Sakroiliyak eklem ayrışması veya kresent kırığı olan hastaların cerrahi tedavi sonrası uzun dönem fonksiyonel sonuçları
Küçük Resim Yok
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada sakroiliyak eklem ayrışması veya sakroiliyak eklemin kırıklı çıkığı olan kresent kırıklı hastaların cerrahi tedavi sonuçlarının uzun vadeli olarak klinik ve radyolojik olarak değerlendirilmesi amaçlanmıştır. Materyal ve Metot: İnönü Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalında 2000-2020 yılları arasında tedavi edilen 850 pelvis yaralanmalı hasta retrospektif olarak değerlendirilmiş; bunlar arasından, sakroiliyak eklem yaralanması ve kresent kırığı olan, iliosakral vida ve/veya plak ile tedavi edilen 110 hasta çalışmaya dahil edilmiştir. Hastalar son takiplerinde subjetif pelvik semptom skorlaması kullanılarak değerlendirilmiştir. Hastaların sonuçları aldıkları skora göre çok iyi, iyi, orta ya da kötü olarak sınıflandırılmıştır. İstatiksel değerlendirme için IBM SSPS (İnternational Business Machine Statistical Package for the Social Sciences) Statistics 26,0 paket programı kullanılmıştır. Tanımlayıcı istatistiksel analizlerde sürekli değişkenler için ortalama ± standart sapma ve ortanca (minimum- maksimum); kategorik değişkenler için sayı ve yüzde (%) verilmiştir. Kategorik verilerin karşılaştırılmasında Ki kare testi kullanılmıştır. İstatistiksel anlamlılık düzeyi p<0,05 olarak kabul edilmiştir. Bulgular: Hastaların yaralanma anındaki yaş ortalaması 35.15±17.09 (minimum 6-maksimum 80) 'dur. Hastaların 74'ü erkek(%67,3), 36 'sı(%32,7)' kadındır. Yaralanma etiyolojisinde en sık neden %35.5 ile araç içi trafik kazası olarak bulunmuştur. Hastaların %50.9'unda kırık tipi OTA Tip B2 şeklindedir. Hastaların %48.2'sinde ek ortopedik yaralanma, %40.9'unda ek organ yaralanması bulunmaktadır. Fonksiyonel skorlama sonuçlarına bakıldığında hastaların %47.9'unda mükemmel, %38.2'sinde iyi, %12.7'sinde orta ve %1.8'inde kötü olarak bulunmuştur. Sakroiliyak plak vida ile ARİF, sakroiliyak kapalı redüksiyon perkütan vida ile tespit ve her iki yöntemin birlikte uygulandığı hastaların fonksiyonel skorlama sonuçları arasında istatistiksel olarak anlamlı fark bulunmamıştır (p>0.05). Ayrıca anterior ve posterior sakroiliyak plak vida ile ARİF uygulanan hastalar, anterior sakroiliyak plak vida kullanılarak ARİF ile perkütan sakroiliyak vida yöntemi uygulanan hastalar ve posterior sakroiliyak plak vida kullanılarak ARİF ile perkütan sakroiliyak vida yöntemi uygulanan hastaların fonksiyonel skorlama sonuçları arasında da istatistiksel olarak anlamlı fark bulunmamıştır (p>0.05). Sonuç: Çalışmamızda kresent kırığı ve sakroiliyak eklem ayrışması olan hastalarda uygun cerrahi tedavi ile tatmin edici fonksiyonel sonuçlar alındığı ortaya konmuştur. Anahtar Kelimeler: Kresent kırığı, pelvis kırığı, sakroiliyak eklem yaralanması
Objective: In this study, it was aimed to evaluate the long-term clinical and radiological results of surgical treatment of patients with crescent fractures or dislocation of the sacroiliac joint. Methods: 850 patients with pelvic injuries treated between 2000-2020 in İnönü University, Faculty of Medicine, Department of Orthopedics and Traumatology were evaluated retrospectively. Among these, 110 patients with sacroiliac joint injury and crescent fracture treated with iliosacral screw and/or plate were included in the study. Patients were evaluated using subjective pelvic symptom scoring at their final follow-up. The results of the patients were classified as very good, good, moderate or bad according to their scores. For statistical evaluation, IBM SSPS (İnternational Business Machine Statistical Package for the Social Sciences) statistics 26.0 package program was used. In descriptive statistical analyses, mean ± standard deviation and median (minimum-maximum) for continuous variables; numbers and percentages were given for categorical variables. Chi-square test was used to compare categorical data. Statistical significance level was accepted as p<0.05. Results: The mean age of the patients at the time of injury was 35.15±17.09 (minimum 6-maximum 80). 