A��k tibia k�r�klar� nas�l tedavi edilmelidir? �ntramed�ller �ivileme ve biyolojik plaklama aras�nda k�yaslamal� geriye d�n�k �al��ma

Kayal�, Cemil; A�u�, Haluk; Eren, Ahmet; �zl�k, Serkan

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A��k tibia k�r�klar� nas�l tedavi edilmelidir? �ntramed�ller �ivileme ve biyolojik plaklama aras�nda k�yaslamal� geriye d�n�k �al��ma [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2009; 15(3): 243-248

A��k tibia k�r�klar� nas�l tedavi edilmelidir? �ntramed�ller �ivileme ve biyolojik plaklama aras�nda k�yaslamal� geriye d�n�k �al��ma

Cemil Kayal�¹, Haluk A�u�¹, Ahmet Eren¹, Serkan �zl�k²
¹Tepecik E�itim Ve Ara�t�rma Hastanesi
²Elaz�� Devlet Hastanesi

AMA�
A��k tibia k�r�klar�nda iki farkl� tedavi y�nteminin geriye d�n�k incelemeyle kar��la�t�r�lmas� ama�land�.
GERE� VE Y�NTEM
Tip I ve II a��k tibia k�r�kl� 45 olgu �al��maya al�nd�. Olgular�n 25�i (Grup I) minimal invasif plak osteosentezi (M�PO) ile, geriye kalan 20 olgu (Grup II) k�smi oymal� intramed�ller �ivi ile tedavi edildi. Son kontrolde klinik de�erlendirme modifiye Ketenjiyan �l��tler kullan�larak yap�ld�.
BULGULAR
Olgular�n tam y�klenme s�releri Grup I�de 21, Grup II�de 22,4 hafta idi. Grup I�de kaynamama saptanan bir olguya halkasal fiksat�rle yeniden tespit sa�land�. Bir olguda kronik ostemiyelit geli�mesi nedeniyle tespit cihaz� ��kar�ld�. Bir di�er olguda da k�t� kaynama saptand�. Grup II�de kaynamama geli�en iki olguya; biri intramed�ller �ivi ile di�eri halkasal fiksat�rle yeniden tespit uyguland�. Ek olarak bir olguda k�t� kaynama, bir de�erinde ise kronik osteomiyelit geli�en ge� komplikasyonlard�. Son kontrolde klinik yeterlilik oranlar�; Grup I�de 21/25, Grup II�de 18/20 idi. Bu sonu�lar aras�nda anlaml� fark saptanmad� (p>0,05).
SONU�
Her iki grupta sa�lanan klinik sonu�lar benzerdir. �ntramed�ller �iviler a��k tibia k�r�klar�nda ilk tercih olmas�na ra�men M�PO alternatif bir tedavi se�ene�idir.

Anahtar Kelimeler: Biological fixation, intramedullary nailing; open fracture; tibia; partial reaming.

How should open tibia fractures be treated? A retrospective comparative study between intramedullary nailing and biologic plating

Cemil Kayal�¹, Haluk A�u�¹, Ahmet Eren¹, Serkan �zl�k²
¹Tepecik Education And Research Hospital
²Elaz�� State Hospital

BACKGROUND
In this retrospective study, our purpose was to compare two treatment alternatives clinically.
METHODS
Forty-five patients who had grade I or II open tibia fractures were included. Twenty-five of them, treated via minimally invasive plate osteosynthesis (MIPO), comprised group I. The latter 20 cases, treated via partial reamed intramedullary nailing (PR-IMN), comprised group II. Clinical evaluation was made on the basis of modified Ketenjian�s criteria.
RESULTS
Full weight-bearing periods in groups I and II were 21 and 22.4 weeks, respectively. Non-union in one case of group I was revised with circular fixator. In another case, implant removal was needed due to chronic osteomyelitis. Mal-union was detected in another. In group II, two cases needed implant revision with intramedullary nail in one and circular fixator in another for non-union. Mal-union in one case and chronic osteomyelitis in another were the late complications in group II. At the last follow-up, satisfaction rates were: 21/25 in group I and 18/20 in group II. There was no significant difference between groups (p>0.05).
CONCLUSION
The clinical results of both groups were similar. Although intramedullary nailing is the first choice, MIPO is an alternative method for open tibia fractures.

Keywords: Biyolojik tespit, intramed�ller �ivileme; a��k k�r�klar; tibia; k�smi oyma.

Sorumlu Yazar: Cemil Kayal�, T�rkiye
Makale Dili: �ngilizce

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