You are here

Çocuk Femur Cisim Kırıklarının İntramedüller Kirschner Teli ile Tespit Sonuçları

The Results of Intramedullary Kirschner Wire in Fixation of Pediatric Femoral Shaft Fractures

Journal Name:

Publication Year:

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: In our this study, we evaluated the results which we obtained by using intramedulary Kirschner wire (K wire) in the children with femoral shaft fractures between the age 3 and 10. Materials and Methods: Between the years 2007 and 2011, 39 patients (28 male, 11 female) with isolated femur fractures, whose intramedullary K wire were applied were studied. Results: The average age of the patients was as 5,6 (age 3-10). All the femur fractures were in diaphysis and all of them were closed fractures. 11 of the fractures (28,2%) were transverse, 20 of them (51,3%) were oblique, 8 of them (20,5%) were spiral. The average operation time was determined as 55,38 (40-90) minutes. The average patient follow-up time was 17,07 (12-24) months, femur union was found almost in 7,10 (6-10) weeks. App¬roximately, in 6,87 (5-12) months, K wire were removed. In the first year after the operation, all the patients' had a full hip and knee range of motion and clinically rotational and angular deformity were not found out. In the last follow-up of these patients, it was observed that inequality reduced to 2,17 (0-5) mm, varus-valgus was average angularity 4,15° (0°-10°), sagittal plane was average angularity 3,10° (0°-10°) . Conclusion: Intramedullary K wire presents the translation of fracture parts. We think that fixation through intramedullary K wire is the suitable choice in healing femoral shaft fractures in children between the age 3-10 of the fact that it can prevent extremity inequality and angular alignment.
Abstract (Original Language): 
Amaç: Bu çalışmamızda, 3 ile 10 yaş arasındaki femur cisim kırıklı çocuk hastalarda intramedüller Kirschner teli (K teli) kullanarak elde ettiğimiz sonuçları değerlendirdik Gereç ve Yöntem: Kliniğimizde 2007-2011 yılları arasında intramedüller K teli ile tespit uygulanan izole femur cisim kırıklı 39 hasta (28 erkek [%71,8], 11 kız [%28,2]) incelendi. Bulgular: Hastaların ortalama yaşı 5,6±2,21 (3-10 yaş) olarak tespit edildi. Bütün kırıklar femur diyafizinde idi. Hepsi kapalı kırıktı. Kırıkların (%28,2) transvers, 20'si (%51,3) oblik, 8'i (%20,5) spiraldi. Ortalama ameliyat süresi 55,38±12,26 (40-90 dk) dakika olarak bulundu. Hastaların ortalama takip süresi 17,07±3,84 (12-24) ay idi. Ortalama 7,10±0,91 (6-10) haftada tam kaynama saptandı. Ortalama 6,87±1,7 (5-12) ayda K telleri çıkartıldı. Ameliyat sonrası birinci yılda tüm hastaların kalça ve diz hareket genişlikleri tamdı ve klinik olarak rotasyonel veya açısal deformite sap¬tanmadı. Hastalarımızda ortalama 5,05±2,71 (0-10) mm'lik uzunluk farkı belirlendi; Bu hastaların son takiplerinde eşitsizliğin 2,17±1,43 (0-5) mm'ye düştüğü gözlendi. Hastalarımızda ortalama 8,64±4,73 derecelik (0°-16°) varus-valgus açılanması görülmesine rağmen son takiplerinde bu açılanma ortalama 4,15±3,68 dereceye (0°-10°) düştü. Sagital planda görülen ortalama 4,17±3,77 derecelik ( 0°-13°) açılanma son takiplerde 3,10±2,83 derece¬ye (0°-10°) düştü. Sonuç: Ekstremite eşitsizliği ve açısal dizilim bozukluğu gibi komplikasyonları önleyebilmesi, ilk ameliyat ve tellerin çıkarımı esnasında küçük yara yeri, az kanama ve skar dokusu olması, kolay uygulanabilir ve bulunabilir olması, ucuz olması nedeni ile 3-10 yaş arası çocuklarda görülen femur cisim kırıklarının tedavisinde intramedüller Kirschner teli ile tespitin uygun bir seçenek olduğunu düşünmekteyiz.
233-237

REFERENCES

References: 

