Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis
Yıl: 2019 Cilt: 11 Sayı: 3 Sayfa Aralığı: 141 - 148 Metin Dili: İngilizce DOI: 10.5222/iksstd.2019.41713 İndeks Tarihi: 04-03-2020
Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis
Öz: Objective: In this study we aimed to present the midterm clinical and radiological outcomes of low contact dynamic compression plate fixation of adult forearm frac-tures.Method: The study included 104 patients with adult forearm fractures who were com-patible with the inclusion criteria and have attended the last follow up.Results: The mean time to union was 10,82 weeks. Mean Disabilities of the Arm, Shoulder and Hand (DASH) score was 12.75. There were no cases with implant failure, mechanical irritation, refractures and radioulnar synostoses. 36 patieents were evalu-ated as perfect, 34 patients as good, 34 patients as acceptable outcomes. No unac-ceptable outcomes have been obtained.Conclusion: Adult forearm diaphyseal fractures are challenging cases in terms of treat-ment rehabilitation and complications. In order to prevent medicolegal consequences soft tissues and periosteum must be handled gently and anatomic, rigid, and stable reduction must be obtained in primary surgery. Open reduction and internal fixation with LC DCP’ is the golden standart treatmen option for forearm diaphyseal fracture management and perfec radiologic and functional outcomes can be obtained with this method.
Anahtar Kelime: Konular:
Yetişkin Önkol Diyafiz Kırıklarının Düşük Temaslı Dinamik Kompresyon Plağı ile Tedavi Sonuçları
Öz: Amaç: Bu çalışmada amacımız, 2009-2017 yılları arasında LC-DCP ile belirlediğimiz yetişkin önkol kırığı olan olgularımızın uzun dönem sonuçlarını literatürdeki diğer çalış-malarla karşılaştırmayı amaçladık. Yöntem: Çalışmaya önkol diyafiz kırığı olan 104 hasta dâhil edildi. Hastaların 80’i (%76,92) erkek, 24’ü (%23,07) kadındı. Kırıkların etiyolojik dağılımında; 56 düşme (%53,84), 32 trafik kazası (%30,76), 8 iş kazası (%7,69), 8 darp (%7,69) sonucu kırık gelişmişti. Bulgular: Ortalama kaynama süresi 10,82 hafta (8-20) haftaydı. Hastaların ortalama Disabilities of the Arm, Shoulder and Hand (DASH) skoru ortalaması 12,75 (3,3-38,8) olarak değerlendirildi. İmplant yetmezliği, mekanik irritasyon, implant kırılması, ref-raktür ve radioulnar sinostoz gelişen hasta olmadı. Grace-Eversman’nın fonksiyonel ve kaynama yönünden değerlendirme kriterlerine göre 36 hastada (%34,61) kusursuz, 34 hastada (%32,69) iyi, 34 hastada (%32,69) kabul edilebilir sonuçlar elde edilirken, kabul edilemez sonuç yoktu. Sonuç: Önkol diyafiz kırıklarının rekonstrüksiyonunda tam anatomik redüksiyon önce-likli amaçtır. Önkol kırıklarında yetersiz anatomik redüksiyon önkol rotasyonunu etkile-yen önemli bir faktördür. Önkol diyafiz kırıklarının cerrahi tedavisinde LC-DCP belirleme materyalleri ile kusursuz radyolojik ve fonksiyonel sonuçlar elde edilmektedir.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Charles A. Rockwood. Rockwood and Green’s Fractures in Adults 6th edition. Lippincott Williams & Wilkins; 2011.p.965-87.
- 2. Stannard JP, Schmidt AH, Kregor PJ. Surgical Treatment of Orthopaedic Trauma. Thieme; 2010;340-61.
- 3. Canale ST. Campbell’s Operative Orthopaedics 12 Edition. Philadelphia: Mosby; 2013. 2887-90
- 4. Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg Am. 2001;26:908-15. https://doi.org/10.1053/jhsu.2001.26322
- 5. Markolf KL, Lamey D, Yang S, Meals R, Hotchkiss R. Radioulnar load-sharing in the forearm. A study in cadavera. J Bone Joint Surg Am. 1998;80:879-88. https://doi.org/10.2106/00004623-199806000-00012
- 6. Andrew, H. Fractures of shoulder, arm, and forearm. Campbell’s operative orthopaedics. 10th ed. Philadelphia: Mosby; 2003;3058-66.
