ÝLERÝ YAÞDAKÝ HASTALARDA ÝNTERTROKANTERÝK KIRIKLARIN LEINBACH TÝPÝ ENDOPROTEZLE TEDAVÝSÝ

Ýntertrokanterik kýrýklar özellikle ileri yaþ grubunda görülmekte ve daha çok basit travma ile oluþmaktadýr. Mortalite ve morbidite oraný yüksektir. Tedavide internal tespit, eksternal tespit yöntemleri uygulanabilmektedir. 1995-1999 yýllarý arasýnda kliniðimizde Leinbach tipi endoprotez uygulanarak tedavi edilen, yaþ ortalamasý 78(71-95) olan 27 intertrokanterik kýrýklý hasta deðerlendirildi. Hastalarýn 14'ü (%51) kadýn, 13'ü (%49) erkek idi. Olgular genel durumlarý uygun olduðu en erken dönemde ameliyata alýndýlar. Hastalarýn 2'si (%7) ameliyat bitiminde, 1'i (%3.7) postoperatif birinci hafta içinde kaybedildiler. Ortalama 14(5-21) ay izlenen hastalar Amerikan Ortopedi Cerrahlarý Akademisi kriterlerine göre deðerlendirildi ve %80 iyi sonuç elde edildiði görüldü. Ýleri yaþlarda basit travma ile oluþan intertrokanterik kýrýklarda ek patolojiler ve bunlara baðlý komplikasyonlarýn yaný sýra immobilizasyon sonucu oluþan komplikasyonlar da sýktýr. Bu komplikasyonlarý azaltmak, hastayý en erken dönemde mobilize etmek için protez uygulamanýn yardýmcý olduðu düþüncesindeyiz.

TREATMENT WITH LEINBACH ENDOPROTEZ OF INTERTROCHANTERIC FRACTURES IN ELDERLY PATIENCE

Intertrochanteric fractures are seen in elderly ages and occur mostly by minor trauma. Mortality and morbidity rates high and internal fixation and external methods are used for the treatment. Twenty-seven patients with intertrochanteric fractures who were at the mean age of 78 ranging between 71-95 and were treated by Leinbach type endoprosthesis during 1995-1999 were evaluated. Fourteen (%51) patients were female and 13 (%49) were male. The patients underwent operation as early as they were convenient. If they could, they were advised to walk at the second or third day of the operation. Two (%7) patients died at the end of the operation and 1 (%3.7) patient died during the first week after the operation. The patients were followed up mean 14(5-21)months and evaluated according to the criteria of American Academy of Orthopedic Surgeons which displayed good results in %80 of patients. In elderly patients with intertrochanteric fractures due to pathologies and related complications and also complications due to immobilization are seen frequently. Treatment with endoprosthesis is thought to be helpful in decreasing these complications and early mobilization of the patients.