Cerrahi olarak tedavi edilen boks�r k�r�klar�nda, erken harekete ba�lamak red�ksiyon kayb�na neden olmaz

Uzun, Metin; Tetik, Cihangir

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H�zl� Arama

Cerrahi olarak tedavi edilen boks�r k�r�klar�nda, erken harekete ba�lamak red�ksiyon kayb�na neden olmaz [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2022; 28(8): 1142-1147 | DOI: 10.14744/tjtes.2021.24668

Cerrahi olarak tedavi edilen boks�r k�r�klar�nda, erken harekete ba�lamak red�ksiyon kayb�na neden olmaz

Metin Uzun¹, Cihangir Tetik²
¹Mehmet Ali Ayd�nlar Ac�badem �niversitesi, �lk ve Acil Yard�m B�l�m�, �stanbul
²Ac�badem Maslak Hastanesi, Ortopedi ve Travmatoloji B�l�m�, �stanbul

AMA�: Be�inci metakarpal k�r�klar�n, �zellikle Kirschner teli teknikleri kullan�larak cerrahi tedavisi, erken el hareketini sa�lad�� i�in son zamanlarda pop�ler hale gelmi�tir. K�r��n ba�ar�l� anatomik red�ksiyonu genellikle cerrahi ile sa�lanmakla birlikte; anatomik bir red�ksiyon her zaman elde edilemez ve 30� oblik grafilerde, k�r�k 40��nin alt�ndaki dorsal a��lanma ile sabitlenir. Bu �al��man�n amac�, ameliyat sonras� bu t�r k�r�klar�n stabilitesini de�erlendirmek ve el ve bile�in erken hareket etmesini sa�layan iki farkl� a��lanma se�ene�ini kar��la�t�rmakt�.
GERE� VE Y�NTEM: Be�inci metakarpal boyun k�r��n�n 30 ard��k olgusu bir Kirschner teli ile intramed�ller olarak tedavi edildi. Olgular iki gruba ayr�ld�: Biri anatomik red�ksiyonla sabitlendi (grup 1) ve di�eri (grup 2) 30� oblik radyografiye g�re apeks dorsal a��lanmada 40��nin alt�nda sabitlen-di. Quick DASH skorlar� ve kavrama kuvvetleri olarak a��lanma, k�salma ve fonksiyonel sonu� alt�nc� ayda de�erlendirildi.
BULGULAR: Grup 1 i�in ortalama d�zeltme a��s� 56.6� (30� ile 110� aras�nda) ve rezid�el a�� 0� idi. Grup 2 i�in ortalama d�zeltme a��s� 42.4� (20� ile 75� aras�nda) ve rezid�el a�� 23.6� (10� ile 45� aras�nda) idi. Ortalama Quick DASH skorlar� grup 1 i�in 1.9 (SS: 1.7) ve grup 2 i�in 5.67 (SS: 2.93) idi (p<0.05). Kavrama g�c� de�erleri her iki grup i�in benzerdi. Ortalama 4. haftada (SS: 1.4) (da��l�m, 2�6 hafta) t�m hastalar herhangi bir s�n�rlama olmaks�z�n �nceki mesleklerine d�nd�ler. Red�ksiyon kayb� veya k�salma gibi komplikasyonlar tespit edilmedi. Fizik muayenede rotasyon tespit edilmedi.
TARTI�MA: Ara�t�rmam�z, k�r��n k�salmas� veya rotasyon riski olmad��n� ortaya koydu; hastalar g�nl�k aktivitelerine h�zla geri d�nebildi.

Anahtar Kelimeler: Antegrad intramed�ller �ivileme, be�inci metakarpal boyun; boks�r k�r��; K teli; sonu�lar.

Early movement does not cause loss of reduction in surgically treated boxer fractures

Metin Uzun¹, Cihangir Tetik²
¹Department of First Aid and Emergency, Mehmet Ali Ayd�nlar Ac�badem University, �stanbul-T�rkiye
²Department of Orthopedics and Traumatology, Ac�badem Maslak Hospital, �stanbul-T�rkiye

BACKGROUND: The surgical treatment of fifth metacarpal fractures, especially using Kirschner (K) wire techniques, has recently become popular because it provides for early hand movement. Successful anatomical reduction of the fracture is often achieved with surgery; however, an anatomical reduction cannot always be achieved and, according to 30� oblique radiography, the fracture is fixed with an apex dorsal angulation below 40�. The aim of this study was to evaluate the stability of such fractures postoperatively and compare the two different angulation options that provide early movement of the hand and wrist.
METHODS: Thirty consecutive cases of neck fractures of the fifth metacarpal were treated intramedullarly with one K wire. Cases were divided into two groups: One fixed with anatomical reduction (Group 1) and the other (Group 2) fixed in apex dorsal angulation below 40�, according to 30� oblique radiography. Angulation, shortening, and functional outcome as Quick DASH scores and grip strengths were evaluated at 6 months.
RESULTS: The mean correction angle was 56.6� (between 30� and 110�) for Group 1 and the residual angle was 0�. The mean cor-rection angle was 42.4� (between 20� and 75�) for group 2 (Figs. 4 and 5) and the residual angle was 23.6� (between 10� and 45�). The mean Quick DASH scores were 1.9 (SD: 1.7) for Group 1 and 5.67 (SD: 2.93) for Group 2 (p<0.05). Grip strength values were similar for both groups. All the patients returned to their previous occupations without any limitations in an average of 4 weeks (SD: 1.4) (range 2�6 weeks). No complications such as correction loosening or shortening were detected. Rotation was not detected during physical examination.
CONCLUSION: Our investigation revealed no risk of shortening or rotation of the fracture; the patients were able to return quickly to their everyday activities.

Keywords: Antegrade intramedullary pinning, boxer fracture; fifth metacarpal neck; K wire; outcomes.

Metin Uzun, Cihangir Tetik. Early movement does not cause loss of reduction in surgically treated boxer fractures. Ulus Travma Acil Cerrahi Derg. 2022; 28(8): 1142-1147

Sorumlu Yazar: Metin Uzun, T�rkiye
Makale Dili: �ngilizce

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