المعالجة الجراحية للمفاصل الموهمة المكتسبة في العظام الأنبوبية الطويلة
Abstract
شملت الدراسة 68 مفصلا موهما في العظام الأنبوبية الطويلة عند 67مريضاً قبلوا في قسم الجراحة في مشفى الأسد الجامعي باللاذقية بين عامي(1997 – 2003) وخضعوا لعمل جراحي للمفصل الموهم.
حيث توزع هؤلاء المرضى بين ذكور بنسبة89.55% وإناث بنسبة 10.45% ولوحظ أن هذه المفاصل الموهمة تكون أكثر شيوعاً عند الأعمار الشابة (20 –40 سنة) وذلك بنسبة 62.68% وهي الفئة العاملة في المجتمع ومن هنا تكمن أهمية علاج هذه المشكلة .
توزعت أنواع المفاصل الموهمة إلى ضمورية بنسبة 79.41% وضخامية بنسبة 17.64% .
وكانت الكسور المفتوحة موجودة عند 12 مريضاً بنسبة 17.45%.
أما الإنتان فلوحظ عند 15 مريضاً بنسبة 22.05%.
وتمت المقارنه بين طرق العلاج التي تم اتباعها في دراستنا واستخلاص عدة نتائج أهمها:
1) أهمية استخدام الطعم العظمي في علاج المفاصل الموهمة خاصة الضمورية.
2) فائدة استخدام المثبتات الخارجية في علاج المفاصل الموهمة في الحالات المختلطة بالإنتان أو ضياع مادي بالنسج الرخوة أو العظم خاصةً في الظنبوب.
3) فعالية استخدام الصفائح الضاغطة في علاج المفاصل الموهمة خاصةً في الساعد والعضد.
The study included 68 pseudoarthrosis in long bones in 67 patients aplicated in the surgery ward at Al-Assad hospital in lattakia between 1997-2003 and underwent procedures over pseudoarthrosis.
The distribution was: % 89.55 male and % 10.45 female
We noted that this problem is common in young age (20-40 years) 62.68%. This is the working group in society, thus it is important to fix it.
In our study atrophic pseudoarthosis was % 79.41 and hypertrophic was %17.64, 12 patients suffered from open fractures in %17.45, and 15 patients % 22.05 had infections.
We had compared between the treatment methods in our studies and the results were:
1-It is necessary to use bone graft in pseudoarthrosis especially in dystrophi
2-The benefit of using external fixator in manegment of pseudoarthrosis especially in cases of infection or in cases with defect of soft tissue or bone .
3-The activity of using compression plates in treatment of pseudoarthrosis especially in humerus and forearm.
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