Ulus Travma Acil Cerrahi Derg. 2021; 27(2): 238-242 | DOI: 10.14744/tjtes.2020.28934

Eklem içi uzanýmlý distal radius kýrýklarýnýn tedavisinde kapalý redüksiyon perkütan pinlemeye karþýn açýk redüksiyon internal tespit: Dört yýllýk sonuçlarýmýz

Sertac Saruhan¹, Cumhur Deniz Davulcu^2
1Ýzmir Bozyaka Eðitim ve Araþtýrma Hastanesi, Ortopedi ve Travmatoloji Kliniði, Ýzmir
²Ýzmir Katip Çelebi Üniversitesi, Atatürk Eðitim ve Araþtýrma Hastanesi, Ortopedi ve Travmatoloji Kliniði, Ýzmir

AMAÇ: Bu çalýþmada, eklem içi uzanýmlý distal radius kýrýklarýnýn tedavisinde kapalý redüksiyon perkütan pinlemeye (KRPP) karþýn açýk redüksiyon internal fiksasyon (ARÝF) tedavi yöntemlerinin dört yýllýk sonuçlarý karþýlaþtýrýlmýþtýr.
GEREÇ VE YÖNTEM: KRPP (n=19; 11 erkek ve sekiz kadýn) ile tedavi edilen tek taraflý intraartiküler distal radius kýrýðý (tip B ve C) olan ve ARÝF yapýlan (n=24; 14 erkek ve 10 kadýn) toplam 43 hasta geriye dönük olarak incelendi. Ortalama takip süresi kRPP grubunda 50.3 ay (12–74) ve ARÝF grubunda 45.2 ay (40–65) idi. Ortalama yaþ KRPP grubunda 50.8 (29–73), ARÝF grubunda 51.5 (19–75) idi. Hastalar son takipte fonksiyonel ve radyolojik olarak deðerlendirildi.
BULGULAR: Takip, yaþ ve cinsiyet açýsýndan gruplar arasýnda istatistiksel olarak anlamlý fark yoktu. Her ne kadar kavrama gücü ve hareket aralýðý ile ilgili istatistiksel bir fark olmasa da ARÝF grubunda kol, omuz ve el sorunlarý skoru (Q-DASH) daha iyiydi. Voler tilt ve radyal yükseklik ölçümleri ARÝF grubunda istatistiksel olarak anlamlý derecede daha iyi idi. Dejeneratif artrit KRPP grubunda %63 ve ARÝF grubunda %41 idi ve istatistiksel olarak anlamlý fark yoktu.
TARTIÞMA: Dört yýllýk takip sonucunda volar plak ile ARÝF yapýlan eklem içi uzanýmlý distal radius kýrýðý olan hasta grubunda, KRPP’den daha iyi fonksiyonel ve radyolojik sonuçlara sahip olduðu saptandý.

Anahtar Kelimeler: Açýk redüksiyon internal fiksasyon, distal radius kýrýklarý; eklem içi distal radius kýrýklarý; perkütan pinleme; volar kilitli plak.

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Closed reduction percutaneous pinning versus open reduction internal fixation in the treatment of intraarticular distal radius fractures: Mean four-year results

Sertac Saruhan¹, Cumhur Deniz Davulcu^2
1Department of Orthopaedics and Traumatology, Bozyaka Training and Research Hospital, Ýzmir-Turkey
²Department of Orthopaedics and Traumatology, Katip Çelebi University, Atatürk Training and Research Hospital, Ýzmir-Turkey

BACKGROUND: This study was performed to compare the results of closed reduction percutaneous pinning (CRPP) versus open reduction internal fixation with a volar locking plate (ORIF) in the treatment of intraarticular distal radius fractures (IDRF) average four-year follow-up.
METHODS: In this study, 43 patients had unilateral intraarticular distal radius fractures (type B and C) treated with CRPP (n=19; 11 males and eight females) and ORIF (n=24; 14 males and 10 females) were retrospectively evaluated. The mean follow-up was 50.3 months (12–74) at the CRPP group and 45.2 months (40–65) at the ORIF group. The mean age was 50.8 years (29–73) in the CRPP group and 51.5 (19–75) in the ORIF group. The patients were evaluated functionally and radiologically at the last follow-up.
RESULTS: There was no statistically significant difference between the groups concerning follow-up, age, and gender. However, there was no statistical difference concerning grip power and the range of motion. The Disabilities of the Arm, Shoulder and Hand Score (Q-DASH) was better in the ORIF group. Voler tilt and radial height measurements were statistically significantly better in the ORIF group. Degenerative arthritis was 63% in the CRPP group and 41% in the ORIF group, and there was no statistically significant difference.
CONCLUSION: ORIF with a volar locking plate has better functional and radiological results than CRPP in IDRF patients’ average four-year follow-up.

Keywords: Distal radius fractures, intraarticular distal radius fractures open reduction internal fixation; percutaneous pinning; volar locking plate.

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