Mustafa ALTINTAŞ, Mehmet OZEL, Ali Cankut TATLIPARMAK

Pediatrik Ön kol Kırıklarının Cerrahi Tedavisinde TEN (Titanyum Elastik Çivi) ile Plak Vida Tespitinin karşılaştırılması

Amaç: Pediatrik önkol kırıklarında cerrahi teknik ve tespit yöntemi seçimi zor olabilir. Titanyum Elastik Çivilerle(TEN) veya Plak Vida Tespiti(PSF) ile cerrahi olarak tedavi edilen 14 yaşından küçük pediyatrik hastalar klinik, maliyet ve postoperatif sonuçlar açısından karşılaştırıldı. Yöntemler: Retrospektif vaka-kontrol çalışmasında 2017-2022 yılları arasında I. seviye bir travma merkezinde opere edilen pediatrik önkol kırıkları incelenmiştir. Bu çalışma grubuna 14 yaş altı pediatrik hastalarda cerrahi olarak tedavi edilen ön kol kırıkları dahil edildi. Sonuçlar: 109 hastanın ortalama yaşı 10,83 +- 3,28 bulundu. PSF grubu (12,87±2,76 yıl), TEN grubundan (9,7±3 yıl) 3,17 (%95 GA 2,02 - 4,33) yıl daha büyüktü (p<0,001; student's t-testi). TEN grubunda medyan implant maliyeti (85 [IQR 64 - 120] dolar), PSF grubundan (258 [IQR 205 - 336] dolar) anlamlı derecede düşüktü (p<0.001; Mann-Whitney-U). Röntgende kallus dokusunun görüldüğü gün gruplar arasında anlamlı farklılık gösterdi (p<0.001; ki-kare testi). Tartışma: Ortopedistler küçük yaştaki çocuklarda, büyüme ile ilişkili yeniden şekillenme olasılığı, daha erken bir kallus oluşturma olasılığı ve PSF ile karşılaştırıldığında daha düşük maliyet nedeniyle TEN tercih ettiler.

Anahtar Kelimeler:

Pediatrik Ön Kol Kırığı, Titanyum Elastik Çivi, Plak Vida Tespiti, Maliyet

Pediatric Forearm Fractures: TEN (Titanium Elastic Nail) versus Plate Screw Fixation for Surgical Treatment

Background/Aims: In pediatric forearm fractures, the choice of surgical technique and fixation method can be challenging. Surgically treated pediatric patients younger than 14 years with Titanium Elastic Nails (TEN) or Plate Screw Fixation(PSF) were compared clinically, in cost, and in terms of postoperative outcomes. Method: In the retrospective case-control study, pediatric forearm fractures operated on at a level I trauma center between 2017 and 2022 were examined. Surgically treated forearm fractures in pediatric patients under 14 years of age were included in this study group. Results: A mean age of 10.83 +- 3.28 years was found among the 109 patients. The PSF group (12.87+-2.76 years) was 3.17 (95% CI 2.02 - 4.33) years older than the TEN group (9.7+-3 years) (p<0.001; student’s t-test). The median implant cost in the TEN group (85 [IQR 64 - 120] dollars) was significantly lower than in the PSF group (258 [IQR 205 - 336] dollars) (p<0.001; Mann-Whitney-U). The day callus tissue was observed on the X-ray differed significantly between the groups (p<0.001; chi-square test). Conclusion: In younger children, surgeons preferred TEN due to the likelihood of remodeling associated with growth, the possibility of forming a callus sooner, and the lower cost compared to PSF

Keywords:

Pediatric Forearm Fracture, TEN, Plate Screw Fixation, Cost,

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