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Amaç: Yaşlı hastaların intertrokanterik kırıklarının intramedüller çivi ile tedavisi sırasında kullanılan anestezi yöntemi (spinal/ genel), elde edilen redüksiyon kalitesini ve erken fonksiyonel sonuçları etkiler mi? Gereç ve Yöntem: 65 yaş ve üzeri, AO 31A2 tip intertrokanterik kırık tanısı koyulup çivi ile tedavi edilmiş hastalar retrospektif olarak çalışmaya alındı. ASA skoru 3 olup ameliyat sonrası yoğun bakımda kalmış olan hastaların, demografik bilgileri, ameliyat notları, ameliyat öncesi ve sonrası grafileri hastane kayıtlarından elde edildi. Hastalar 6. ayda kontrole çağrılarak Harris ve Oxford kalça skoru ile Barthel bağımsızlık indeksi hesaplandı. Hastalar spinal veya genel anestezi olanlar şeklinde gruplandırılarak analiz edildi. Bulgular: Toplam 60 intertrokanterik kırıklı hasta (Grup 1; 30 spinal / Grup 2; 30 genel anestezi) çalışmada incelendi. Grup 1’deki hastaların yaş ortalaması 80,4± 7,9 iken Grup 2’de 80,4± 9,8 (p=0,994) idi. Operasyon sonrası Grup 1’deki 16 hastada iyi, 14 hastada orta; Grup 2’deki 13 hastada iyi, 14 hastada orta ve 3 hastada kötü redüksiyon elde edildi, bu fark istatistiksel olarak anlamlı bulunmadı (p=0.191). Hastaların fonksiyonel sonuçlarında Grup 1 hastalarının 6. ay Harris kalça skorları 84,4±7,3 iken Grup 2’de 80,7±6,8 (p=0,154); Oxford kalça skorları Grup 1’de ortalama 43±3,3 iken Grup 2’de 41,3±3,7 (p=0,123) idi. Bağımsızlık değerlendirmelerinde ise Grup 1 hastalarının 6. aydaki Barthel indeksi 82 ±18,4 iken Grup 2’de 80,7±16,4 olarak bulundu (p=0,327). Altıncı aydaki değerlendirmede gruplar arasında Harris, Oxford ve Barthel skorları arasında fark bulunmadı. Sonuç: İntertrokanterik kırık cerrahisi sırasında tercih edilen anestezi yöntemi; kırık redüksiyon kalitesini ve erken dönem fonksiyonel sonuçları etkilemez.
Purpose: Does the method of anesthesia (spinal/general) used during the treatment of the intramedular narrow of intertrokantheric fractures in elderly patients affect the quality of the reduction achieved and the early functional results? Instruments and Methods: Patients aged 65 and older, diagnosed with AO 31A2 type intertrocanteric fractures and treated with nails were taken to retrospective study. The ASA score is 3 and the patient’s demographic information, surgery notes, pre-operative and post-operative graphs were obtained from the hospital records. Patients were called to check in the 6th month with Harris and Oxford scores of the Barthel Independence Index calculated. Patients were analyzed by grouping in the form of those with spinal or general anesthesia. Results: A total of 60 intertrokantheric fractures were studied in the study (Group 1 30 spinal / Group 2 30 general anesthesia). The average age of patients in Group 1 was 80.4±7.9 while in Group 2 80.4±9.8 (p=0.994). After the operation, 16 patients in Group 1 were good, 14 patients in middle Group 2 were good, 14 patients in middle and 3 patients were bad, this difference was not statistically meaningful (p=0.191). In the functional results of patients, the 6th month of the group 1 patients had Harris scores of 84.4±7.3 while 80.7±6.8 (p=0.154) in the group 2 Oxford scores of the group 1 were an average of 43±3.3 while 41.3±3.7 (p=0.123) in the group 2. In independence assessments, the Barthel index in the 6th month of Group 1 was 82 ±18,4 while in Group 2 it was 80,7 ±16,4 (p=0,327). In the sixth month rating there was no difference between Harris, Oxford and Barthel scores between the groups. The preferred method of anesthesia during interrocanterial break surgery does not affect the quality of the breakdown and early functional results.
Aim: Does the preferred anesthetical technique (spinal/general) influence the quality of fracture reduction and early functional outcomes during intramedullary nailing of intertrochanteric fractures in elderly? Material and Methods: Patients that were treated for intertrochanteric fractures with a nail who were graded as ASA(American Society of Anesthesiologists) 3 and had postoperative intensive care and aged 65 years or older with a AO type 31A2 fracture were retrospectively included in the study. Patient demographic data, surgical notes and radiographies before and after surgery were obtained from hospital records. Patients were asked for a visit at 6th months of surgery and examined for Harris and Oxford hip scores and Barthes independence index. Patients were divided into two groups as spinal or general anesthesia and groups were compared. Results: A total of 60 patients with intertrochanteric fractures (Group 1; 30 spinal anesthesia / Group 2; 30 general anesthesia) were studied. The mean age of the patients in Group 1 was 80.4 ± 7.9, while it was 80.4 ± 9.8 (p = 0.994) in Group 2. In group 1; 16 patient had good, 14 had acceptable and in group 2; 13 patient had good, 14 had acceptable and 3 had poor fracture reduction after surgery, this difference was not statistically significant (p = 0.191). In the functional results of the patients, the 6th month Harris hip scores of Group 1 patients were 84.4 ± 7.3 while it was 80.7 ± 6.8 in Group 2 (p = 0.154); while the average Oxford hip scores were 43 ± 3.3 in Group 1, it was 41.3 ± 3.7 (p = 0.123) in Group 2. In the independence evaluations, the Barthel index of Group 1 patients at the 6th month was 82 ± 18.4 while it was 80.7 ± 16.4 in Group 2 (p = 0.327). The functional assessments revealed no significant differences throughout groups regarding Harris, Oxford and Barthel scores 6 months after surgery. Conclusion: The anesthetical method which is preferred for the intertrochanteric fracture surgery has no effect on postoperative quality of fracture reduction and early functional outcomes.
Field : Sağlık Bilimleri
Journal Type : Ulusal
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