Ulus Travma Acil Cerrahi Derg. 2020; 26(3): 439-444 | DOI: 10.14744/tjtes.2020.81780

Altmýþ beþ yaþ üstü kalça kýrýðý olgularýnda tedavi yöntemi ve ameliyata alýnma zamanýnýn mortaliteye etkisi

Cihat Ekici, Özhan Pazarcý, Seyran Kýlýnç, Zekeriya Öztemür, Hayati Öztürk, Gündüz Tezeren, Okay Bulut
Cumhuriyet Üniversitesi Týp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalý, Sivas

AMAÇ: Sunulan çalýþmada 65 yaþ üstündeki kalça kýrýðý nedeni ile ameliyat edilen hastalarda implant çeþidi ve cerrahi zamanlamanýn mortaliteye etkisinin deðerlendirilmesi amaçlandý.
GEREÇ VE YÖNTEM: Altmýþ beþ yaþ üstü 301 hasta incelendi. Hastalar Grup 1 çimentolu hemiartroplasti, Grup 2 çimentosuz hemiartroplasti ve Grup 3 femur proksimal çivi yapýlanlar olarak ayrýldý. Ameliyat zamaný, kýrýk ve demogrofik bilgileri geriye dönük kaydedildi.
BULGULAR: Bilgilerine ulaþýlamayan 59 hasta çýkarýldýktan sonra çalýþmaya 242 hasta dahil edildi. Hastalarýn ortalama yaþý 80.5 (65–100) idi. Tedavi yöntemine göre hasta gruplarýna bakýldýðýnda; Grup 1 (n=146) %60.3, Grup 2 (n=54) %22.3, Grup 3 (n=42) %17.4. Ýlk 48 saate opere edilenlerle, sonrasýnda opere edilenler arasýnda anlamlý bir fark bulunmadý (p=0.834). Tedavide implant seçiminin survey üzerine etkisi vardý (p=0.016). Çimentolu hemiartroplasti yapýlan hastalarýn surveyinin çimentosuz hemiartroplasti ve proksimal femoral çivi (PFN) yapýlanlara göre daha uzun olduðu görüldü.
TARTIÞMA: Her üç grupta da ilk 48 saatte ameliyata alýnmamanýn mortalite üzerinde anlamlý etkisinin olmadýðý görüldü. Bunun yanýnda yaþ ve cinsiyet mortalite üzerine etkilidir. Ayrýca implant seçimide mortaliteyi etkilemektedir.

Anahtar Kelimeler: Ameliyat zamaný, hemiarthroplasti; kalça kýrýðý; mortality; proksimal femoral nail.

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Effect on mortality of treatment method and surgery time for hip fracture patients aged over 65 years

Cihat Ekici, Özhan Pazarcý, Seyran Kýlýnç, Zekeriya Öztemür, Hayati Öztürk, Gündüz Tezeren, Okay Bulut
Department of Orthopaedics and Traumatology, Cumhuriyet University Faculty of Medicine, Sivas-Turkey

BACKGROUND: This study aimed to evaluate the effects on mortality of implant selection used and time to surgery in patients aged over 65 years operated for hip fractures.
METHODS: A total of 301 patients aged over 65 years were investigated in this study. Patients were divided into three groups as follows: Group 1 cemented hemiarthroplasty (CH), Group 2 cementless hemiarthroplasty (CLH), and Group 3 proximal femoral nail (PFN). Time of surgery, fracture and demographic information were retrospectively recorded.
RESULTS: After removing 59 patients with missing information, this study included 242 patients. Mean age of patients was 80.5 years. When patient groups were examined according to treatment method, Group 1 (n=146) comprised 60.3%, Group 2 (n=54) comprised 22.3% and Group 3 (n=42) comprised 17.4% of the study group. There was no significant difference in survival between the patients operated in the first 48 hours and the patients operated later (p=0.834). There was an effect on the survival of treatment implant selection (p=0.016). Patients with CH were observed to survive longer than patients with CLH and PFN.
CONCLUSION: Operation in the first 48 hours was not observed to affect mortality. Additionally, while sex and age were found to be effective on mortality, implant selection was also concluded to affect mortality.

Keywords: Hemiarthroplasty, hip fracture; mortality; proximal femoral nail; surgery time.

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