Proksimal femur çivisi ile tedavi edilen intertrokanterik femur kırığı olgularında cerrahi sonrası abduktor kas güçlerinin shear-wave elastografi ile değerlendirilmesi
Küçük Resim Yok
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmanın amacı antirotasyonel proksimal femur çivisi (PFN-A) ile tedavi edilen intertrokanterik femur kırıklı hastalarda shear-wave elastografi ile abduktor kas (gluteus medius) elastisitesinin sağlam kalçaya göre karşılaştırarak değerlendirilmesi ve kalça fonksiyonlarının Harris kalça skorlaması ile değerlendirilmesidir. Trakya Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı'nda, Temmuz 2016 ile Temmuz 2019 tarihleri arasında, intertrokanterik femur kırığı tanısı alan ve kırıkları antirotasyonel proksimal femur çivisi (PFN-A) kullanılarak tedavi edilen ve cerrahi üzerinden en az 6 hafta geçmiş olan 40 olgu çalışmaya alındı. Çalışmaya alınan 40 olgunun 23 (%57,5) 'ü kadın kadın, 17 (%42,5)'si erkekti. Çalışmadaki yaş ortalaması 70,53 idi. En genç olgu 26 en yaşlı olgu 91 yaşındaydı. Çalışmaya alınan tüm olgular yaş, cinsiyet, travma şiddeti, cerrahi tedaviden çalışma için yapılan muayeneye dek geçen süre açısından değerlendirildi. Çalışma için yapılan poliklinik kontrolünde olguların opere taraf kalça aktif abduksiyon derecesi ölçüldü, Harris kalça skorlaması hesaplandı. Ayrıca olguların shear wave elastografi ile opere olan taraf gluteus medius kası ve opere olmayan taraf gluteus medius kasının elastikiyeti ve kas kalınlıkları ölçüldü. Çalışmamızda yüksek enerjili travma geçiren olguların genellikle genç yaştaki olgular olduğu ve erkek olguların yoğunluklu olduğu bulundu. Erkek olguların Harris kalça skoru ortalamalarının kadın olgulara göre anlamlı derecede yüksek olduğu, olguların yaş ortalamaları arttıkça Harris kalça skorlarının azaldığı bulundu. Olguların yaş ile aktif abduksiyon derecesi ilişkisine bakıldığında yaş ilerledikçe aktif abduksiyon derecesinin azaldığı, ayrıca kadın olguların erkek olgulara kıyasla aktif abduksiyon derecesi ortalamalarının daha düşük olduğu bulundu. Çalışmaya katılan olguların opere olan taraf ile sağlam taraf gluteus medius kas kalınlıkları ve shear wave elastografi ile değerlendirilen gluteus medius kas elastikiyetleri benzer bulundu. Bu benzerliğin sebebi çalışmaya dahil edilme kriterlerinden olan olguların cerrahi tedavilerinin üzerinden en az 6 hafta geçmiş olması kriterine, 6 haftada yumuşak dokunun iyileşmesinin tamamlanmış olduğuna bağlandı. Çalışmamız neticesinde intertrokanterik femur kırıklarının tedavisinde PFN-A ile çivileme yönteminin gluteus medius kasının elastikiyet özelliğinde ve kasılabilirliğinde olumsuz bir etki oluşturmadığı görülmüştür. Çalışmamız PFN-A ile tedavi edilen intertrokanterik femur kırığı olguların gluteus medius kaslarının shear wave elastografi ile değerlendirildiği literatürdeki ilk çalışma olup, çalışmamızın ilerideki çalışmalara öncü olacağı ve literatüre farklı bir bakış açısı kazandıracağını düşünmekteyiz. Anahtar kelimeler: Gluteus medius, shear wave elastografi, PFN-A, intertrokanterik femur kırığı
The aim of this study is to evaluate the elasticity of the abductor muscle (gluteus medius) with shear-wave elastography and the hip functions by Harris hip scoring in patients with intertrochanteric femoral fractures treated with antirotational proximal femur nail (PFN-A). Forty patients who were diagnosed with intertrochanteric femoral fracture and treated with an antirotational proximal femur nail (PFN-A) and who had undergone surgery at least 6 weeks prior to the study in Trakya University Faculty of Medicine, Department of Orthopedics and Traumatology between July 2016 and July 2019 were included in the study. Of the 40 cases included in the study, 23 (57.5%) were female and 17 (42.5%) were male. The average age in the study was 70.53. The youngest case was 26 years oldest and 91 years old. All cases included in the study were evaluated in terms of age, gender, severity of trauma, time from surgical treatment to examination for the study. In the control performed for the study, the degree of active abduction on the operated side was measured, and Harris hip scoring was calculated. In addition, elasticity and muscle thickness of the operated gluteus medius muscle and non-operated operated gluteus medius muscle were measured by shear wave elastography. In our study, it was found that the cases with high energy trauma were generally young