöntemlerinin karşılaştırılması. TJCL. 2018;9(3):199-204.


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