| Abstract | CILJ ISTRAŽIVANJA
Ciljevi ove retrospektivne studije su ustanoviti broj, spol i dob pacijenata s
prijelomima distalnog dijela palčane kosti, njihovo prebivalište, incidenciju u Splitskodalmatinskoj
županiji, incidenciju po dobnim skupinama, koliko ih se operativno liječilo, jesu
li isti prvotno liječeni konzervativnom metodom, koji operacijski zahvati su primijenjeni te
dobivene rezultate usporediti sa rezultatima iz dostupnih svjetskih literatura.
MATERIJALI I METODE
Za izradu ovog istraživanja bilo je nužno prikupiti podatke o pacijentima primljenima
na Hitni kirurški prijem KBC-a Split 2014. godine s dijagnozom prijeloma distalnog dijela
palčane kosti te pacijentima s istom dijagnozom operiranima na Odjelu za traumatologiju
tijekom 2014. godine.
REZULTATI
Analizom prikupljenih podataka utvrđeno je da je tijekom 2014. godine na Hitnom
kirurškom prijemu liječeno 899 pacijenata s 18 i više godina zbog prijeloma distalnog dijela
palčane kosti i 38 operativno na Odjelu za traumatologiju KBC-a Split.
Na Hitnom kirurškom prijemu 73,41% pacijenata su bile žene a 26,59% muškarci.
Omjer žena i muškaraca je 2,76:1.
81,55% pacijenata dolazi iz područja Splitsko-dalmatinske županije, 4,39% iz ostalih
županija te 14,06% pacijenata imalo je strano prebivalište.
Incidencija prijeloma distalnog dijela palčane kosti stanovništva Splitsko-dalmatinske
županije starosti od 20 godina i više je 20,23 na 10000 osoba-godina. Incidencija za žene je
28,52 dok za muškarce 10,98 na 10000 osoba-godina.
Prosječna dob svih pacijenata je 62,68 godina. Najstariji liječeni pacijent imao je 94, a
najmlađi 18 godina. Prosječna dob pacijenata ženskog spola je 65,39 godina, a prosječna dob
pacijenata muškog spola je 55,23 godine.
Konzervativno liječeno je 95,77% pacijenata dok operativno 4,23% pacijenata.
Od 38 pacijenata liječenih operativno 71,05% prvotno je liječeno konzervativnom
terapijom ali zbog komplikacija su operirani. 28,95% pacijenata liječeno je operativno kao
terapijom prvog izbora.
Prilikom 52,36% operacija rađena je osteosinteza pločicama dok u 47,37% operacija
vanjska fiksacija.
Perkutana fiksacija Kirschnerovim žicama nijednom nije izvedena kao zaseban
operacijski zahvat.
ZAKLJUČAK
Rezultati dobiveni ovom studijom većinom se razlikuju od rezultata iz navedene
svjetske literature. Udio ženskog i muškog spola jedini ne odstupa od rezultata drugih studija
dok je prosječna dob nešto niža. Razlike u incidencijama su znatne ali još veće su u
primjenama operativnih zahvata gdje se perkutano postavljanje žica samostalno ne izvodi.
Znatna razlika postoji i kod udjela operativno liječenih prijeloma distalnog dijela palčane
kosti, koji je puno manji u KBC-u Split nego u SAD-u. Ovim radom otvorila su se nova
pitanja koja zahtijevaju daljnje studije kojima bi se u konačnici mogla smanjiti incidencija,
uspjeh liječenja poboljšati te troškovi smanjiti. |
| Abstract (english) | OBJECTIVES
Objectives of this retrospective study were to establish the number, sex and age of
pacients diagnosed with distal radius fracture, their residence, incidence in Split-Dalmatia
County, incidence by age-groups, number of operations performed and were those patients
initially treated witch closed reduction and casting, what surgical procedures were performed
and to compare those results with those available in other world publications.
MATERIAL AND METHODS
For this study it was necessary to collect data about patients diagnosed with distal
radius fractures in HKP Split and patients with the same diagnosis surgically treated in
Department of traumatology in 2014. from the archives of the Split Clinical hospital centre.
RESULTS
During 2014. 899 pacients aged 18 and more were diagnosed with distal radius
fracture in HKP Split and 38 received surgical treatment in Department of traumatology in
Split Clinical hospital centre.
73,41% of the pacients were female and 26,59% were male. Female to male ratio is
2,76:1.
81,55% of the pacients came from the Split-Dalmatia County, 4,39% from the rest of
the croatian counties and 14,06% of the pacients were foreigners.
Incidence of distal radius fracture for population of Split-Dalmatia County aged 20
years or more was 20,23 per 10000 person-years. Incidence for females was 28,52 and for
males 10,98 per 10000 person-years.
Average age of all patients was 62,68 years. Oldest recorded patient was 94 and the
youngest 18. Average age of the females was 65,39 years and males was 55,23 years.
95,77% of the pacients received closed reduction and casting treatment while 4,23%
received surgical treatment.
Out of 38 patients who received surgical treatment 71,05% were initially treated with
closed redutcion and casting but due to complications surgical operations were performed.
28,95% received surgical treatment as the first choice of therapy.
Open reduction and plate fixation was performed in 52,36% operations while external
fixation was performed in 47,37%.
Percutaneous k-wire fixation was always performed as an addition to plate fixation or
external fixation.
CONCLUSION
Results are mostly differing from those mentioned in world publications. Sex
distribution has the only result similar to others while average age is slightly lower. Incidence
rates differ significantly but even greater difference is in the use of surgical tehnicques, where
percutaneous pinning is only performed as an addition to plate fixation or external fixation.
Another significant differnce is percentage of the distal raidus fractures treated surgically,
which is far less than in United States. Further studies are required to determine causes of this
differences which could lead to reduction of incidence and improvement of treatment while
reducing costs. |
