Tibia pilon kırığı nedeniyle opere edilen hastaların ayak bileği fonksiyonlarının klinik ve radyolojik değerlendirilmesi
No Thumbnail Available
Date
2012
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Trakya Üniversitesi
Access Rights
info:eu-repo/semantics/openAccess
Abstract
ÖZETBu çalışmada amaç, tibia pilon kırıklarında kırık tiplerinin, radyolojik değerlendirmenin, redüksiyon kalitesinin, uygulanan cerrahi yöntemin ve komplikasyonların fonksiyonel sonuçlara etkisini saptamaktı. Ocak 2007-Kasım 2011 tarihleri arasında Trakya Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı Kliniği' de tibia pilon kırığı nedeni ile cerrahi tedavi edilen toplam 40 hastadan, 42 tibia pilon kırığı retrospektif olarak incelendi.Tibia pilon kırığı olan, cerrahi tedavi yöntemi ile tedavi edilen, en az 6 ay takibi olan ve dosyalarında preoperatif ve postoperatif radyografileri standartlara uygun çekilen hastalar çalışmaya alındı. Standart radyografiler Arbeitsgemeinschaft für Osteosynthesefragen Association for the Study of Internal Fixation ve Rüedi Allgöwer sınıflamasına göre sınıflandırıldı. Cerrahi tespit yönteme göre hastalar A, B ve C gruplara ayrıldı. Postoperatif dönemde redüksiyon kalitesi Ovadia ve Beals' in parametrelerine göre değerlendirildi. AOFAS ve Teeny ve Wiss' in skor parametreleri kullanılarak ayak bileği ekleminin klinik ve fonksiyonel sonuçları değerlendirildi.Erkeklerde yaş ortalaması yüksek bulundu. Yüksek enerjili travma oranı 3 kat fazla idi. Ek kırık oranı % 36, eşlik eden fibula kırığı oranı % 83,3, açık kırık oranı % 35,7 olduğu saptandı. En iyi redüksiyon oranı açık redüksiyon ve internal fiksasyon yapılan olgularda olduğu saptandı. Tedavi grupları arasında (Grup A, B ve C) klinik ve fonksiyonel sonucun redüksiyon kalitesinin başarı oranı ile doğru orantılı olduğu görüldü. İstatistiksel açıdan anlamlı fark bulundu. En yüksek oranda posttravmatik artrit, eklem içi kompleks kırıklar olan AO/ASIF C2 ve C3 kırık tiplerinde ve tedavi gruplarından Grup B ve C' de olduğu saptandı.Anahtar kelimeler: Tibia pilon, ayak bileği fonksiyonu, redüksiyon kalitesi
SUMMARYAim of this study was to determine the effects of the fracture types, quality of reduction, chosen surgical intervention and its complications on the functional results of the patients treated surgically for pilon fractures.Forty-two ankles of 40 patients, treated surgically for pilon fractures between January 2007 and November 2011 in the Orthopaedics and Traumatology department of Trakya University Medical Faculty were included in the study. Plain radiographs of the patients were classified according to the Arbeitsgemeinschaft für Osteosynthesefragen-Association for the Study of Internal Fixation and Rüedi-Allgöwer classifications. The patients were also splitted into treatment groups A, B and C according to the types of surgical intervention. The quality of reduction was evaluated according to the Ovadia and Beals? parameters in the postoperative period. The ankle joints of the patients were evaluated clinically and radiologically using the AOFAS and Teeny and Wiss? scoring systems.The mean age was found higher in the male patients. The ratio of high-energy trauma was found 3 times higher than low energy trauma in the entire group. Additional injuries were determined in 36 % of the patients, while accompanying fibula fractures were found in 83,3 % and open fractures were found in 35,7 % of the patients. According to the quality of reduction, best results were found in the open reduction-internal fixation group. There was a statistically significant positive correlation between the clinical and functional results and the treatment groups A, B and C. The highest rates of posttraumatic arthritis were found in the intraarticular-complex C2 and C3 type fractures and the treatment groups B and C.Keywords: pilon fractures, ankle function, quality of reduction
SUMMARYAim of this study was to determine the effects of the fracture types, quality of reduction, chosen surgical intervention and its complications on the functional results of the patients treated surgically for pilon fractures.Forty-two ankles of 40 patients, treated surgically for pilon fractures between January 2007 and November 2011 in the Orthopaedics and Traumatology department of Trakya University Medical Faculty were included in the study. Plain radiographs of the patients were classified according to the Arbeitsgemeinschaft für Osteosynthesefragen-Association for the Study of Internal Fixation and Rüedi-Allgöwer classifications. The patients were also splitted into treatment groups A, B and C according to the types of surgical intervention. The quality of reduction was evaluated according to the Ovadia and Beals? parameters in the postoperative period. The ankle joints of the patients were evaluated clinically and radiologically using the AOFAS and Teeny and Wiss? scoring systems.The mean age was found higher in the male patients. The ratio of high-energy trauma was found 3 times higher than low energy trauma in the entire group. Additional injuries were determined in 36 % of the patients, while accompanying fibula fractures were found in 83,3 % and open fractures were found in 35,7 % of the patients. According to the quality of reduction, best results were found in the open reduction-internal fixation group. There was a statistically significant positive correlation between the clinical and functional results and the treatment groups A, B and C. The highest rates of posttraumatic arthritis were found in the intraarticular-complex C2 and C3 type fractures and the treatment groups B and C.Keywords: pilon fractures, ankle function, quality of reduction
Description
Tıpta Uzmanlık
Keywords
Ortopedi ve Travmatoloji, Orthopedics and Traumatology
