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Enfekte psödoartrozda antibiyotikli polimetilmetakrilat çimento kaplı intramedüler çivi ile fiksasyon tekniğinin etkinliği
2016
Journal:  
Şişli Etfal Hastanesi Tıp Bülteni
Author:  
Abstract:

Amaç: Kronik enfeksiyon ile birlikte kaynamama varlığında, hem enfeksiyonun tedavisi hem de kırığın stabilizasyonu gereklidir. Bu çalışma, femur ya da tibiasında enfekte psödoartrozu olan hastalarda, ‘antibiyotikli polimetilmetakrilat çimento kaplı intramedüler çivi kullanılarak fiksasyon’ tekniğinin etkinliğini değerlendirmiştir. Gereç ve Yöntem: Femurunda ya da tibiasında Cierny-Mader evre 4 enfekte kaynamama gelişen 14 hasta çalışmaya alındı. Hastalar lokal debridman, antibiyotik içeren PMMA kaplı intramedüler çivi uygulaması ve sistemik antibiyotik ile tedavi edildi. Hastalar kaynama ve enfeksiyonun iyileşmesi açısından takip edildi. Bulgular: Hastaların 3’ünde femurda, 11’inde ise tibiada enfekte psödoartroz gelişmişti. Hastaların 3’ünde atrofik, 11’inde hipertrofik enfekte kaynamama mevcuttu. Hastaların ortalama takip süresi 24.7 ay idi (aralık: 8-37 ay). Hastaların takipleri sonrasında % 85.7’sinde (12 hasta) enfeksiyonun gerilediği tespit edildi. Takipte toplam 10 hastada kaynama gerçekleşti (71.4%). Onbir hipertofik enfekte psödoartroz hastasının 10’unda (%90.9) kaynama gerçekleşirken, 3 atrofik psödoartroz hastasının hiçbirisinde kaynama gerçekleşmedi. Sonuç: Segmenter defekti olmayan hipertrofik psödoartroz tedavisinde antibiyotikli PMMA kaplı kilitli intramedüler çivi kullanımı, yüksek doz lokal antibiyotik etkisi ve intramedüller çivi ile stabilizasyon avantajı nedeniyle önerilebilir. Atrofik psödoartrozda ise enfeksiyon tedavisinin etkili olduğu ancak kemik kaynaması açısından yöntemin yetersiz olduğu söylenebilir. Bu konuda yapılacak daha geniş çalışmalara ihtiyaç vardır.

Keywords:

The effectiveness of the fixation technique with an intramedular nail covered by cement polymethylmethylmethylmethylmethyl
2016
Author:  
Abstract:

Purpose: In the presence of cooking with chronic infection, both the treatment of the infection and the stabilization of the break is necessary. This study assessed the effectiveness of the "antibiotic polymethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmethylmeth Method and method: 14 patients developed infected cooking in the Cierny-Mader stage 4 in the Femurunda or Tibias were taken to study. Patients were treated with local debridman, PMMA-covered intramedular nails and systemic antibiotics containing antibiotics. Patients were monitored for the healing and cure of the infection. Results: In 3 patients femurda and 11 in tibiada infected psedoarthrosis developed. In 3 patients there was atrophic, and in 11 there was hypertrophic infection. The patient’s average tracking time was 24.7 months (December: 8-37 months). After the follow-up of patients, 85.7 percent (12 patients) found that the infection declined. In the follow-up, a total of 10 patients sucked (71.4%). In ten of the infected hyperthyroidism patients (90.9 percent) the swelling occurred, while in none of the atrophic psedoarthrism patients the swelling occurred. Result: In the treatment of non-segmental defect hypertrophic psedoarthrosis, the use of an antibiotic PMMA-covered locked intramedular nail may be recommended due to the high dose of local antibiotic effect and the stabilization advantage of intramedular nails. In atrophic psedoarthrosis, it can be said that the treatment of infection is effective but the method is insufficient in terms of bone coating. We need more work to be done on this.

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Şişli Etfal Hastanesi Tıp Bülteni

Field :   Sağlık Bilimleri

Journal Type :   Ulusal

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Şişli Etfal Hastanesi Tıp Bülteni