- 7. Arens S, Schlegel U, Printzen G, Ziegler WJ, Perren SM, & Hansis M. Influence of materials for fixation implants on local infection. An experimental study of steel ver-sus titanium DCP in rabbits. J Bone Joint Surg Br. 1996;78:647-51. https://doi.org/10.1302/0301-620X.78B4.0780647
- 8. Dodge HS, Cady GW. Treatment of fractures of the radius and ulna with compression plates. J Bone Joint Surg. 1972;54A:1167-76. https://doi.org/10.2106/00004623-197254060-00003
- 9. Gautier E, Ganz R. The biological plate osteosynthesis. Zentralblatt fur Chirurgie. 1994;119:564-72.
- 10. Gautier E, Perren S. Limited Contact Dynamic Compression Plate (LC-DCP)--biomechanical research as basis to new plate design. Der Orthopade. 1992;21:11-23.
- 11. Miclau T, Remiger A, Tepic S, Lindsey R, McIff T. A mechanical comparison of the dynamic compression plate, limited contact-dynamic compression plate, and point contact fixator. J Orthop Trauma. 1995;9:17-22. https://doi.org/10.1097/00005131-199502000-00003
- 12. Maurice ME, Allgöwer M, Perren SM. Manual of inter-nal fixation: techniques recommended by the AO-ASIF group. Springer Science & Business Media, 1991.
- 13. Perren SM. The concept of biological plating using the limited contact-dynamic compression plate (LC-DCP). Scientific background, design and application. Injury. 1991;22 Suppl 1:1-41. https://doi.org/10.1016/0020-1383(91)90123-V
- 14. Rodriguez-Merchan EC and Gomez-Castresana F. Internal fixation of nonunions. Clinical Orthopaedics and Related Research. 2004;419:13-20. https://doi.org/10.1097/00003086-200402000-00004
- 15. Rosson JW. Refracture after the removal of plates from the forearm. An avoidable complication. Bone & Joint Journal 1991;73(3):415-7. https://doi.org/10.1302/0301-620X.73B3.1670441
- 16. Roy D, Crawford A. Operative management of fractures of the shaft of the radius and ulna. Orthop Clinic North Am. 1990;21:245-50.
- 17. Wei SY, et al. Diaphyseal forearm fractures treated with and without bone graft. J Trauma and Acute Care Surg. 1999;46(6):1045-8. https://doi.org/10.1097/00005373-199906000-00011
- 18. Grace TG, Eversmann WW Jr. Forearm fractures: treat-ment by rigid fixation with early motion. J Bone Joint Surg Am. 1980 Apr;62(3):433-8. https://doi.org/10.2106/00004623-198062030-00013
- 19. Hudak P, et al. “Development of an upper extremity outcome measure: the DASH (Disabilities of the Arm, Shoulder, and Hand).” Am J Industrial Med. 1996;29(6): 602-8. https://doi.org/10.1002/(SICI)1097-0274(199606)29: 6<602::AID-AJIM4>3.0.CO;2-L
- 20. Anderson LD, Sisk D, Tooms RE, Park WI. Compression-plate fixation in acute diaphyseal fractures of the radius and ulna. J Bone Joint Surg Am. 1975;57:287-97. https://doi.org/10.2106/00004623-197557030-00001
- 21. Schemitsch EH, Jones D, Henley MB, Tencer AF. A com-parison of malreduction after plate and intramedullary nail fixation of forearm fractures. J Orthop Trauma. 1995;9:8-16. https://doi.org/10.1097/00005131-199502000-00002
- 22. Schemitsch EH, Richards RR. The effect of malunion on functional outcome after plate fixation of fractures of both bones of the forearm in adults. J Bone Joint Surg Am. 1992;74:1068-78. https://doi.org/10.2106/00004623-199274070-00014
