DÝPSLASE ÝNTRAKAPSULER UNSTABÝL FEMUR BOYUN KIRIKLARININ HEMÝARTROPLASTÝ ÝLE TEDAVÝSÝ

1986-1993 yýllarý arasýnda Uludað Üniversitesi Týp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalý'nda displase intrakapsüler femur kýrýðý nedeniyle hemiartroplasti uygulanan 37 hasta gözden geçirildi. Hastalarýn yaþ ortalamasý 65.5 (41-86) olup, 25'i (%67.6) kadýn, 12'si (%32.4) erkekti. Hastalarýn ameliyat öncesi ve sonrasý radyografileri incelendi ve ameliyatlarýn teknik yeterliliðini deðerlendirmek için protez basýnýn büyüklüðü, femur boyun uzunluðu, protezin pozisyonu, protez steminin kalkara yerleþimi deðerlendirildi ve çok iyi-iyi sonuç %81 olmak saptandý. Harris sýnýflamasýna göre çok iyi ve klinik sonuç %81 olarak belirlendi. Bir (%2.7) hastada dislokasyon meydana geldi. Ýki (%5.4) hastada yüzeyel, 1 (%2.7) hastada derin yara enfeksiyonu oluþtu. Üç (%8.1) hastaya gevþeme, 2 (%5.4) hastaya da protruzyo nedeniyle TKP uygulandý. Yaþlý, orta derecede aktif hastalarýn displase unstabil intrakapsüler femur boyun kýrýklarýnýn tedavisinde hemiartroplasti yapýlmasý güncelliðini korurken, bu hastalarýn 1-2 yýldan fazla yaþam beklentisi olanlarýnda bipolar protez kullanýlmasý uygun olacaktýr.

TREATMENT OF DISPLACED INTRACAPSULAR UNSTABLE FEMORAL FRACTURES BY HEMIARTROPLASTY

Thirty seven patients who underwent hemiartroplasty due to displaced intracapsular femoral neck fracture were studied in Orthopaedics and Traumatology department, Medical Faculty, Uludað University in 1993. The mean age of the patients 65.5 (41-86), 25 (67.66%) female and 12 (%32.4%) male. Roentgenograms of all patients were assessed preoperative and postoperative and in order to evaluate technical efficiency of operations, head sizes, neck length, position of prothesis, calcar seating were assessed. The excellent and good results were 81%. According to Harris clasification the excellent and good clinical results in our patients were 81%. Dislocation occurred in I (2.7%) patient. Superficial infection occurred in 2 (5.4%) patients and there was deep infection in I (2.7%) patient. THA was applied to 3 (8.1%) due to loosening and to 2 (5.4%) due to protrusion. We haw the opinion that it would be proper to perform hemiartroplasty in the treatment of displaced unstable intracapsular fractures of the femoral neck in elderly and moderately active patients and that the use of bipolar prosthesis will be convenient in the patients who are likely to have a 1 or 2 year life expectancy.