Konservatif ve cerrahi tedavi edilen deplase asetabulum kýrýklý hastalarýn fonksiyonel ve radyolojik sonuçlarýnýn karþýlaþtýrýlmasý

AMAÇ: Çalýþmanýn amacý, konservatif ve cerrahi olarak tedavi edilen deplase asetabulum kýrýklý hastalarýn fonksiyonel ve radyolojik sonuçlarýný karþýlaþtýrmaktý.
GEREÇ VE YÖNTEM: Çalýþmaya, 2000–2014 yýllarý arasýnda asetabulum kýrýklarý nedeniyle konservatif veya cerrahi olarak tedavi edilen 18 yaþ üstü yer deðiþtirmiþ asetabulum kýrýðý olan 61 hasta alýndý. Hastalar tedavi þekline göre iki gruba ayrýldý. Grup 1, 2000–2010 yýllarý arasýnda konservatif tedavi gören 31 hastadan, grup 2 ise 2010–2014 yýllarý arasýnda cerrahi tedavi gören 30 hastadan oluþuyordu. Kýrýklar Judet ve Letournel sýnýflandýrmasýna göre sýnýflandýrýldý. Hastalarýn klinik deðerlendirmesi Modifiye Merle D’Aubigne Skoru, SF-36 ve Harris Kalça Skoruna göre yapýldý. Radyolojik deðerlendirme Matta’nýn Radyolojik Deðerlendirme Kriterlerine göre deðerlendirildi. Ýstatistiksel analiz için Kolmogorov Smirnov, t-testi, Mann-Whitney U-testi ve iki Wilcoxon eþleþtirilmiþ örnek testi kullanýldý. Anlamlýlýk sýnýrý p<0.05 olarak seçildi.
BULGULAR: Ortalama takip süresi konservatif grup için 10 yýl, cerrahi grup için 5.5 yýldý. Her iki grup arasýnda fonksiyonel skorlarda istatistiksel olarak anlamlý fark yoktu (p>0.05), ameliyat edilen grupta Matta’nýn radyolojik evreleme skoru anlamlý olarak yüksekti (p=0.023).
TARTIÞMA: Radyolojik skorlar, fonksiyonel kapasite ile doðrudan iliþkili deðildir. Cerrahi grupta iyi radyolojik ve fonksiyonel skorlar elde ettik, mutlak endikasyonlar mevcut olduðunda cerrahi tedavi düþünülmelidir. Konservatif olarak yönetilen kýrýklarýn sonucu kasvetli deðildir. Yer deðiþtirmiþ asetabular kýrýklarda cerrahi tedaviye bir alternatif olduðunu ve seçilmiþ olgularda benzer fonksiyonel sonuçlarýn alýnabileceðini düþünüyoruz.

Comparison of the functional and radiological results of the conservatively and surgically treated displaced acetabulum fractured patients

BACKGROUND: The purpose of the study was to compare the functional and radiological results of the conservatively and surgically treated displaced acetabular fractured patients.
METHODS: The study included 61 patients with a displaced acetabulum fracture over the age of 18, who have been treated con-servatively or surgically for acetabular fractures, between 2000 and 2014. Patients were divided into two groups according to their treatment type. Group 1 consisted of conservatively treated 31 between 2000 and 2010 patients and Group 2 consisted of surgically treated 30 patients between 2010 and 2014. The fractures were classified according to Judet and Letournel classification. Clinical evaluation of the patients was conducted according to Modified Merle D’Aubigne Score, SF-36, and Harris Hip Score. Radiological evaluation was evaluated according to Matta’s Radiological Evaluation Criteria. Kolmogorov–Smirnov, t-test, Mann–Whitney U-test, and two Wilcoxon paired sample tests were used for statistical analysis. The significance limit was chosen as p<0.05.
RESULTS: The mean follow-up time was 10 years for the conservative group and 5.5 years for the surgery group. There was no statistically significant difference in functional scores between both groups (p>0.05), Matta’s radiological staging score was significantly higher in the operated group (p=0.023).
CONCLUSION: Radiological scores are not directly correlated with the functional capacity. We obtained good radiological and functional scores in the surgical group, operative treatment should be considered when absolute indications are there. The outcome of conservatively managed fractures is not bleak. We think that there is an alternative to surgical treatment in displaced acetabular fractures and that similar functional results can be obtained in selected cases.