استجدال كسور جدل الظنبوب بالأسياخ المستبطنة للنقي ( TENS )
Abstract
يمثل الـ TENS مبدأ جديد في الاستجدال النقوي حيث أنه يبدو مناسبا جدا للرضوض عند الأطفال مع عدم وجود تلك المساوئ التي تشاهد في وسائل الاستجدال الأخرى .
شمل البحث الأطفال المصابين بكسور جدل الظنبوب اللذين تم قبولهم وعلاجهم جراحيا في مشفى الأسد الجامعي في اللاذقيه في جامعة تشرين في الفتره الواقعه بين عامي 2010 – 2014 حيث بلغ عدد الحالات المدروسه 34 حاله وذلك عند 33 مصاب .
تراوحت أعمار المصابين بين 5 - 15 سنه , بعمر وسطي 11 سنه و سيطرة الذكور على الإناث .
كان السبب المسيطر هو حوادث الطرق العامه , والجهة المسيطرة هي الجهة اليمنى ( 20 ) حالة .
كان موقع الكسر في الثلث السفلي للظنبوب بنسبة 64% (أي 21 حاله), وشكل الكسر مائلا في 18 حاله .
بالنسبة للاذيات المشاركة كانت السيطرة لرضوض الدماغ ( 5 حالات), رض الوجه ( 2 حاله ), رض البطن ( 2 حاله ).
تم نزع الجبيرة في اليوم 15 , و نزع الأسياخ بعد حوالي 6 أشهر .
كانت الاختلاطات الأكثر شيوعا عبارة عن خروج الأسياخ من الجلد والانتانات الجلدية التي اختفت بعد نزعها.
تبقى الـ TENS طريقه سهله في مفهومها و تطبيقها مع استطبابات متعددة وهي لا تحمل إلا اختلاطات صغيره وسهلة الوقاية والمراقبة .
Management of tibiodiaphysial fractures in the age group of 5-15 years is controversial ,there has been a resurgence world wide for operative fixation in general and TENS(titanium elastic nailing system) in particular. We performed a retrospective review of pediatric tibial fractures treated by TENS. The data was collected from cases operated between 2010 and 2014 at Al Assad university hospital ,Lattakia. We had treated 34 children (boys and girls) with TENS for tibial shaft fractures. Average load of age was 11 years(range 5-15 years).All fractures were radiographically united at a mean of 7,5 weeks (range 5-10) weeks.The nails were removed mean of 22 weeks (range 6-31 weeks) postoperatively. At follow up we had found leg length discrepancy of 1 cm in one child and 10 degrees of internal rotational deformity in another. No angular deformity had occured.Titanium elastic nailing seems to be a safe and effective method for treatment of tibial shaft fractures in childreen between 5 and 15 years of age.
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