74 (67.3%) of the patients were male and 36 (32.7%) of them were female. The most common cause of injury was found to be in-vehicle traffic accident with 35.5%. Fracture type was OTA Type B2 in 50.9% of the patients. 48.2% of the patients had additional orthopedic injuries and 40.9% of them had additional organ injuries. Functional scoring results were excellent in 47.9%, good in 38.2%, moderate in 12.7%, and poor in 1.8% of the patients. There was no statistically significant difference between the functional scoring results of patients treated with sacroiliac ORIF plate method, sacroiliac closed reduction percutaneous screw therapy and both treatments (p>0.05). In addition, no significant difference was observed among different treatment groups (anterior or posterior ORIF /w plate and screws, closed reduction /w percutaneus iliosacral screw) (p>0.05). Conclusions: In our study, it was demonstrated that satisfactory functional results were obtained with appropriate surgical treatment in patients with crescent fracture and sacroiliac joint dislocation. Keywords: Crescent fracture, pelvic fracture, sacroiliac joint injury
Objective: In this study, it was aimed to evaluate the long-term clinical and radiological results of surgical treatment of patients with crescent fractures or dislocation of the sacroiliac joint. Methods: 850 patients with pelvic injuries treated between 2000-2020 in İnönü University, Faculty of Medicine, Department of Orthopedics and Traumatology were evaluated retrospectively. Among these, 110 patients with sacroiliac joint injury and crescent fracture treated with iliosacral screw and/or plate were included in the study. Patients were evaluated using subjective pelvic symptom scoring at their final follow-up. The results of the patients were classified as very good, good, moderate or bad according to their scores. For statistical evaluation, IBM SSPS (İnternational Business Machine Statistical Package for the Social Sciences) statistics 26.0 package program was used. In descriptive statistical analyses, mean ± standard deviation and median (minimum-maximum) for continuous variables; numbers and percentages were given for categorical variables. Chi-square test was used to compare categorical data. Statistical significance level was accepted as p<0.05. Results: The mean age of the patients at the time of injury was 35.15±17.09 (minimum 6-maximum 80). 74 (67.3%) of the patients were male and 36 (32.7%) of them were female. The most common cause of injury was found to be in-vehicle traffic accident with 35.5%. Fracture type was OTA Type B2 in 50.9% of the patients. 48.2% of the patients had additional orthopedic injuries and 40.9% of them had additional organ injuries. Functional scoring results were excellent in 47.9%, good in 38.2%, moderate in 12.7%, and poor in 1.8% of the patients. There was no statistically significant difference between the functional scoring results of patients treated with sacroiliac ORIF plate method, sacroiliac closed reduction percutaneous screw therapy and both treatments (p>0.05). In addition, no significant difference was observed among different treatment groups (anterior or posterior ORIF /w plate and screws, closed reduction /w percutaneus iliosacral screw) (p>0.05). Conclusions: In our study, it was demonstrated that satisfactory functional results were obtained with appropriate surgical treatment in patients with crescent fracture and sacroiliac joint dislocation. Keywords: Crescent fracture, pelvic fracture, sacroiliac joint injury
Açıklama
Anahtar Kelimeler
Ortopedi ve Travmatoloji, Orthopedics and Traumatology
