Distal radius kırıklarında eksternal fiksasyon tedavisi
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- Tez No: 91250
- Danışmanlar: Belirtilmemiş.
- Tez Türü: Tıpta Uzmanlık
- Konular: Ortopedi ve Travmatoloji, Orthopedics and Traumatology
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 2000
- Dil: Türkçe
- Üniversite: Sağlık Bakanlığı
- Enstitü: Ankara Eğitim ve Araştırma Hastanesi
- Ana Bilim Dalı: Ortopedi ve Travmatoloji Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 109
Özet
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Özet (Çeviri)
IX-SUMMARY Fractures of the distal radius are extremely common, and a large majority are well treated nonoperatively. However, recent critical evaluation of fracture patterns and results of treatment have demonstrated the need for surgical intervention in fractures demonstrating instability with or without articular incongruity. Recognition of those patterns that are interently unstable and therefore necessitate additional forms of fixation to searne and maintain reduction and prevent late collapse is the key to successful management of the more complex fractures of the distal radius. External fixation has been shown to be effective in the surgical management of unstable intra-articular fractures of the distal radius. At the ministry of health Ankara Education and Research Hospital, 1st Orthopedic and Travmatology Clinic 25 distal radius fracture have been treated with external fixsator between Agust 1998 and Agust 2000. The average age of patients were 40.8 (18-63), whom 15 (60 %) were female, 10 (40 %) were male. Average follow up is 12.1 months (3-23). All fractures were classified according to the Fernandez and Jupiter classification system. 20 fracture (80 %) were classified as Tip V unstabil communicate and 5 fracture (20 %) were classified as Tip I Bending fractures. The evaluation of the results (excellent, good, fair and poor) was based on the Gartland and Werley demerit point system, as modified by Sarmiento et al. The result were excellent in 10 (40 %) of cases, good in 9 (36 %), fair in 6 (24 %). Superficial pin tract enfection was present in 2 (8 %), parestesi was present in 3 (12 %), finger stiffness was present in 4 (16 %), reflex sympattatic dystrophy was present in 5 (20 %). 89Distal radius fractures especially the intraarticular ones are very demanding fractures which should not be underestimated and cannot all be treated conservatively. External fixtion is most commonly employed in unstable intra-articular fractures of the distal radius, successful use of external fixation in the management of the distal radius fractures necessitates careful assessment of the fracture pattern, appropriate patient selection, a careful and meticulous surgical approach, appropriate choise of fixation device and pins, judicious use of augmentiation with percutan, internal fixation and bone grafting, aggressive early rehabilitation and careful postoperative monitoring. 90
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