Primena sistema unutrašnjeg fiksatora za prednji prsten karlice uz istovremenu unutrašnju fiksaciju zadnjeg prstena karlice sakroilijačnim zavrtnjem kod nestabilnih preloma karlice tipa C po Tile-u
Sažetak
Uvod/Cilj. Broj slučajeva povrede karlice je u porastu na globalnom nivou, najviše zbog saobraćajnih nezgoda, ali i zbog sve većeg broja sportsko-rekreativnih povreda. Nestabilna povreda karlice tipa C po Tile-u (Tile C-type unstable pelvic trauma-TCUPT) je povreda koja se dešava tokom saobraćajnih nezgoda ili prilikom pada sa velike visine. Cilj rada bio je da se ispita primena sistema unutrašnje fiksacije (internal fixation-INFIX) za prednji karlični prsten (anterior pelvic ring-APR) uz istovremenu primenu INFIX zadnjeg karličnog prstena (posterior pelvic ring-PPR) primenom sakroilijačnog zavrtnja (sacroiliac screw-SS) (INFIX PPR SS) kod TCUPT. Metode. Ispitanici (ukupno 89) selektovani su među bolesnicima sa TCUPT u periodu od decembra 2020. do decembra 2023. godine. Izvršena je retrospektivna analiza podataka ispitanika, nakon čega su ispitanici podeljeni na dve grupe na osnovu različitih terapijskih protokola kojima su podvrgnuti: grupa A (INFIX sistem za APR + INFIX PPR SS, n = 46) i grupa B (spoljni fiksator za APR + INFIX PPR SS, n = 43). Rezultati. U poređenju sa grupom B, grupa A imala je kraće vreme: do početka prve aktivnosti nakon operacije, zarastanja preloma i oporavka funkcije zgloba, kao i kraću dužinu boravka u bolnici (t = 6,623, 4,796, 7,992 i 5,227, redom, p < 0,05). Nije bilo značajne razlike između dve grupe po pitanju dužine trajanja operacije i obima krvarenja (t = 1,433, 1,123, redom, p > 0,05). Rezultati redukcije preloma bili su bolji u grupi A nego u grupi B (Z = 2,058, p < 0,05). Stopa incidencije komplikacija bila je niža u grupi A nego u grupi B (2,17% vs. 18,60%) (χ2 = 4,917; p < 0,05). Zaključak. Kod bolesnika sa TCUPT, primenom INFIX sistema za APR sa istovremenom primenom INFIX PRR SS, postižu se dobri rezultati redukcije preloma.
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