SUMMARYObjective: We evaluated the effectivity of conservative treatment for acute mallet finger deformity in hands of pediatric patients due to trauma in this study. Method: Between 2011Between -2013 pediatric patients treated due to mallet finger deformity disturbance were reviewed retrospectively. The demographic data and the injury mechanisms of the patients were recorded. We obtained the X-ray films of the patients via PACS system. The classification was applied by the Doyle system. A standard conservative treatment protocol that maintained distal interphalangeal joint (DIP) at extension were applied to all patients. Finger splint was used during the first week for DIP extension. Then another splint that is arranged by also considering the finger diameter and made up of thermoplastic material was used to keep DIP in extension. After the treatment, the patients were clinically evaluated according to Crawford criteria. Results: 13 patients were male and 6 of them were female. 12 patients were Doyle type 1 and 7 of them were Doyle type 4a.The patients were among 9-16 ages. The mean age was 13.2. The fixation time in extension for Doyle type 1 patients was 4 weeks and was 5 weeks for the patients with Doyle type 4a. Exercise program was started fixation; splint was used one week more only at nights. Excellent results were obtained according to Crawford criteria. 2 patients experienced superficial skin problems which healed without any complication. The duration for achieving full range of motion was one week longer than the other children in three patients. Conclusion: Thermoplastic stent is an effective and easily applicable treatment method with high patient compliance for patients with acute type1 and type 4a mallet finger deformity due to trauma.Keywords: Mallet finger, pediatric patient, conservative treatment, thermoplastic splint ÖZET Amaç: Bu çalışmada, travma sonucu elde akut çekiç parmak deformitesi gelişen çocuk hastalarda konservatif tedavinin etkinliği değerlendirildi. Yöntem: Çekiç parmak deformitesi nedeniyle 2011-2013 yılları arasında tedavi edilen 19 çocuk hasta retrospektif olarak incelendi. Hastaların demografik bilgileri, yaralanma mekanizmaları kaydedildi. Hastaların grafilerine PACS sisteminden ulaşıldı. Sınıflandırma Doyle sistemine göre yapıldı. Tüm hastalara distal interfalangeal eklemi ekstansiyonda tutan standart konservatif tedavi protokolü uygulandı. İlk hafta distal interfalangeal (DİP) eklemi ekstansiyonda tutan parmak ateli ile takip yapıldı. Sonrasın da ise hastanın parmak çapına göre thermoplastik malzemeden hazırlanan yine DİP eklemi ekstansiyonda tutan splint kullanıldı. Tedavi sonrasında hastalar klinik olarak Crawford ölçütlerine göre değerlendirildi. 122 CMJ Cumhuriyet Medical JournalBulgular: Hastaların 13 tanesi erkek, 6 tanesi kadın idi. Hastaların 12 tanesi Doyle Tip I, 7 tanesi Doyle Tip IVa idi. Hastalar 9-16 yaş arasında idi. Ortalama yaş 13,2 idi. Ekstansiyonda tespit süresi Doyle Tip 1 hastalarda 4 hafta, Doyle Tip 4a hastalar da ise 5 hafta idi. Tespit sonlandır...
Siyanoakrilat birçok cerrahi alanda başarıyla kullanılmakta olup, son yıllarda mikrovasküler anastomoz amacıyla kullanılmaya başlanmıştır. Çalışmamızın amacı geleneksel sütür tekniği ile kendi geliştirdiğimiz siyanoakrilat ile güçlendirilmiş sütür tekniğini karşılaştırmaktır. Gereç ve Yöntemler: Çalışmaya toplam 16 Yeni Zelanda türü tavşan alındı. 8 Tavşan kontrol grubuna, 8 tavşan ise çalışma grubuna dâhil edildi. Sol femoral arterleri hazırlanarak, tam kat kesildi. Kontrol grubunda 90° acı ile dört sutur konularak geleneksel anastomoz uygulandı. Deney grubunda ise ön yüze tek sütür konulup, arka yüzde proksimal parça distalin içine geçirilip, siyanoakrilat damlatılarak anastomoz uygulandı. Klinik değerlendirme ve istatistik analiz yapılarak, operasyon süresi, kanama süresi ve geciş incelendi. Sonuçlar: Anastomoz iyileşmesi, 21. günde tavşanların sakrifiye edilerek alınan biyopsilerin ışık mikroskopisi altında histolojik olarak incelenmesi ile değerlendirildi. İki grup arasında lümen çapları açısından anlamlı fark vardı. Deney grubunda operasyon ve kanama süreleri anlamlı olarak kısa bulundu. Daha fazla endotel kaybı ve inflamasyon görülmesine rağmen akım engellemiyordu. Çıkarım: Uyguladığımız yöntem basit, az sütürle, kısa zamanda gerçekleştirilen, geçiş oranını azaltmayan, bir teknik olarak değerlendirilmiştir.
Aim. In this study, clinical outcome of long-term conservative treatment on adult pelvis fractures were evaluated. Methods. Adult patients (n=75) admitted to the Emergency and Orthopedics and Traumatology Services of Cumhuriyet University Hospital for major pelvic trauma from 2000 to 2007 were retrospectively studied. All patients were treated with various conservative methods. Results. Of the study population, 31, 11, and 33 patients were Tile Types A, B, and C, respectively. Subsequent to the treatment, patients were evaluated by IPS scoring system and excellent, good, medium, and bad results in 44, 17, 7, and 7 patients, respectively, were obtained. Conclusions. In this study, conservative treatment was performed in all the patients. Long-term hospital stay and long-term recovery was prominent in the Tile Type C managed with a success rate of 81.4%. Conservative treatment has been considered as safe and effective in Tile Types A and B fractures. Although the popularity of surgical treatment in Tile Type C fractures has been increasing, when the surgical risks are considered, conservative treatment may be also alternative treatment method.
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