PATELLA KIRIKLARINDA CERRAHÝ TEDAVÝ SONUÇLARI

Çalýþma; Mart 1996 Mart 2000 tarihleri arasýnda cerrahi tedavi uygulanan 20 hasta ile yapýldý. Hastalarýn 13'ü erkek, 7'si kadýn ve yaþ ortalamasý 39.5 idi. Transvers kýrýðý olan 10 hastaya modifiye tension band, vertikal kýrýðý olan 3 hasta ile distal pol kýrýðý olan 2 hastaya lag screw veya mini spongioz vida ile fiksasyon, parçalý kýrýðý olan 5 hastaya ise K teli + periferik sirküler serklaj ile tespit uygulandý. Ortalama 24 ay süreyle takip edilen hastalar radyolojik bulgulara ve Levack tarafýndan tanýmlanan kriterlere göre deðerlendirildiler. Vakalarýn %55'inde iyi, %35'inde orta ve %10'unda kötü sonuç elde edildi. En iyi sonuçlar modifiye tensiyon band yöntemi ile tedavi edilen transvers kýrýklarda elde edilirken, en kötü sonuçlar, periferik sirküler serklaj uygulanarak patellanýn korunmaya çalýþýldýðý parçalý kýrýklarda elde edildi. Çalýþmanýn sonucunda, cerrahi olarak tedavi edilen patella kýrýklarýnda; kýrýðý oluþturan travmanýn þiddeti, kýrýk tipi, uygulanan cerrahi teknik ve ameliyat sonrasý rehabilitasyonun sonuç üzerinde önemli etkileri olduðu saptandý. Ayrýca, patella eklem yüzü bütünlüðünün korunamadýðý çok parçalý kýrýklarda patellektominin ciddi bir tedavi seçeneði olarak düþünülmesinin uygun olacaðý sonucuna varýldý.

RESULTS OF SURGICAL TREATMENT IN PATELLAR FRACTURES

Twenty patients were treated surgically between March 1996 and March 2000. The mean age was 39.5 (18-68) and whom 13 were male and 7 were female. Surgical treatment methods as follows; modified tension band wiring in 10 of the patients with transverse fractures, mini cancellous screw and lag-screw fixation in 7 with vertical fractures and in 2 with distal pol fractures, combination of K wire and circumferential cerclage wire fixation in 5 with comminuted fractures. The average follow-up time was 24 months (6-54 months) and findings were evaluated radiologically and according to scale of Levack. Results were rated as good in 55%, moderate in 35% and poor in 10% of the patients. It was found that modified tension band wiring technique gave the best results. We concluded that majority of the trauma, type of the fracture, surgical technique and post operative rehabilitation were affected the results of patellar fractures treated surgically. In addition to this, patellectomy may be performed in severely comminuted fractures where no major fragments containing of articular surface of the patella exist.