- 23. Van Riet RP, Van Glabbeek F, Neale PG, et al. Anatomical considerations of the radius. Clin Anat. 2004;7:564-9. https://doi.org/10.1002/ca.10256
- 24. Köse A, Aydın A, Ezirmik N, Can CE, Topal M, Tipi T. Alternative treatment of forearm double fractures: new design intramedullary nail. Archives of Orthopaedic and Trauma Surgery. 2014;134:1387-96. https://doi.org/10.1007/s00402-014-2058-9
- 25. Matthews LS, Kaufer H, Garver DF, Sonstegard DA. The effect on supination-pronation of angular malalign-ment of fractures of both bones of the forearm. J Bone Joint Surg Am. 1982;64:14-7. https://doi.org/10.2106/00004623-198264010-00003
- 26. Tarr RR, Garfinkel AI, Sarmiento A. The effects of angu-lar and rotational deformities of both bones of the forearm. An in vitro study. J Bone Joint Surg Am. 1984;66:65-70. https://doi.org/10.2106/00004623-198466010-00010
- 27. Tynan MC, Fornalski S, McMahon JP. The effects of ulnar axial malalignment on supination and pronation. J Bone Joint Surg Am. 2000;82:1726-31. https://doi.org/10.2106/00004623-200012000-00005
- 28. Behnke NM, Redjal HR, Nguyen VT, Zinar DM. Internal fixation of diaphyseal fractures of the forearm: a retro-spective comparison of hybrid fixation versus dual plating. Journal of Orthopaedic Trauma. 2012;26: 611-6. https://doi.org/10.1097/BOT.0b013e31824aee8e
- 29. Lee SK, Kim KJ, Lee JW, Choy WS. Plate osteosynthesis versus intramedullary nailing for both forearm bones fractures. European Journal of Orthopaedic Surgery & Traumatology. 2014;24:769-76. https://doi.org/10.1007/s00590-013-1242-x
- 30. Barbieri, C. H., et al. Use of a bone block graft from the iliac crest with rigid fixation to correct diaphyseal defects of the radius and ulna. The Journal of Hand Surgery: British & European Volume 1997;22(3):395- 401. https://doi.org/10.1016/S0266-7681(97)80411-1
- 31. Grace TG, and Eversmann WW. The management of segmental bone loss associated with forearm frac-tures. J Bone Joint Surg Am. 1980;62(7):1150-5. https://doi.org/10.2106/00004623-198062070-00014
- 32. Miller RC and Phalen GS. The repair of defects of the radius with fibular bone grafts. J Bone Joint Surg Am. 1947;29(3):629-36.
- 33. Langkamer VG and Ackroyd CE. Internal fixation of forearm fractures in the 1980s: lessons to be learnt. Injury 1991;22(2):97-102. https://doi.org/10.1016/0020-1383(91)90063-K
- 34. Ross ERS, et al. Retrospective analysis of plate fixation of diaphyseal fractures of the forearm bones. Injury 1989;40(4):211-4. https://doi.org/10.1016/0020-1383(89)90114-9
- 35. Nevile BH and Charnley AD. “Treatment of forearm fractures in adults with particular reference to plate fixation.” Bone & Joint Journal 1964;46(3):404-25. https://doi.org/10.1302/0301-620X.46B3.404
- 36. Younger EM and Chapman MW. Morbidity at bone graft donor sites. J Orth Trauma 1989;3(3):192-5. https://doi.org/10.1097/00005131-198909000-00002
- 37. Enneking WF, Eady JL and Burchardt HANS. Autogenous cortical bone grafts in the reconstruction of segmental skeletal defects. J Bone Joint Surg Am 62.7 1980;62(7):1039-58. https://doi.org/10.2106/00004623-198062070-00001
