Ulus Travma Acil Cerrahi Derg. 2012; 18(2): 162-166 | DOI: 10.5505/tjtes.2012.64022

Radius alt uç kýrýklarýnda volar plak ile tedavi uygulamalarý

Emrah Rýza Demirbaþ¹, Ali Akýn Uðraþ¹, Ýbrahim Kaya¹, Ýbrahim Sungur¹, Cemal Kural², Ercan Çetinus^1
1Haseki Eðitim Ve Araþtýrma Hastanesi, Ortopedi Ve Travmatoloji Kliniði
²Bakýrköy Sadi Konuk Eðitim Ve Araþtýrma Hastanesi, Ortopedi Ve Travmatoloji Kliniði

Amaç: Eriþkin radius alt uç kýrýklarýnda volar yaklaþýmla kilitli ve kilitsiz plak uygulamalarýnýn sonuçlarý deðerlendirildi.
Çalýþma planý: Distal radius kýrýðý nedeni ile cerrahi tedavi uygulanan 14'ü kadýn, 20'si erkek, yaþ ortalamasý 48.5±17.9 olan toplam 34 hasta retrospektif olarak incelemeye alýndý. Kýrýklarýn tipi AO sýnýflamasýna göre %17.6 B3, %11.8 C2 ve %70.6 C3 olarak daðýlým göstermekteydi. Klinik sonuçlar Gartland ve Werley deðerlendirme skalasý, Görsel analog ölçüt (VAS), Kol omuz el sorunlarý anketi (DASH) ile, radyolojik deðerlendirme ise Stewart deðerlendirme ölçütleri ile yapýldý.
Sonuçlar: Hastalarýn ortalama takip süresi 24±16.3 aydý. Gartland-Werley deðerlendirme skalasýna göre %29.4 hastada mükemmel, %55.9 hastada iyi, %11.8 hastada orta ve %2.9 hastada kötü sonuç alýndý. Ortalama VAS skoru 0.5±1.1, ortalama DASH subjektif sorgulama puaný 26.1 olarak bulundu. Stewart skoruna göre %44.1 mükemmel, %52.9 iyi, %2.9 orta sonuç elde edildi. Olgularýn kavrama gücü geri kazanýmlarý saðlam tarafa göre %43.1 olarak bulundu. Ýki hastada kompleks rejyonel aðrý sendromu, bir karpal tünel sendromu ve bir tenosinovit görüldü.
Çýkarýmlar: Radius distal uç kýrýklarýnýn tedavisinde volar plak ile tespit etkin ve iyi bir yöntemdir. Plak özenli yerleþtirilmeli ve ameliyat sonrasý rehabilitasyon ihmal edilmemelidir.

Anahtar Kelimeler: distal radius fracture, locking plate, plate fixation

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Volar plate fixation of distal radius fractures

Emrah Rýza Demirbaþ¹, Ali Akýn Uðraþ¹, Ýbrahim Kaya¹, Ýbrahim Sungur¹, Cemal Kural², Ercan Çetinus^1
1Haseki Training And Research Hospital, Orthopedics And Traumatology
²Bakýrköy Sadi Konuk Training And Research Hospital, Orthopedics And Traumatology

Objective: To evaluate results of volar locking and unlocking plate fixation of adult distal radius fractures.
Methods: 34 patients (14 female and 20 male, the mean age was 48.5±17.9) who were treated for distal radius fractures,retrospectively investigated. The fractures were distirubuted as follows; 17.6% AO type B3, 11.8% AO type C2 and 70.6% AO type C3. The patients were evaluated clinically (Gartland and Werley scale, Visual analog score (VAS), Disabilites of the arm shoulder and hand score (DASH)) and radiographically (Stewart score).
Results: The mean follow-up of patients were 24±16.3 months. According to Gartland-Werley scale, the results were excellent in 24.9% of patients, good in 55.9% of patients, moderate in 11.8% of patients and poor in 2.9% of patients. The mean VAS score was 0.5±1.1, and the mean DASH score was 26.1. According to Stewart criteria, 44.1% of patients rated as excellent, 52.9% of patients rated as good and 2.9% of patients rated as moderate. 2 patients had complex regional pain syndrome, one patient had carpal tunnel syndrome and one patient had tenosynovitis.
Conclusions: Volar plate fixation is a good and an effective treatment for distal radius fractures. Plate should be inserted properly and physiotherapy should not be ignored.

Keywords: distal radius fracture, locking plate, plate fixation

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