ROTATIONAL DEFORMITIES AS THE COMPLICATION OF THE CONSERVATIVE TREATMENT IN CHILDREN'S FEMORAL SHAFT FRACTURES (FREQUENCY AND CLINICAL RESULTS)

In this study, it was tried to determine the frequency and violence of rotational deformities and evaluated their clinical results by the physical examination findings and the foot-progression angle in children's femoral shaft fractures that were applied the conservative treatment. In the Department of Orthopaedics and Traumatology of Atatürk University Medical School, between 1992-1999 years, of 82 children who were treated with traction and spica cast, 50 who could be done control and had unilateral fracture were included into this study. Of these cases, l 1 (22%) were females and 39 (78%) males. The average age was 4.2 years, ranging from 4 days to 13 years. The traction period was 10-25 (average 18.1) days, and the cast period was from 20 days to 12 weeks (average 8.4 weeks). The cases were followed up with an average period of 3.5 years (5 months-6 years). The foot-progression angle increased in 21 cases (42%) as average 2.1 ° and decreased in 26 cases (52%) as average 4.9°. The change amount in angle was excessive in the elder children, the proximal femoral fractures and the cases whose the follow-up was smaller than 1 years (p < 0.01). However, in the final control, none of the cases and their parents had complaint, and physical and walking examinations were normal. In the result of this study, it was concluded that the rotational deformities that were symptomatic and required treatment were not the common complication after the conservative treatment in children's femoral shaft fractures.

ÇOCUK FEMUR CÝSÝM KIRIKLARININ KONSERVATÝF TEDAVÝSÝNÝN BÝR KOMPLÝKASYONU OLARAK GÖRÜLEN ROTASYONAL DEFORMÝTELER (GÖRÜLME SIKLIÐI VE KLÝNÝK SONUÇLAR)

Bu çalýþmada konservatif olarak tedavi edilen çocuk femur cisim kýrýklarýnda rotasyonal deformitelerin hangi sýklýkta ve büyüklükte görüldüðü fizik muayene bulgularý ve ayak geliþme açýsýnýn ölçülmesiyle tesbit edilmeye çalýþýlmýþ ve bunlarýn klinik sonuçlarý deðerlendirilmiþtir. Atatürk Üniversitesi Týp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalý'nda 1992-1999yýllarý arasýnda traksiyon ve pelvipedal alçý ile tedavi edilen 82 femur cisim kýrýktý çocuktan kontrolleri yapýlabilen ve tek taraflý kýrýk olan 50'si çalýþmaya dahil edilmiþtir. Yaþlarý 4 gün -13yýl (ortalama 4.2 yýl) olan olgularýn 11'i (%22) kýz, 39'u (%78) erkektir. Traksiyonda kalma süresi 10-25 (ortalama 18.1)gün, alçýda kalma süresi ise 20 gün 12 hafta arasýnda ortalama 8.4 haftadýr. Olgular 5 ay ile 6yýl arasýnda, ortalama 3.5yýl takip edilmiþlerdir. Ayak geliþme açýsý; 21 olguda (%42) ortalama 2.1° artmýþ, 26 olguda (%52) ortalama 4.9° azalmýþtýr. Ayak geliþme açýsýndaki deðiþiklik takip süresi 1 yýlýn altýnda olanlarda, büyük çocuklarda ve kýrýk yeri proksimalde olanlarda daha fazladýr (p< 0.01). Ancak son kontrollerinde hiçbir hastanýn ve ebeveyninin þikayeti yoktur, fizik muayene bulgularý ve yürüyüþ muayeneleri normaldir. Bu çalýþmanýn sonucunda çocuk femur cisim kýrýklarýnýn konservatif tedavisinden sonra sorun yaratan ve tedavi gerektiren rotasyonal deformitelerin alýþýlmýþ bir komplikasyon olmadýðý kanaatine varýlmýþtýr.