Alt ekstremite kısalıklarının uzayabilen intramedüller çivi ile tedavisinin klinik ve radyolojik sonuçlarının değerlendirilmesi
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Dosyalar
Tarih
2019
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Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Alt ekstremite kısalıklarının tedavisinde yeni bir yöntem olan uzayabilen intramedüller çivi ile ekstremiteuzatmaları yapılan hastaların klinik ve radyolojik sonuçlarının değerlendirilmesi amaçlanmıştır.Yöntemler: Retrospektif olan bu çalışmada, kliniğimize 2013-2016 yılları arasında alt ekstremitede kısalık nedeniylebaşvuran hastalardan uzayabilen intramedüller çivi ile ekstremite uzatma operasyonu yapılan 12 hastaya ait 13ekstremitenin klinik ve radyolojik sonuçları değerlendirilmiştir. Hastaların ortalama yaşı 26,9 (dağılım:13-51),cinsiyet dağılımı 2 erkek, 10 kadındır. Kemik dağılımı 5 tibia, 8 femur olarak tespit edilmiştir. Hastaların karşıekstremiteye göre kısalığı ortalama olarak 54,6 mm (dağılım: 30-140 mm)ve taraf olarak dağılımı ise 8 sağ, 5 soldur.Hastalardan 3 tanesinde post travmatik kısalık, 6 tanesinde konjenital kısalık ve 3 tanesinde de opere gelişimsel kalçadisplazisine sekonder kısalık tespit edilmiştir.Bulgular: Hastaların ortalama takip süresi 35,7 (dağılım: 12-36) aydır. Ortalama distraksiyon indeksleri 1,12(dağılım:1,05-1,52) gün/mmdir. Ortalama kemik iyileşme indeksi 37,3 (dağılım: 27-70) gün/cm olarak hesaplanmışolup, ortalama uzatma miktarı 5,15 (dağılım: 3-10) cm olarak gözlenmiştir. Paleyinintramedüller çivi üzerinde uzatmahastaları için kullandığı kemik ve fonksiyonel skorlamasına göre hastalar değerlendirildiğinde, hepsinin fonksiyonelskoru çok iyi, 11 hastanın kemik skoru çok iyi ve 1 hastanın kemik skoru iyi olarak değerlendirilmiştir. Tümhastalarda tam kaynama sağlanmış olup, sadece bir hastada gecikmiş kaynama saptanmıştır. Bu hastada da grefttatbiki ihtiyacı olmadan kontrollerde kaynama gözlenmiştir. Tüm hastaların eklem hareket açıklıkları operasyonöncesi değerlerine ulaşmıştır. Tüm hastalarda post op medial aks sapması (MAD) fonksiyonel sınırlar içerisindegözlemlenmiştir. Bir hastanın konsolidasyon safhasında intramedüller çivisinde kırık saptanmış ve plak vida iledesteklenmiştir. Hiç bir hastada derin enfeksiyon tespit edilmemiştir.Sonuç: Alt ekstremite kısalığı olan hastaların tedavisinde uzayabilen intramedüller çivi ile uzatma operasyonlarınınklinik ve radyolojik sonuçlarının tatmin edici olduğu söylenebilir.
Objective: The aim of this study was to evaluate the clinical and radiological outcomes of patients in lengthening intramedullary nails as a new method to treat lower limb discrepancies. Method: In our retrospective study, we evaluated the clinical and radiological results of 13 extremities of 12 patients who applied to our clinic due to a discrepancy of the lower extremity between 2013-2016 and underwent extremity lengthening with lengthening nail. Mean age of patient the patients was 26, 9 (range: 13-51). Gender distribution was as 2 males and 10 females. Bone distribution was determined as 5 tibias and 8 femurs. The mean discrepancy of the patients was 54.61 mm (range: 30-140 mm). The side distribution of the patients was as 8 right and 5 left. Three of our patients had post-traumatic shortness, 6 had congenital discrepancies and left 3 cases had discrepancies secondary to developmental hip dysplasia. Findings: The mean follow-up period of our patients was 35.7 (range: 12-36) months. The mean distraction index of our patients was 1.12 (range: 1.05-1.52) days/mm. Mean bone healing index was 37.3 (range: 27-70) days/cm. The mean length of extension was 5.15 (range: 3-10) cm. When the patients were evaluated according to the bone and functional scoring used by Paley for intramedullary lengthening nails, all our patients were found to have very good functional scores, where 11 patients had very good bone scores and 1 patient had a good bone score. Complete union was achieved in all patients. In one of our patients, delayed union was detected. The range of motion of all patients reached preoperative values. Post-op medial axis deviation (MAD) was determined to be within the functional limits in all our patients. In the consolidation phase, a fracture was detected on the intramedullary nail in one of our patients, and osteosynthesis was supported with plate screw. None of our patients had deep infection. Conclusion: The clinical and radiological outcomes of intramedullary lengthening nails and lengthening surgery can be considered as satisfactory in the treatment of patients with lower extremity discrepancy.
Objective: The aim of this study was to evaluate the clinical and radiological outcomes of patients in lengthening intramedullary nails as a new method to treat lower limb discrepancies. Method: In our retrospective study, we evaluated the clinical and radiological results of 13 extremities of 12 patients who applied to our clinic due to a discrepancy of the lower extremity between 2013-2016 and underwent extremity lengthening with lengthening nail. Mean age of patient the patients was 26, 9 (range: 13-51). Gender distribution was as 2 males and 10 females. Bone distribution was determined as 5 tibias and 8 femurs. The mean discrepancy of the patients was 54.61 mm (range: 30-140 mm). The side distribution of the patients was as 8 right and 5 left. Three of our patients had post-traumatic shortness, 6 had congenital discrepancies and left 3 cases had discrepancies secondary to developmental hip dysplasia. Findings: The mean follow-up period of our patients was 35.7 (range: 12-36) months. The mean distraction index of our patients was 1.12 (range: 1.05-1.52) days/mm. Mean bone healing index was 37.3 (range: 27-70) days/cm. The mean length of extension was 5.15 (range: 3-10) cm. When the patients were evaluated according to the bone and functional scoring used by Paley for intramedullary lengthening nails, all our patients were found to have very good functional scores, where 11 patients had very good bone scores and 1 patient had a good bone score. Complete union was achieved in all patients. In one of our patients, delayed union was detected. The range of motion of all patients reached preoperative values. Post-op medial axis deviation (MAD) was determined to be within the functional limits in all our patients. In the consolidation phase, a fracture was detected on the intramedullary nail in one of our patients, and osteosynthesis was supported with plate screw. None of our patients had deep infection. Conclusion: The clinical and radiological outcomes of intramedullary lengthening nails and lengthening surgery can be considered as satisfactory in the treatment of patients with lower extremity discrepancy.
Açıklama
Anahtar Kelimeler
Tıbbi Araştırmalar Deneysel, Ortopedi
Kaynak
Dicle Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
46
Sayı
3
