STABILIZACIJA PRELOMA DISTALNOG OKRAJKA KLJUČNE KOSTI NEER IIB TIPA UPOTREBOM TIGHTROPE SISTEMA – PRIKAZ SLUČAJA
Sažetak
Uvod: Prelomi distalnog okrajka klavikule prestavljaju 10% – 30% svih preloma ove kosti, ali je čak 50% nesraslih i loše sraslih preloma ključne kosti lokalizovano u ovoj regiji. Od svih preloma distalne klavikule najveći procenat komplikacija je u vezi sa prelomima IIB grupe po Neer-ovoj klasifikaciji. Cilj ovog rada je prikaz slučaja pacijentkinje sa prelomom klavikule Neer IIB tipa, lečenog repozicijom i fleksibilnom stabilizacijom korakoklavikularnog zgloba pomoću TightRope sistema.
Prikaz slučaja: Pacijentkinja stara 48 godina, povređena u saobraćajnom udesu kao vozač automobila, zadobila je prelom distalnog okrajka leve ključne kosti tipa IIB po Neer-ovoj klasifikaciji. Tri dana nakon povrede, pacijentkinja je operisana indirektnom stabilizacijom korakoklavikularnog zgloba fiksacijom pomoću TightRope sistema. Rehabilitacija je započeta prvog postoperativnog dana i završila se tri meseca nakon operacije, uz postizanje punog obima pokreta u levom ramenu, povratak trofike i snage mišića ramena, nakon čega je usledio povratak uobičajenim životnim i radnim aktivnostima, kao i pre povrede.
Zaključak: Iako nema zlatnog standarda u operativnom lečenju ovih povreda, dobri do odlični rezultati postižu se indirektnom metodom stabilizacije i fleksibilnim fiksiranjem korakoklavikularnog zgloba pomoću različitih tipova sutura. Upoređivanje ove metode sa drugim opisanim tehnikama ukazuje da ona ima bolji funkcionalni rezultat, koji se brže postiže, uz manji stepen komplikacija. Funkcionalni rezultati naše pacijentkinje doprinose podacima iz literature i još jednom pokazuju delotvornost ovakvog vida lečenja ovih složenih povreda.
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