PROKSIMALNI PRELOMI FEMURA SA OBRNUTOM KOSINOM (AO/OTA 31-A3) LEČENI METODOM INTRAMEDULARNE FIKSACIJE
Sažetak
Intertrohanterni prelomi femura sa obrnutom kosinom su nestabilni prelomi jedinstvenih anatomskih i biomehaničkih karakteristika, koji se hirurški zbrinjavaju ekstra-medularnim ili intramedularnim metodama fiksacije.
Cilj ove studije je procena efikasnosti primene metode proksimalne cefalomedularne fiksacije transtrohanternih preloma sa inverznom kosinom u odnosu na samu hiruršku proceduru, komplikacije i ishod lečenja.
Retrospektivno su analizirane primene proksimalne intramedularne fiksacije u hirurškom zbrinjavanju 32 bolesnika sa kosim, inverznim, intertrohanternim prelomima, koje su bile izvršene u periodu od 2012. do 2020. godine na Klinici za ortopediju i traumatologiju, UKC Niš. Postoperativno praćenje bolesnika kretalo se u rasponu od 12 meseci do 22 meseca (12,36 meseci).
Operativni zahvati izvedeni su u proseku 4,45 dana od povrede. Prosečno vreme trajanje hirurške intervencije iznosilo je 64 minuta. Zatvorena repozicija preloma i unutrašnja fiksacija postignute su u 26 slučajeva. Prihvatljiva anatomska repozicija postignuta je u 17 slučajeva (53,12%), a anatomska repozicija u 15 slučajeva (46,88%). Srednja vrednost Harris hip skora bila je 74,66 (65 ‒ 96), a srednja vrednost Barthelovog skora aktivnosti iznosila je 15,71 (12 ‒ 20). Zarastanje preloma nakon intramedularne fiksacije postignuto je u 29 slučajeva, dok su u 2 slučaja zabeležene komplikacije u vidu neuspeha unutrašnje fiksacije preloma i nezarastanja preloma (6,25%).
Intramedularna fiksacija inverznih transtrohanternih preloma (AO/OTA 31 A3) kratkim ili dugim cefalomedularnim klinom obezbeđuje adekvatne biomehaničke uslove za zarastanje preloma u optimalnom vremenskom periodu, uz mogućnost izvođenja minimalno invazivne hirurške procedure.
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