Comparison of minimally invasive plate osteosynthesis and intramedullary nailing in the treatment of distal extraarticular tibial fractures

Mert Kumbaracı; Ahmet Savran

doi:10.19161/etd.990612

TR EN

Eklem dışı distal tibia kırıklarının tedavisinde minimal invazif plaklı osteosentez ile intramedüller çivilemenin karşılaştırılması

Öz

Amaç: Çalışmamızın amacı, eklem dışı distal tibia kırıklarının tedavisinde kullanılan intramedüller çivileme (İMÇ) ve minimal invazif plaklı osteosentezin (MİPO) fonksiyonel ve radyolojik sonuçlarının karşılaştırılmasıdır. Gereç ve Yöntem: Ocak 2008 ve Ocak 2015 tarihleri arasında hastanemizde eklem dışı distal tibia kırığı tanısıyla MİPO ya da İMÇ ile tedavi edilen 59 hasta geriye dönük olarak değerlendirildi. Kırık kaynamasının ve açısal deformitelerin değerlendirilmesi için postoperatif radyografiler kullanıldı. Hastaların fonksiyonel sonuçlarının değerlendirilmesinde ise Olerud-Molender Ankle Scoring (OMAS) yöntemi kullanıldı ve hastaların ayak bileği hareket genişlikleri goniometre ile ölçüldü. Bulgular: Yapılan son değerlendirmede tüm kırıkların kaynadığı görüldü. Kırıkların ortalama kaynama süresi MİPO grubunda 16,1 hafta (12-24 hafta) ve İMÇ grubunda ise 15,5 hafta (10-24 hafta) idi (p= 0.254). Ortalama OMAS skoru İMÇ grubunda 67,5 (40–90) MİPO grubunda ise 63 (30-90) idi (p= 0,12). Ortalama operasyon süresi İMÇ grubunda 95(45-115) dakika ve MİPO grubunda 75 (40-100) dakikaydı (p= 0,04). Ortalama radyasyon maruziyet süresi İMÇ grubunda 30 (8-143) saniye ve MİPO grubunda 17 (5-65) saniyeydi (p= 0,03). Açısal deformiteler İMÇ grubunda 7 (%23) hastada MİPO grubunda 5 (%17) hastada görüldü. Yumuşak doku problemleri ise MİPO grubunda daha fazla hastada görüldü. Sonuç: Sonuç olarak İMÇ ve MİPO distal tibia metafizer bölge kırıklarının tedavisinde güvenle kullanılabilmektedir. İntramedüller çivileme daha fazla hastada açısal deformiteye ve gecikmiş kaynamaya neden olurken MİPO daha sık yumuşak doku sorunlarına ve daha kötü fonksiyonel sonuçlara sebep olabilmektedir.

Anahtar Kelimeler

Comparison of minimally invasive plate osteosynthesis and intramedullary nailing in the treatment of distal extraarticular tibial fractures

Abstract

Aim: Our study’s aim was to investigate the effectiveness of minimal invasive plate osteosynthesis (MIPO) and intramedullary nailing (IMN) in extraarticular distal tibia fractures and to compare the outcomes of these two treatment methods. Materials and Methods: Between January 2008 and January 2015, 59 patients had extraarticular distal tibia fracture and treated with MIPO or IMN were evaluated retrospectively. Postoperative x-rays were evaluated for fracture consolidation and angular deformities. For the functional evaluations of the patients Olerud-Molender Ankle Scoring (OMAS) method was used and ankle joint range of motion was measured by goniometer. Results: At the last visit, all the fractures consolidated. Average union time was 16.1weeks (range, 12-24 weeks) in MIPO group and 15.5 weeks (range 10-24 weeks) in IMN group, respectively (p = 0.254). The mean OMAS scores were 67.5 (range 40–90) and 63 (range 30-90) in the IMN and MIPO groups, respectively (p= 0.12). The mean operation time was 95(range 45-115) minutes in IMN group and 75(range 40-100) minutes in MIPO group (p= 0.04). The mean operative radiation exposure times were 30(range 8-143) and 17 (range 5-65) seconds in IMN and MIPO groups, respectively (p= 0.03). Angular deformities were found in IMN group at 7 (23%) patients and in MIPO group at 5 (17%) patients, respectively. Soft tissue problems were seen in more patients in MIPO group. Conclusion: In conclusion, IMN and MIPO can be used safely in the treatment of distal tibial metaphyseal fractures. While IMN caused more angular deformity and more union delay, patients treated with MIPO had poorer functional results and more soft tissue problems.

Keywords

Kaynakça

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Ayrıntılar

Birincil Dil

İngilizce

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

Mert Kumbaracı ^*
0000-0003-1849-3520
Türkiye

Ahmet Savran
0000-0003-4609-9547
Türkiye

Yayımlanma Tarihi

13 Eylül 2021

Gönderilme Tarihi

25 Ocak 2021

Kabul Tarihi

15 Şubat 2021

Yayımlandığı Sayı

Yıl 2021 Cilt: 60 Sayı: 3

DOI

https://doi.org/10.19161/etd.990612

IZ

https://izlik.org/JA33AJ54LG

Kaynak Göster

RIS / Bibtex

Vancouver

1.Mert Kumbaracı, Ahmet Savran. Comparison of minimally invasive plate osteosynthesis and intramedullary nailing in the treatment of distal extraarticular tibial fractures. ETD. 01 Eylül 2021;60(3):288-95. doi:10.19161/etd.990612