EARLY SURGICAL TREATMENT RESULT OF ACETABULAR POSTERIOR COLUMN FRACTURE

Yıl 2010, Cilt: 4 Sayı: 3, 104 - 108, 22.11.2010

Kasım Kılıçarslan

Öz

Introduction: Fractures of the acetabulum result from high-energy traumas and the restoration of the articular surface achieved through the treatment is the most indicative factor which determines the subsequent arthrosis. In this study, following the retrospective inspection of the patients diagnosed with acetabular fracture and treated at our clinic we evaluate the results of those patients who had posterior column fractures and were treated with surgery.
Materials and Method: We reviewed the files of 83 patients with acetabular fracture who were referred to emergency department of Orthopaedic and Trauma Clinic-Ill at Ataturk Training Research Hospital. Among these patients we evaluated the results of those with posterior column fracture who were treated with surgery.
Findings: Patients were assessed based on Merle D’Aubigne and Postel scoring systems and the clinical results were poor at 1 patient (10%), fair at 4 patients (30%), good at 6 patients (50%), excellent at 1 patient (10%). Mean age was 42,7 (28-58), mean follow up period was 23 months (13-46). The history of 10 patients (80%) was traffic accident, that of 2 patients (20%) falling down from height. Skeletal traction conjoined with 5 kg weight was in place for all of the patients for a mean period of 3,2 days and they were operated after mean 4,3 days.
Results: The most significant point at deciding the treatment for the acetabular fractures is to determine the fracture type. Hip joint instability at posterior column fractures, sciatic injury are common findings and surgical treatment using Kocher-Langenbeck incision for these patients gives successful outcomes.

Anahtar Kelimeler

Acetabular Fractures, Surgical Treatment, Posterior Column Fractures

ASETABULUM POSTERIOR KOLON KIRIKLARININ ERKEN DÖNEM CERRAHİ TEDAVİ SONUÇLARI

Öz

Amaç: Asetabulum kırıkları yüksek enerjili travmalar sonrasında oluşur ve tedavide eklem yüzeyinin restorasyonu, daha sonra gelişecek artrozu belirleyen en önemli faktördür. Bu çalışmada asetabulum kırığı tanısıyla kliniğimizde tedavi edilen hastaların retrospektif olarak incelenmesinde, posterior kolon kırığı olan ve cerrahi tedavi edilen hastaların sonuçları değerlendirildi.
Gereç ve Yöntemler: Ocak 2006 - Şubat 2010 tarihleri arasında Ankara Atatürk Eğitim ve Araştırma Hastanesi 3. Ortopedi ve Travmatoloji Kliniğinin acil servisine başvuran asetabulum fraktürü olan 83 hastanın dosyaları incelendi. Bu hastalardan cerrahi olarak tedavi edilen ve posterior kolon kırığı olan hastaların sonuçları değerlendirildi.

Bulgular: Hastalar, Merle D’Aubigne ve Postel’in skorlama sistemi ile değerlendirilmiştir ve buna göre 1 hastada (%10) kötü, 4 hastada (%30) orta, 6 hastada (%50) iyi, 1 hastada (%10) çok iyi sonuç elde edilmiştir. Ortalama yaş 42,7 (28-58), ortalama takip süresi 23 ay (13-46) dır. Öykü 10 hastada (%80) trafik kazası iken, 2 hastada (%20) yüksekten düşmedir. Hastaların tamamı ortalama 3,2 gün 5 kg ağırlıkla iskelet traksiyonunda tutulmuş ve ortalama 4,3 gün sonra öpere edilmiştir.

Sonuç: Asetabulum kırıklarında tedaviyi belirlemede en önemli nokta kırık tipinin belirlenmesidir. Posterior kolon kırıklarında, kalça eklemi instabilitesi, siyatik sinir ağrazı sık görülen bulgulardır ve bu hastaların Kocher-Langenbeck insizyonu ile yapılan cerrahi tedavilerinde başarılı sonuçlar alınmaktadır.

Anahtar Kelimeler

Asetabulum Kırıkları, Cerrahi Tedavi, Posterior Kolon Kırıkları

Kaynakça

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