- 38. Deluca PA, Lindsey RW, Ruwe PA. Refracture of bones of the forearm after the removal of compression plates. J Bone Joint Surg Am. 1988;70:1372-6. https://doi.org/10.2106/00004623-198870090-00015
- 39. Labosky DA, Cermak MB, Waggy CA. Forearm fracture plates: to remove or not to remove. J Hand Surg Am. 1990;15:294-301. https://doi.org/10.1016/0363-5023(90)90112-5
| APA | KÖSE A, ENGİN M, TOPAL M, Paksoy A, İpteç M, ÖZTÜRK İ, Aykut S (2019). Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis. , 141 - 148. 10.5222/iksstd.2019.41713 |
| Chicago | KÖSE AHMET,ENGİN Muhammed Çagatay,TOPAL Murat,Paksoy Ahmet E,İpteç Murat,ÖZTÜRK İbrahim Avşin,Aykut Serkan Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis. (2019): 141 - 148. 10.5222/iksstd.2019.41713 |
| MLA | KÖSE AHMET,ENGİN Muhammed Çagatay,TOPAL Murat,Paksoy Ahmet E,İpteç Murat,ÖZTÜRK İbrahim Avşin,Aykut Serkan Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis. , 2019, ss.141 - 148. 10.5222/iksstd.2019.41713 |
| AMA | KÖSE A,ENGİN M,TOPAL M,Paksoy A,İpteç M,ÖZTÜRK İ,Aykut S Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis. . 2019; 141 - 148. 10.5222/iksstd.2019.41713 |
| Vancouver | KÖSE A,ENGİN M,TOPAL M,Paksoy A,İpteç M,ÖZTÜRK İ,Aykut S Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis. . 2019; 141 - 148. 10.5222/iksstd.2019.41713 |
| IEEE | KÖSE A,ENGİN M,TOPAL M,Paksoy A,İpteç M,ÖZTÜRK İ,Aykut S "Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis." , ss.141 - 148, 2019. 10.5222/iksstd.2019.41713 |
| ISNAD | KÖSE, AHMET vd. "Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis". (2019), 141-148. https://doi.org/10.5222/iksstd.2019.41713 |
| APA | KÖSE A, ENGİN M, TOPAL M, Paksoy A, İpteç M, ÖZTÜRK İ, Aykut S (2019). Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis. İstanbul Kanuni Sultan Süleyman Tıp Dergisi, 11(3), 141 - 148. 10.5222/iksstd.2019.41713 |
| Chicago | KÖSE AHMET,ENGİN Muhammed Çagatay,TOPAL Murat,Paksoy Ahmet E,İpteç Murat,ÖZTÜRK İbrahim Avşin,Aykut Serkan Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis. İstanbul Kanuni Sultan Süleyman Tıp Dergisi 11, no.3 (2019): 141 - 148. 10.5222/iksstd.2019.41713 |
| MLA | KÖSE AHMET,ENGİN Muhammed Çagatay,TOPAL Murat,Paksoy Ahmet E,İpteç Murat,ÖZTÜRK İbrahim Avşin,Aykut Serkan Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis. İstanbul Kanuni Sultan Süleyman Tıp Dergisi, vol.11, no.3, 2019, ss.141 - 148. 10.5222/iksstd.2019.41713 |
| AMA | KÖSE A,ENGİN M,TOPAL M,Paksoy A,İpteç M,ÖZTÜRK İ,Aykut S Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis. İstanbul Kanuni Sultan Süleyman Tıp Dergisi. 2019; 11(3): 141 - 148. 10.5222/iksstd.2019.41713 |
| Vancouver | KÖSE A,ENGİN M,TOPAL M,Paksoy A,İpteç M,ÖZTÜRK İ,Aykut S Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis. İstanbul Kanuni Sultan Süleyman Tıp Dergisi. 2019; 11(3): 141 - 148. 10.5222/iksstd.2019.41713 |
| IEEE | KÖSE A,ENGİN M,TOPAL M,Paksoy A,İpteç M,ÖZTÜRK İ,Aykut S "Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis." İstanbul Kanuni Sultan Süleyman Tıp Dergisi, 11, ss.141 - 148, 2019. 10.5222/iksstd.2019.41713 |
| ISNAD | KÖSE, AHMET vd. "Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis". İstanbul Kanuni Sultan Süleyman Tıp Dergisi 11/3 (2019), 141-148. https://doi.org/10.5222/iksstd.2019.41713 |
