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Amaç:

Yaşlılarda kalça kırıklarının tedavisi hala güçlükler içermektedir. Çalışmamızda; femur boyun ya da intertrokanterik kırığı olan yaşlı hastalarda uzun stemli çimentosuz artroplastinin kısa dönem klinik sonuçlarını değerlendirmeyi amaçladık.

Gereç ve Yöntem:

Ocak 2011’den Aralık 2019’a kadar kalça kırığı nedeniyle uzun stemli çimentosuz artroplasti ile tedavi ettiğimiz hastaların verilerini topladık. Femur boyun ya da intertrokanterik kırığı olan 48 hasta (≥65 yaş) çalışmaya dahil edildi. Hastalara bipolar veya total kalça artroplastisi uygulandı. Tüm hastalar en az 2 yıl takip edildi. Sonuçlar Harris kalça skoru (HHS), Koval kategorileri, komplikasyon, kalça ağrısı ve uyluk önü ağrısı açısından değerlendirildi. Femur boyun kırığı olan hastalarla ve intertrokanterik kırığı olan hastaların klinik sonuçlarını karşılaştırdık.

Bulgular:

Ortalama takip süresi 57 (34-92) aydı. On altı hastada femur boyun kırığı, 32 hastada intertrokanterik kırık vardı. Demografik özellikler ve komorbiditeler açısından gruplar arasında fark yoktu. Preoperatif, Barthel günlük yaşam aktivite indeksi puanı ortalama 79 olarak hesaplandı. Son kontrollerde ortalama HHS 77 ve Koval kategorileri 3’tü. Çıkık sebebiyle 2 hastaya revizyon uygulandı. Sadece 1 hastada enfeksiyon vardı ve debridman ve antibiyoterapi ile tedavi edilebildi. İmplant yetersizliği veya periprostetik kırık hiçbir hastada görülmedi.

Sonuç:

İyi klinik sonuçlarla, uzun stemli çimentosuz artroplasti yaşlı hastalarda kalça kırıklarının tedavisi için bir seçenek olabilir. Bu protezlerin etkinliğini değerlendirmek için daha uzun takip süreleriyle yapılmış çalışmalar daha uygun olacaktır.

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Yaşlılarda İntertrokanterik ve Femur Boyun Kırıklarında Uzun Stemli Protezler: Kısa Dönem Klinik Sonuçlarının Retrospektif Karşılaştırılması

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References