1. Fyodorov I, Sturm PF, Robertson WW Jr. Compression-plate fixation of femoral shaft fractures in children aged 8 to 12
years. J Pediatr Orthop 1999; 19: 578-81.
2. Sanders JO, Browne RH, Mooney JF et al. Treatment of femoral fractures in children by pediatric orthopedists: results of a 1998 survey. J Pediatr Orthop 2001; 21: 436-41.
3.
Çeleb
i L, Biçimoğlu A: Çocuk femur cisim kırıkları. TOTBID
Dergisi 2006; 34-43.
4. Flynn JM, Luedtke LM, Ganley TJ, et al. Comparison of titanium elastic nails with traction and spica cast to treat femo¬ral fractures in children. J Bone Joint Surg Am 2004; 86: 770¬7.
5. Simanovsky N, Porat S, Simanovsky N, Eylon S. Close reduc¬tion and intramedullary flexible titanium nails fixation of fe¬moral shaft fractures in children under 5 years of age. J Pediatr Orthop B 2006; 15: 293-7.
6. Bopst L, Reinberg O, Lutz N. Femur fracture in preschool children: experience with flexible intramedullary nailing in 72
children. J Pediatr Orthop 2007; 27: 299-03.
7. Poolman RW, Kocher MS, Bhandari M. Pediatric femoral fractures: A systematic review of 2422 cases. J Orthop Trauma
2006; 20: 648-54.
8. Curtis JF, Killian JT, Alonso JE. Improved treatment of femoral shaft fractures in children utilizing the pontoon spica cast: a long-term follow-up. J Pediatr Orthop 1995; 15: 36-40.
9. Martinez AG, Carroll NC, Sarwark JF, Dias LS, Kelikian AS,
Sisson GA Jr. Femoral shaft fractures in children treated with early spica cast. J Pediatr Orthop 1991; 11: 712-6.
10. Fyodorov I, Sturm PF, Robertson WW Jr. Compression-plate fixation of femoral shaft fractures in children aged 8 to 12
years. J Pediatr Orthop 1999; 19: 578-81.
11. Blasier RD, Aronson J, Tursky EA. External fixation of pediatric femur fractures. J Pediatr Orthop 1997; 17: 342-6.
12. Beaty JH, Austin SM, Warner WC, Canale ST, Nichols L:
Interlocking intramedullary nailing of femoral shaft fractures in adolescents: Preliminary results and complications. J
Pediatr Orthop 1994; 14: 178-83.
13. Astion DJ, Wilber JH, Scoles PV. Avascular necrosis of the capital femoral epiphysis after intramedullary nailing for a fracture of the femoral shaft. A case report. J Bone Joint Surg Am 1995; 77: 1092-94.
14. Raney EM, Ogden JA, Grogan DP. Premature greater trochanteric epiphysiodesis secondary to intramedullary femoral rodding. J Pediatr Orthop 1993; 13: 516-20.
15. Flynn JM, Luedtke LM, Ganley TJ, Dawson J, Davidson RS,
Dormans JP et al. Comparison of titanium elastic nails with traction and a spica cast to treat femoral fractures in children. J
Bone Joint Surg Am 2004; 86: 770-7.
16. Özdemir HM, Yensel U, Senaran H, Mutlu M, Kutlu A. Immediate percutaneous intramedullary fixation and functional bracing for the treatment of pediatric femoral shaft
fracture. J Pediatr Orthop 2003; 23: 453-57.
17. Fricka KB, Mahar AT, Lee SS, Newton PO. Biomechanical
analysis of antegrade and retrograde flexible intramedullary nail fixation of pediatric femoral fractures using a synthetic
bone model. J Pediatr Orthop 2004; 24: 167-71.
18. Al-Zahrani S, Al-Fahal H, Zamzam M et al. Treatment of proximal third femoral shaft fractures in children by intramedullary Kirschner wires. Saudi Med J 1998; 19: 41-4.
19. Qidwai SA, Khattak ZK. Treatment of femoral shaft fractures in children by intramedullary Kirschner wires. J Trauma 2000;
48: 256-59.
20. Matsubara H, Yasutake H, Matsuda E, Uehara K, Niwada M, Tanzawa Y: Treatment of femoral shaft fractures in children using intramedullary kirschner wire pinning. J Orthop Sci 2005; 10: 187-91.
21. Jawadi AH, Abdul-Samad A. Intramedullary Kirschner wire (K-wire) fixation of femoral fracture in children. J Child Ort-
hop 2007; 1: 277-80.
22. SD Chitgopkar. Flexible nailing of fractures in children using stainless steel Kirschner wires. J Pediatr Orthop B 2008; 17:
251-55.
23. Serin E, Yılmaz E, Belhan O. Çocuk femur cisim kırıklarının tedavi sonuçları. Hacettepe ortopedi dergisi 2001; 11: 65-70.
236
Fırat Tıp
Dergis
i 2012; 17(4): 233-237
Belhan ve Gürger
24. Yandow SM, Archibeck MJ, Stevens PM, Shultz R: Femoral shaft fractures in children: a comparison of immediate casting
and traction. J Pediatr Orthop 1999; 19: 55-9.

Thank you for copying data from http://www.arastirmax.com