LEČENJE VIŠEKOMADNIH PRELOMA DONJEG OKRAJKA GOLENJAČE ILIZAROVLJEVOM TEHNIKOM
Sažetak
Uvod: Visokoenergetski prelomi distalne tibije odlikuju se velikom kominucijom i obimnim lezijama okolnih mekih tkiva. Rizik od stvaranja komplikacija tokom lečenja je visok. Primenom Ilizarovljeve tehnike u velikoj meri se smanjuje rizik od nastanka komplikacija i daje nam dobre krajnje rezultate lečenja.
Metode: U našu prospektivnu opservacionu studiju bio je uključen 41ispitanik a njihove kliničke karakteristike procenjivane tokom evaluacionog razdoblja koristeći sledeće instrumente: Gustillo-Anderson, Checketts-Otterburns i AO/OTA klasifikacije. Koštani rezultati srastanja procenjivani su primenom ASAMI protokola. Funkcionalni rezultati lečenja prikazivani su pomoću modifikovanog Karlstrom-Olerud bodovnog sistema. Vreme analize i praćenja iznosilo je 18 meseci .
Rezultati: Radiografskim i kliničkim parametrima zabeležili smo potpuno srastanje kod svih preloma. U grupi intraartikularnih preloma 43B cirkularni fiksator je odstranjen nakon 16 nedelja (opseg 13- 31), dok je kod onih sa tipom preloma 43C odstranjen nakon 18 nedelja (opseg 13-29). ASAMI procena koštanog srastanja dala nam je: 31 (75%) odličnih, 76(15%) dobrih, 3 (8%) zadovoljavajućih i 1 (2%) loših rezultata. Funkcionali rezultati oporavka primenom modifikovanog Karlstrom-Olerud bodovnog sistema u tri perioda praćenja dao nam je nakon 6 meseci srednju vrednost od 24,7 što predstavlja oporavak. Rezultati nakon 12 meseci od operacije daju srednju vrednost od 27,6 što predstavlja zadovoljavajući oporavak dok je na poslednjem merenju u 18 mesecu ta vrednost iznosila 29,5 što nam je ukazivalo na dobar funkcionalni oporavak.
Zaključak: Primenjen Ilizarovljev tretman transosealne osteosinteze kod zatvorenih i otvorenih višekomadnih preloma distalne golenjače dao nam je dobre krajnje koštane i funkcionalne rezultate sa minimalnim komplikacijama i doprineo boljem kvalitetu života ispitanika.
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