Ulus Travma Acil Cerrahi Derg. 2012; 18(1): 65-70 | DOI: 10.5505/tjtes.2012.33427

Femur boyun kýrýklarýnýn tedavisinde perkütan kanüle vida, dinamik kompresyon plak ve vidanýn karþýlaþtýrmalý sonuçlarý

Tolga Kaplan¹, Burak Akesen², Burak Demirað², Sadýk Bilgen², Kemal Durak^2
1Medical Park Hastanesi, Ortopedi Ve Travmatoloji Kliniði, Bursa
²Uludað Üniversitesi Týp Fakültesi Ortopedi Ve Travmatoloji Anabilim Dalý, Bursa.

AMAÇ
Bu çalýþmanýn amacý, perkütan kanüle vida veya dinamik kalça vidasý (DKV) ile tedavi edilen femur boyun kýrýklý hastalarýn kaynama süresi, fonksiyonel sonuçlar ve komplikasyonlar açýsýndan karþýlaþtýrýlmasýdýr.
GEREÇ VE YÖNTEM
Aðustos 1999 ile Ekim 2003 tarihleri arasýnda femur boyun kýrýðý bulunan altmýþ altý hasta perkütan kanüle vida (n=33) veya DKV (n=33) ile tedavi edildi. Fonksiyonel sonuçlar Harris kalça skoru ile deðerlendirildi. Çalýþmada ayrýca kayanama süreleri, kanama miktarý ve komplikasyon oraný ölçüldü.
BULGULAR
Kaynama süreleri ve fonksiyonel sonuçlar açýsýndan iki grup arasýnda anlamlý fark bulunmadý. Avasküler nekroz riski en çok kýrýðýn kayma miktarý ile iliþkili bulundu. Perkütan kanüle vida uygulanan grupta ameliyat süresi ve kanama miktarý anlamlý olarak daha düþük bulundu.
SONUÇ
Kayanama süresi ve fonksiyonel sonuç açýsýndan perkütan kanüle vida ve DKV uygulamarýnýn birbirlerine üstünlüðü bulunmamaktadýr. Avasküler nekroz riski kýrýðýn kayma miktarý ile iliþkilidir. Bununla birlikte ayný kayma miktarý bulunan hastlarda iki tekniðin birbirleri ile karþýlaþtýrýlmasý için prospektif randomize bir çalýþma gereksinimi vardýr.

Anahtar Kelimeler: Dinamik kalça vidasý, femur boyun kýrýðý; perkütan; kanüle vida.

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Comparative results of percutaneous cannulated screws, dynamic compression type plate and screw for the treatment of femoral neck fractures

Tolga Kaplan¹, Burak Akesen², Burak Demirað², Sadýk Bilgen², Kemal Durak^2
1Medical Park Hospital, Department Of Orthopaedics And Traumatology, Bursa
²Uludag University Medical School, Department Of Orthopaedic Surgery, Bursa.

BACKGROUND
The purpose of this study was to compare the period of union, functional outcomes and complications of patients with femoral neck fracture treated with percutaneous cannulated screws versus dynamic hip screw (DHS).
METHODS
Sixty-six patients with femoral neck fracture were treated with percutaneous cannulated screws (n=33) or with DHS (n=33) between August 1999 and October 2003. Functional outcome was measured using Harris Hip Score, and period of union, amount of bleeding and complications were also recorded.
RESULTS
The period of union and functional outcomes were not different between the two groups. Risk of avascular necrosis (AVN) was associated mainly with the grade of fracture displacement. In the percutaneous cannulated screw group, duration of surgery was shorter and blood loss was less than in the other group.
CONCLUSION
There was no superiority between cannulated screws and DHS according to union times and functional results. Risk of AVN is related to the degree of displacement. However, a prospective randomized study is needed to determine the outcome of each technique for patients suffering similar displacement rates.

Keywords: Dynamic hip screw, fractures of the femoral neck; percutaneous; cannulated screw.

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ATIF KOPYALA