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Humerus Cisim Kırıklarının Cerrahi Tedavisinde Konvansiyonel Plaklama mı Minimal İnvaziv Plak Osteosentezi mi Daha Üstün?

Which One is better for Surgical Treatment of Humeral Shaft Fractures? Conventional plating versus Minimal Invasive Approach

Journal Name:

  • Abant Tıp Dergisi

Publication Year:

  • 2017
DOI: 
10.5505/abantmedj.2017.55706

Key Words:

Keywords (Original Language):

Author Name
Abstract (2. Language): 
Introduction: Although the gold standard for surgical treatment of humerus shaft fractures is internal fixation there still controversy exists on the fixation method of choice. In this study, we aimed to compare the results of minimally invasive plate osteosynthesis (MIPPO) with posterior conventional plating (ORIF) of the humerus shaft fracture. Methods: Between January 2010 and December 2014, a retrospective study was conducted on 47 patients whom were operated for humerus fracture by internal fixation. Of them, 27 were performed ORIF (Group A) and 20 were performed MIPPO (Group B) technique. Each group was statistically compared for bony union time, functional scores, time to return work and operation time. Results: There were not statistically significant difference between two groups with regard to bony union time, functional scores and time to return to work (p>0.05). The mean bony union time in two groups was 16.37±2.55 weeks. The mean operation time in MIPPO group was lower and it was statistically significant (96.52±10.98’ye vs. 65.90±6.52, <0.001). There was not any radial nerve palsy or deep infection among participants. In Group A, a patient was performed revision ORIF after failed union and latter thrombocyte rich plasma. Discussion and conclusion: In this study we compared the results of conventional posterior plating with MIPPO technique and we found that both technique had high union and low complication rates. In experienced hands one can obtain lower operation time by MIPPO technique.
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Abstract (Original Language): 
Giriş ve Amaç: Humerus cisim kırıklarının cerrahi tedavisinde internal tespit yöntemi altın standart olarak kabul edilse de internal tespitin hangi yöntemle yapılacağı konusunda fikir birliği yoktur. Bu çalışmada, humerus cisim kırığı nedeniyle internal tespit uygulanan hastalarda kullanılan minimal invaziv plaklama (MİPPO) ve posterior yaklaşımla konvansiyonel plaklama (ARIF) yöntemlerinin sonuçlarının karşılaştırılması amaçlanmıştır. Yöntem ve Gereçler: Ocak 2010 ile Aralık 2014 tarihleri arasında humerus cisim kırığı nedeniyle internal tespit uygulanan 47 hasta retrospektif olarak incelenmiştir. Bu hastalardan 27’sine ARIF (Grup A), 20 hastaya ise (10 kadın 10 erkek) MİPPO tekniği uygulandı (Grup B). Her iki grupta kırık kaynama zamanı, fonksiyonel skorlama sonuçları, işe dönüş zamanı ve ameliyat süresi istatiksel olarak karşılaştırılmıştır. Bulgular: Her iki grupta kaynama zamanı, işe dönüş zamanı ve fonksiyonel skorlama sonuçları açısından fark yoktu (p>0.05). Ortalama kaynama süresi her iki grup için 16,37±2,55 hafta idi. Operasyon süresi karşılaştırıldığında MİPPO uygulanan hastalarda istatiksel olarak anlamlı fark tespit edildi (96,52±10,98’ye karşı 65,90±6,52,<0.001). Her iki grupta da radial sinir felci ya da derin enfeksiyon görülmedi. Grup A hastalardan birisinde kaynamama nedeniyle önce trombositten zengin plasma uygulaması, başarısız olunca revizyon internal tespit uygulandı. Tartışma ve Sonuç: Bu çalışmada konvansiyonel posterior plaklama ile MİPPO tekniğinin sonuçları karşılaştırılmış ve her iki yöntemin de yüksek kaynama ve düşük komplikasyon hızına sahip olduğu tespit edilmiştir. Deneyimli cerrahlar tarafından yapıldığında MİPPO ile daha kısa operasyon zamanı elde edilebilir.
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