Kapal� red�kte edilemeyen pediatrik deplase distal radius k�r�klar�nda yeni bir teknik: Fizyolojik salinin kademeli enjeksiyonu sonras� red�ksiyon � Olgu serisi

Karahan, M�min; �ZDEM�R, EKREM; Acar, Erdin�; G�ltekin, Alper; UYAR, AHMET �A�RI; Serarslan, Ula�

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Kapal� red�kte edilemeyen pediatrik deplase distal radius k�r�klar�nda yeni bir teknik: Fizyolojik salinin kademeli enjeksiyonu sonras� red�ksiyon � Olgu serisi [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. Bask�daki Makaleler: UTD-84824

Kapal� red�kte edilemeyen pediatrik deplase distal radius k�r�klar�nda yeni bir teknik: Fizyolojik salinin kademeli enjeksiyonu sonras� red�ksiyon � Olgu serisi

M�min Karahan¹, EKREM �ZDEM�R², Erdin� Acar³, Alper G�ltekin⁴, AHMET �A�RI UYAR⁴, Ula� Serarslan⁴
¹Kafkas �niversitesi T�p Fak�ltesi Ortopedi ve Travmatoloji Anabilim Dal�
²Erzurum �ehir Hastanesi Ortopedi ve Travmatoloji B�l�m�
³Ankara �ehir Hastanesi Ortopedi ve Travmatoloji B�l�m�, El ve �st Ekstremite Cerrahisi B�l�m�
⁴Kocaeli �ehir Hastanesi Ortopedi ve Travmatoloji B�l�m�

Ama�: Bu �al��man�n amac�, pediatrik olgularda kapal� red�kte olmayan deplase distal radius metafiz k�r�klar�nda, fizyolojik salinin kademeli enjeksiyonu ile red�ksiyonu i�eren yeni bir y�ntemi sunmak ve bu y�ntemin klinik ve radyolojik sonu�lar�n� de�erlendirmektir.
Y�ntemler: Klini�imizde May�s 2018�May�s 2020 tarihleri aras�nda, deplase distal radius metafiz k�r�� nedeniyle fizyolojik salinin kademeli enjeksiyonu uygulanarak kapal� red�ksiyon yap�lan toplam 24 pediatrik hasta retrospektif olarak incelendi. T�m hastalar 3., 6. ve 12. aylarda takip edildi. Radyolojik ve fonksiyonel sonu�lar de�erlendirildi. Klinik de�erlendirmede Mayo El Bile�i Skoru kullan�ld�. Radyolojik olarak kaynama ve deformite varl�� de�erlendirildi.
Bulgular: Hastalar�n 16�s� erkek, 8�i k�z olup, ortalama ya� 9,38�2,123 y�ld�. Yaralanma etiyolojileri aras�nda bisikletten d��me 6, paten yaralanmas� 5, skuter d��mesi 4, okulda d��me 4, evde d��me 3 ve merdivenden d��me 2 olgu ile temsil edildi. On d�rt hastada sa�, 10 hastada sol taraf k�r�� mevcuttu. Ameliyatta kullan�lan pin say�s� ortalama 2,79�0,588 idi. Ameliyat s�ras�nda kullan�lan fizyolojik salin miktar� ortalama 16,25�4,72 mL olarak kaydedildi. Hastalar�n ameliyat sonras� hastanede kal�� s�resi ortalama 2,0�0,590 g�n, takip s�resi ise 80,54�24,775 g�nd�. Pinlerin ��kar�lma s�resi ortalama 4,46�0,658 hafta idi. Mayo El Bile�i Skoru�na g�re 4 hastada iyi, 20 hastada m�kemmel sonu� elde edildi. Takiplerde yaln�zca 2 hastada pin dibi enfeksiyonu g�zlendi.
Sonu�lar: Kapal� red�ksiyonla azalt�lamayan pediatrik deplase distal radius k�r�klar�nda, fizyolojik salinin kademeli enjeksiyonu e�li�inde kapal� red�ksiyon ve perk�tan pinleme, etkili ve g�venli bir tedavi y�ntemi olarak g�r�nmektedir.

Anahtar Kelimeler: fizyolojik salin, pediatrik olgular, deplase k�r�k, distal radius

A Novel Technique in Displaced Distal Radius Fractures Not Reduced via Closed Reduction in Pediatric Patients: Reduction After Stepwise Injection of Physiological Saline-A case series

M�min Karahan¹, EKREM �ZDEM�R², Erdin� Acar³, Alper G�ltekin⁴, AHMET �A�RI UYAR⁴, Ula� Serarslan⁴
¹Department of Orthopedics and Traumatology, Faculty of Medicine, Kafkas University
²Department of Orthopedics and Traumatology, Erzurum City Hospital
³Department of Orthopaedics and Traumatology, Hand and Upper Extremity Surgery Division, Ankara City Hospital
⁴Department of Orthopaedics and Traumatology, Kocaeli City Hospital

Purpose: The purpose of this study was to present a new method in cases of displaced metaphyseal fractures in the distal radius not reduced by closed reduction in pediatric cases and evaluate the clinical and radiological outcomes of reduction after the stepwise injection of physiological saline.
Methods: A total of 24 pediatric patients who underwent closed reduction in their distal radius for displaced metaphyseal fractures using the stepwise injection of physiological saline in our clinic between May 2018 and May 2020 were retrospectively examined. Follow-ups were scheduled for all patients at three, six, and 12 months.Radiological and functional outcomes were evaluated.The Mayo Wrist Score was used in the clinical evaluations.The presence of union and deformity was evaluated radiologically.

Results: Of the patients, sixteen were boys, and eight were girls,whereas the mean age of the entire sample was 9.38�2.123 years.Among etiologies of injury, falling off the bike accounted for six, skating injury accounted for five, scooter-related falls accounted for four, fall at the school accounted for four, fall at home accounted for three, and fall from stairs accounted for two cases.Fourteen patients had right-sided fractures, and 10 patients had left-sided fractures.The mean number of pins used during surgery was 2.79�0.588.The mean amount of physiological saline used during surgery was 16.25�4.72 mL.The patients stayed in the hospital for a mean duration of 2�0.590 days after surgery,and their mean follow-up duration was 80.54�24.775 days.The mean time for pin removal was 4.46�0.658 weeks.While four patients had good Mayo Wrist Scores,and excellent scores were found in 20 patients.During follow-up, only two patients had pin site infection.
Conclusions: Closed reduction and percutaneous pinning using the stepwise injection of physiological saline seem to be an effective and safe treatment technique in displaced distal radius fractures that are not reduced by closed reduction in pediatric cases.

Keywords: physiological saline, pediatric cases, displaced fracture, distal radius

Sorumlu Yazar: EKREM �ZDEM�R, T�rkiye
Makale Dili: �ngilizce

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