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YETİŞKİN HASTALARDA PROKSİMAL HUMERUS KIRIKLARI CERRAHİ TEDAVİ SONUÇLARIMIZ

OZET Amac: Humerus proksimal uc kirigi nedeni ile proksimal humerus kilitli plagi kullanilarak ameliyat edilen 38 hastanin kirik tipi ve yasa gore, klinik ve radyolojik sonuclarini degerlendirmeyi amacladik. Yontem: Humerus proksimal kilitli plak cerrahisi uygulanan, yas ortalamasi 45,9 (aralik 16-74) olan 38 hasta (26 erkek , 12 bayan) calismaya alindi. Calismada 11 hasta 60 yas ustu (aralik 60-74), 27 hasta 60 yas alti (aralik 16-57) hastadan olusmakta idi. Hastalarin hastanede kalis suresi ortalama 10.1 gun (aralik 2-46 gun) idi. Hastalarin ortalama takip suresi 9,5 ay (aralik 4-36 ay) idi. Degerlendirmeler Constant-Murley(CM) skorlamasina gore yapildi. Bulgular: Neer siniflamasina gore 2 hasta tip1, 11 hasta tip2, 16 hasta tip 3 ve 9 hasta tip 4 kirik idi. Gruplara gore ortalama CM skoru sirasiyla 93,60/78,27/79,00/62,66 olarak bulundu. 60 yas ustu hasta grubu CM skoru 65,72, 60 yas alti CM skoru 79,74 idi. Tum hastalarda 3 ay sonunda tam kaynama goruldu. Cerrahi islemler sonrasi bir hastada avaskuler nekroz, bir hastada implant yetmezligi, iki hastada antibiyotik tedavisi ve yikama debritman ile tedavi edilen yuzeysel yumusak doku enfeksiyonu ve iki hastada subakromiyal sikisma goruldu. Sonuc: Hastalarin kirik tipi ve fonksiyonel sonucun karsilastirilmasin da kirik tipi arttikca fonksiyonel sonuclarin azaldigi, 60 yas alti hastalarin, 60 yas ustu hastalara gore daha iyi fonksiyonel sonuclarin oldugu izlendi. Kilitli plak uygulamasinin teknigine uygun sekilde yapildiginda, guclu stabilizasyon ve erken rehabilitasyona izin vermesi nedeniyle ozellikle artan yasli nufus populasyonun da iyi bir tercih oldugunu dusunmekteyiz. Anahtar Sozcukler: Proksimal humerus kirigi; Kilitli plak; Constant murley skorlama

A serious case of anthrax associated with compartment syndrome

Abstract Compartment syndrome linked to skin anthrax is a rare complication that may develop and it should be noted that the disease may progress in spite of medical drug treatment. Our case was a farmer who was exposed after slaughtering a dead animal, a time delay for treatment hided this history and then developed compartment syndrome. In anthrax cases with delayed treatment and aggressive progression, circulation in the extremities should be carefully noted. We believe that the cases with compartment syndrome progressing in spite of medical drug treatment may be assessed for fasciotomy as a treatment approach.

Arthroscopic treatment of the septic arthritis of knee joint associated focal osteomyelitis

Septic arthritis is a serious condition and in adults the knee is the most frequently involved joint. Respective indications and limits of arthroscopy or arthrotomy are not well defined.In opposition to many published series. Patient was 60 years old male. Arthroscopic lavage was applied three months ago because of septic arthritis at another hospital. In orthopedic examination the patient had ballotman, swelling. There was 1x1 cm cavitation on the lateral wall of the notch and related the joint in the computed tomography. Arthroscopy was applied, cavity of osteomyelitis was removed. In our case, septic arthritis was occurred leaked supurative material of subchondral localized osteomyeitis in to joint. It was defined by computed tomography and syntigraphy. In Gachter’s IV stage with osseoz involment is recommended arthrotomy. We used arthroscopic method to remove cavity of focal osteomyelitis. After one year follow up period complete resolution of the inflammatory symptoms and laboratory sign proved. As result, arthroscopic treatment of septic arthritis fallow well defined focal osteomyelitis may be useful.