Results of titanyum elastic intramedullary nailing (TEN) in forearm fractures in children; a retroseceptive analysis of 23 cases

bsbd@balikesir.edu.tr www.bau-sbdergisi.com OZET AMAC: Onkol kiriklarinin tedavisinde en seckin yontem kapali reduksiyon ve alci tespiti ile uygulanan konservatif tedavidir. Cerrahi gereken onkol cift kirigi tedavisinde kanal-ici titanyum elastik civi(TEN) yontemi siklikla kullanilmaktadir. Bizde onkol cift kirigi nedeniyle kanal-ici TEN yapilan hastalarimizin tedavi sonuclarini degerlendirdik. YONTEMLER: Calismaya, onkol cift kirigi nedeniyle kanal-ici TEN yapilan ve en az 1 yil sureyle izlenen 23 hasta (2 kiz,19 erkek; ort. yas 12,2;dagilim7–18 yas) alindi. Hastalarin fonksiyonel muayeneleri ve radyolojik takipleri yapildi. Hastalarin fonksiyonel degerlendirmesi Price kriterlerine gore yapildi. Ortalama takip suresi 20,1(dagilim 12-48ay)aydir. BULGULAR: 23 hastanin 21’inde (%91,3) kaynama gozledik. Kaynamayan 2 hasta konservatif alci tedavisiyle kaynama elde ettik. Kiriklarin ortalama kaynama suresi 2,6 (dagilim 1,5-6 ay) aydir. Dort vakada pin dibi enfeksiyonu( % 17,4)gelisti bu hastalar antibiyoterapi ve debritman ile iyilesti. Uc vakada n.ulnaris duyu dali felci (% 12,9) gelisti. Ekstensor policis longus (EPL) rupturu gelisen 1 vakada (%4,3) ekstensor indicis propius tendon transferi ile basparmak ekstansiyonu sagladik. 1 vakada(%4,3) tel malpozisyonu gozlemledik. Fonksiyonel olarak %91,3 (21 vaka) mukemmel sonuc elde ettik. SONUC: Fonksiyonel sonuclarinin iyi olmasi, uygulama tekniginin ve implant cikartilmasinin kolay olmasi, daha az yumusak doku hasarina yol acmasi nedeniyle cocuk onkol cift kiriklarinin cerrahi tedavisinde intrameduller TEN uygulamasinin iyi bir secenek oldugunu dusunuyoruz.

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