Assesment of Surgical And Conservative Treatment Of Forearm Fractures Results In Juvenil's

BACKGROUND
We aimed to assess treatment outcomes of forearm fractures in patients aged between 10-18 years, for whom strict guidelines for surgical and conservative treatment are not yet clear.
METHODS
From a total of 41 patients between the ages of 10-18 years, 34 patients with a minimum of one-year follow-up in our clinic with the diagnosis of forearm fracture were evaluated retrospectively. All the patients had open epiphyses. Twenty-three of these patients were treated conservatively and 11 surgically. Patients were evaluated according to time of union, function and cosmesis. Average follow-up was two years (12-36 months).
RESULTS
Conservative treatment gave excellent and good results in 21 (91%), while surgical treatment gave excellent and good results in 9 (82%) of the patients when evaluated according to Anderson’s criteria. A bad result was seen in one patient who did not accept an operation, and had an angulation of over 15 degrees. We also had one bad result in the operatively treated group because of implant failure and a need for a second operation.
CONCLUSION
According to our results, conservative treatment should be the mainstay in the treatment of childhood fractures of the forearm. However, we should not hesitate in considering surgical treatment when the patients have a malalignment of more than 15 degrees.

Büyük Çocuklarda Önkol Çift Kýrýklarýnýn Konservatif Ve Cerrahi Tedavi Sonuçlarýnýn Deðerlendirilmesi

AMAÇ
Cerrahi ve konservatif tedavi kriterleri henüz kesinleþmemiþ önkol çift kýrýðý olan büyük çocuk ve genç eriþkinlerde tedavi sonrasý ortalama iki yýllýk izlem sonuçlarý deðerlendirildi.
GEREÇ VE YÖNTEM
Mart 2001 ile Aralýk 2003 tarihleri arasýnda, önkol çift kýrýðý tanýsýyla kliniðimize baþvuran ve yaþlarý 10-18 arasýnda deðiþen cerrahi veya konservatif olarak tedavi edilmiþ, epifizleri kapanmamýþ 41 hastadan en az bir yýl takibi olup düzenli kontrole gelen 34 hasta çalýþmaya dahil edildi. Hastalarýn 23’üne konservatif, 11’ine cerrahi tedavi uygulandý. Hastalar kaynama süresi, fonksiyonel ve kozmetik açýdan deðerlendirildi. Ortalama izlem süresi iki yýldý (daðýlým 12-36 ay).
BULGULAR
Konservatif tedavi edilen 23 hastanýn 21’inde (%91) Anderson kriterlerine göre mükemmel ve iyi sonuç, cerrahi tedavi edilen 11 hastanýn 9’unda (%82) Anderson’a göre mükemmel ve iyi sonuç görüldü. Kötü sonuçlar konservatif grupta kabul edilen 15° üzeri açýlanmasý olduðu halde ameliyatý kabul etmeyen hastalarda görüldü. Cerrahi grupta ise 1 hastada implant yetersizliði sonucunda ikinci ameliyat gerekmesi nedeniyle kötü sonuç alýndý.
SONUÇ
Önkol çift kýrýklý büyük çocuklarda öncelikle konservatif tedavi denenmeli, takiplerinde redüksiyonda kayma ve 15 derecenin üzerinde açýlanma olan hastalara cerrahi tedavi planlanmalýdýr.