and the male cases were concentrated. It was found that the average of Harris hip score of male cases was significantly higher than that of female cases, and Harris hip scores decreased as the mean age of the cases increased. When the relationship between age and active abduction degree of the cases was examined, it was found that the degree of active abduction decreased as the age progressed, and that the average of active abduction level of female cases was lower compared to male cases. The operative side and intact side gluteus medius muscle thickness and the elasticity of gluteus medius muscle evaluated by shear wave elastography were similar. The reason for this similarity was attributed to the criteria of inclusion in the study at least 6 weeks after the surgical treatment of the patients, and the healing of the soft tissue in 6 weeks was completed. As a result of our study, it has been observed that PFN-A nailing method does not have a negative effect on the elasticity and contractility of the gluteus medius muscle in the treatment of intertrochanteric femur fractures. Our study is the first study in the literature where the gluteus medius muscles of intertrochanteric femur fracture treated with PFN-A were evaluated by shear wave elastography, and we think that our study will be a pioneer in future studies and give a different perspective to the literature. Key words: Gluteus medius, shear wave elastography, PFN-A, intertrochanteric femur fracture
The aim of this study is to evaluate the elasticity of the abductor muscle (gluteus medius) with shear-wave elastography and the hip functions by Harris hip scoring in patients with intertrochanteric femoral fractures treated with antirotational proximal femur nail (PFN-A). Forty patients who were diagnosed with intertrochanteric femoral fracture and treated with an antirotational proximal femur nail (PFN-A) and who had undergone surgery at least 6 weeks prior to the study in Trakya University Faculty of Medicine, Department of Orthopedics and Traumatology between July 2016 and July 2019 were included in the study. Of the 40 cases included in the study, 23 (57.5%) were female and 17 (42.5%) were male. The average age in the study was 70.53. The youngest case was 26 years oldest and 91 years old. All cases included in the study were evaluated in terms of age, gender, severity of trauma, time from surgical treatment to examination for the study. In the control performed for the study, the degree of active abduction on the operated side was measured, and Harris hip scoring was calculated. In addition, elasticity and muscle thickness of the operated gluteus medius muscle and non-operated operated gluteus medius muscle were measured by shear wave elastography. In our study, it was found that the cases with high energy trauma were generally young and the male cases were concentrated. It was found that the average of Harris hip score of male cases was significantly higher than that of female cases, and Harris hip scores decreased as the mean age of the cases increased. When the relationship between age and active abduction degree of the cases was examined, it was found that the degree of active abduction decreased as the age progressed, and that the average of active abduction level of female cases was lower compared to male cases. The operative side and intact side gluteus medius muscle thickness and the elasticity of gluteus medius muscle evaluated by shear wave elastography were similar. The reason for this similarity was attributed to the criteria of inclusion in the study at least 6 weeks after the surgical treatment of the patients, and the healing of the soft tissue in 6 weeks was completed. As a result of our study, it has been observed that PFN-A nailing method does not have a negative effect on the elasticity and contractility of the gluteus medius muscle in the treatment of intertrochanteric femur fractures. Our study is the first study in the literature where the gluteus medius muscles of intertrochanteric femur fracture treated with PFN-A were evaluated by shear wave elastography, and we think that our study will be a pioneer in future studies and give a different perspective to the literature. Key words: Gluteus medius, shear wave elastography, PFN-A, intertrochanteric femur fracture
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Ortopedi ve Travmatoloji, Orthopedics and Traumatology
