Comparison of Therapeutic Results of Plateau Tibia fracture by Hybrid Method with Double-Plate Classic Methods

سال انتشار: 1397
نوع سند: مقاله کنفرانسی
زبان: فارسی
مشاهده: 341

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OSAMED26_080

تاریخ نمایه سازی: 21 بهمن 1397

چکیده مقاله:

BackhroundsThe Tibia Plateau fracture is the most prevalent in the 3rd to 5th decades of life, seen inolder men and in older women, especially the 6th and 7th decades of life. Falling downis the most common cause of this fracture in the elderly and the most common form offracture is Split depression. In high energy traumas, Split and Rim Avulsion fractures arecommon. The axial force releases more energy than Angular, and Valgus›s pure forcecauses fractures, and the pure axial force causes the local depression. The combination ofthese two forces results in the fracture of the split depression. The Tibia Plato is exposed toValgus force because it is in the normal state of 5 to 7 degrees Valgus. These forces in thehealthy bone cause Split fracture and in the osteoporotic bone, it causes the fracture of thedepression.1,2 Non-surgical treatment is used in the case of a non-deformed fracture or anelderly person or severe medical illness. In the lateral plato, in the case of a small fractureof the joint surface less than 10 mm thickness, localized results are obtained with a nonsurgicaltechnique used for non-surgical treatment of the cast brace to unload the damagedside of the joint. Most surgeons prefer early onset movements with a hinged brace thatallows for detailed movements. The duration of the intolerance of weight (NWB) is basedon the fracture pattern from 4 to 8 weeks.2,3 Surgical treatment is indicated in cases oftransient and unstable fractures, which is not likely to be near normal. Surgical treatmentis considered for individuals including almost all cases of Shaft Dissociation, all condylarmedial fractures (with the exception of low displacement) and lateral fractures with valgusalignment without Open Reduction Internal Fixation (ORIF).MethodsMethod of study implementation all patients with split fractures of Plato Tibia who werereferred to the hospitals between 1393 and 1395 were evaluated. Patients with a history ofdiabetes, immunocompromised, simultaneous fractures of other bones, history of fracture,or previous surgery in the platoitbia region, multiple trauma patients, or patients withconcurrent trauma were excluded from the study. The sample size required for study with%80 strength and %95 confidence interval (α = 0.05), and according to previous studies, 6was determined by the statistical formula of 40 patients (each group of 20 patients) andAccordingly, 40 patients were enrolled in the study. ResultsIn this study, 56 patients were evaluated for inclusion in the study. Of these, 12 patients didnot have the required criteria and 4 patients did not want to participate in the study. Finally,40 patients were enrolled in the study. The patients were randomly divided into two groupsof 20 (Hybrid and Double groups).40 patients remained in the study until the end of thestudy, with 20 patients in the double group and 20 in the hybrid group. 14 patients (%70) inDouble group and 13 patients (%65) in hybrid group were male. There was no statisticallysignificant difference between the sex of the two groups (P = 0.736).ConclusionsPatients were followed up for 18.63 ± 30.68 months (10 to 60 months, 26.5 Median =). Inthe study of the complications of patients, no case was observed with Mal-Union, and in allpatients the union was properly formed. Also, skin necrosis was not seen in any condition.Deep site infection was seen in 5 patients (%25) in the double group, with no disease fromthe hybrid group. The prevalence of deep site infection was significantly higher in patientswith double, so that the risk of this complication in patients undergoing surgery was 2.33times higher than those treated by hybrid method (RR %95 ,2.33 CI: 3.42-1.59, P = 0.024). Theinfection of the Pin Tract Infection was observed in only 8 patients (%40) of the hybrid groupduring follow-up. Depression was seen in 3 patients, one patient in the hybrid group and 2 inthe double group. Contraditionally, in this study, we considered depressing more than 3 mm asCut off of Depression. Considering this criterion, depression in 5 patients in the double group(%25) and 9 patients in the hybrid group were seen (%45 ), There was no significant differencebetween the two groups (P = 0.16). In the quantitative study, the mean of depression in thehybrid group was 0.95 ± 3.84mm (range 3 to 5 mm, 3 = median) and in the double group was1.04 ± 3.44mm (between 2 and 5 mm, 3 = Median) There were no statistically significantdifferences between the two groups (P = 0.23). In total, the complications were observed in 9patients (%45) in the double group and 13 cases (%65) in the hybrid group. The incidence ofcomplications was not significantly different between the two groups (P = 0.17).

نویسندگان

Masoud Shayestehazar

Mazandaran University of Medical Sciences

Vahid Mojrian

Mazandaran University of Medical Sciences

MohammadHossein Kariminasab

Mazandaran University of Medical Sciences

Seyed Mehran Razavipoor

Mazandaran University of Medical Sciences