Absalan, Mohsen

Simorgh Research Repository

   niratalaB    ﻛﺮﻣﺎن داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﻜﻲ و ﺧﺪﻣﺎت ﺑﻬﺪاﺷﺘﻲ درﻣﺎﻧﻲ  داﻧﺸﻜﺪه ﭘﺰﺷﻜﻲ ﻣﻬﻨﺪس اﻓﻀﻠﻲ ﭘﻮر  ﺗﺨﺼﺼﻲ ارﺗﻮﭘﺪيﺟﻬﺖ درﻳﺎﻓﺖ درﺟﻪ دﻛﺘﺮاي   ﻋﻨﻮان:ﻻﻛﻴﻨﮓ ﭘﻠﻴﺖ ( ﺑﺎ  روش C epyTرادﻳﻮس )ﺑﺮرﺳﻲ ﻧﺘﺎﻳﺞ درﻣﺎﻧﻲ ﺷﻜﺴﺘﮕﻲ ﻫﺎي داﺧﻞ ﻣﻔﺼﻞ دﻳﺴﺘﺎل ﻫﻤﺮاه ﭘﻴﻦ و ﭘﻼﺳﺘﺮ و ﮔﭻ ﻛﻮﺗﺎه ﺳﺎﻋﺪ در ﺑﺨﺶ ارﺗﻮﭘﺪي ﺑﻴﻤﺎرﺳﺘﺎن ﺑﺎﻫﻨﺮ ﻛﺮﻣﺎن pcp وﻻر ﻧﺴﺒﺖ ﺑﻪ   4931- 69ﻫﺎي در ﺳﺎل    اﺳﺘﺎد راﻫﻨﻤﺎ: ﻋﻠﻴﺮﺿﺎ ﺳﻌﻴﺪدﻛﺘﺮ     ﭘﮋوﻫﺶ و ﻧﮕﺎرش: ﻻنﺎدﻛﺘﺮ ﻣﺤﺴﻦ آﺑﺴ  79ﺑﻬﺎر   ﭼﻜﻴﺪهﻳﻚ ارﺗﻮﭘﺪ  ﺳﻴﺴﺘﻢ اﺳﻜﻠﺘﻲ اﺳﺖ ﻛﻪﺷﻜﺴﺘﮕﻲ ﻫﺎي دﻳﺴﺘﺎل رادﻳﻮس ﻳﻜﻲ از ﺷﺎﻳﻊ ﺗﺮﻳﻦ ﺷﻜﺴﺘﮕﻲ ﻫﺎي  ﻣﻌﺮﻓﻲ:اﺳﺖ. ﻣﻄﺎﻟﻌﺎت  ﻛﺮده ﺗﻐﻴﻴﺮ زﻳﺎدي زﻣﺎن درﻃﻮل رادﻳﻮس اﻧﺘﻬﺎي ﻫﺎي ﺷﻜﺴﺘﮕﻲ درﻣﺎنﺑﺎ آن ﺑﺮﺧﻮرد ﻣﻲ ﻛﻨﺪ. ﻧﺸﺎن ﻣﻴﺪﻫﺪ اﻓﺮاد ﺟﻮان ﺑﺎ ﺷﻜﺴﺘﮕﻲ ﻫﺎي ﻣﺘﺎﻓﻴﺰﻳﺎل ﺧﺎرج ﻣﻔﺼﻠﻲ ﺑﺎ ﺣﺪاﻗﻞ ﺧﺮدﺷﺪﮔﻲ را ﻣﻴﺘﻮان ﺑﺎ ﭘﻴﻦ ﮔﺬاري ﺳﺎل و ﺷﻜﺴﺘﮕﻲ ﻫﺎي ﺧﺮد ﺷﺪه را ﺗﺮﺟﻴﺤﺎ ﺑﺎ ﭘﻼك  55اﻓﺮاد ﺑﺎ ﺳﻦ ﺑﺎﻻي از ﻃﺮﻳﻖ ﭘﻮﺳﺖ درﻣﺎن ﻛﺮد درﺣﺎﻟﻲ ﻛﻪ  ﺷﻜﺴﺘﮕﻲ،ﻳﺎﻓﺘﻦ ﻣﻨﺎﺳﺐ ﺗﺮﻳﻦ راه درﻣﺎن در اﻳﻦ ﺑﻴﻤﺎران اﻳﻦ ﺑﻪ ﻣﺒﺘﻼﻳﺎن ﺑﺎﻻي ﺗﻌﺪاد ﺑﻪ ﺑﺎﺗﻮﺟﻪ . ﻛﻨﻴﻢ درﻣﺎن ﻣﻲ  دارد. اﻫﻤﻴﺖواﺟﺪ ﺷﺮاﻳﻂ ورود  رادﻳﻮسﺑﻴﻤﺎران ﺑﺎ ﺷﻜﺴﺘﮕﻲ دﻳﺴﺘﺎل  ﺷﺎﻫﺪ-ر ﻳﻚ ﻣﻄﺎﻟﻌﻪ آﻳﻨﺪه ﻧﮕﺮ ﻣﻮرددروش ﻫﺎ: و ﻣﻮادد ﻣﻄﺎﻟﻌﻪ ﺷﺪﻧﺪ. ﭘﺲ از ﻣﻌﺎﻳﻨﺎت ﺑﻴﻤﺎران ﺑﺴﺘﻪ ﺑﻪ اﻧﺘﺨﺎب و ارﺑﻪ ﻣﻄﺎﻟﻌﻪ ﻛﻪ ﺑﻪ ﺑﻴﻤﺎرﺳﺘﺎن ﺑﺎﻫﻨﺮ ﻣﺮاﺟﻌﻪ ﻛﺮدﻧﺪ، وﻫﻤﺮاه ﭘﻴﻦ و ﭘﻼﺳﺘﺮ و ﮔﺞ ﻛﻮﺗﺎه ﺳﺎﻋﺪ ﻳﺎ ﭘﻠﻴﺖ ﻻﻛﻴﻨﮓ وﻻر  ﺗﺤﺖ ﻋﻤﻞ  PCPﺗﺠﺮﺑﻪ ﺟﺮاح آﻧﻜﺎل  ﺑﻪ دو روش ﻣﺎه ﭘﺲ از ﻋﻤﻞ ﺟﺮاﺣﻲ از ﻧﻈﺮ ﻣﻴﺰان ﻓﻌﺎﻟﻴﺖ ﻫﺎي روزاﻧﻪ ،  داﻣﻨﻪ  21 ﻣﺎه و 3ﺟﺮاﺣﻲ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. ﺑﻴﻤﺎران ﺣﺮﻛﺎت و  ﻳﺎﻓﺘﻪ ﻫﺎي رادﻳﻮﻟﻮژﻳﻚ  ، ﻗﺪرت ﮔﺮﻳﭗ دﺳﺖ و ﻋﻔﻮﻧﺖ ﻣﻮرد ﺑﺮرﺳﻲ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. داده ﻫﺎي ﻣﻄﺎﻟﻌﻪ وارد ﺮﻓﺖ. ﻳﻚ ﭼﻚ ﻟﻴﺴﺖ ﺷﺪ و ﭘﺲ از ﺟﻤﻊ آوري ﺑﺎ اﺳﺘﻔﺎده از آزﻣﻮن ﻫﺎي آﻣﺎري ﻣﻮرد ﺗﺠﺰﻳﻪ و ﺗﺤﻠﻴﻞ آﻣﺎري ﻗﺮار ﮔ  ﺑﻮد. 12ﻧﺴﺨﻪ  SSPSﻧﺮم اﻓﺰار ﻣﻮرد اﺳﺘﻔﺎده ورود ﺑﻴﻤﺎران ﺑﻪ ﻣﻄﺎﻟﻌﻪ ﺗﺎ ﺑﺪﺳﺖ  ﺑﻴﻤﺎر ﺑﻪ ﻫﺮ ﮔﺮوه ﺑﻮد ﻛﻪ ﻧﻬﺎﻳﺘﺎ 03ﻫﺪف ورود  ي ﺣﺎﺿﺮ، در ﻣﻄﺎﻟﻌﻪﻳﺎﻓﺘﻪ ﻫﺎ:ﺑﻪ ﻃﻮر ﻛﻠﻲ  MORﻳﺎﻓﺘﻪ ﻫﺎي اﻳﻦ ﻣﻄﺎﻟﻌﻪ ﻧﺸﺎن داد ﻛﻪ ﻣﻴﺎﻧﮕﻴﻦ ﺑﻴﻤﺎر ﺑﺮاي ﻫﺮ ﮔﺮوه اداﻣﻪ ﻳﺎﻓﺖ. 03آﻣﺪن ﺗﻌﺪاد ﺑﻮد ﻫﺮﭼﻨﺪ ﻛﻪ در ﭘﺮوﻧﻴﺸﻦ و ﺳﻮﭘﻴﻨﻴﺸﻦ اﻳﻦ ﻣﻴﺰان ﻣﻌﻨﻲ دار  PCPﻴﺖ ﻻﻛﻴﻨﮓ وﻻر ﺑﻬﺘﺮ از ﮔﺮوه در روش ﭘﻠدر ﮔﺮوه ﭘﻼك ﮔﺬاري ﺑﻪ ﻃﻮر ﻣﻌﻨﻲ داري ﺑﻬﺘﺮ از  ﻣﺎه ﭘﺲ از درﻣﺎن  21ﻧﻴﺰ  ﺗﻮاﻧﺎﻳﻲ اﻧﺠﺎم ﻓﻌﺎﻟﻴﺘﻬﺎي روزاﻧﻪﻧﺒﻮد.   داري ﺑﻴﻦ ﻣﻴﺎﻧﮕﻴﻦ ﻧﻤﺮات ﺗﻤﺎم ﻣﺘﻐﻴﺮﻫﺎي رادﻳﻮﻟﻮژﻳﻚ در دو ﮔﺮوه ﻣﺸﺎﻫﺪه ﺷﺪ.  ﻣﻌﻨﻲ .ﺗﻔﺎوتﺑﻮد PCPﮔﺮوه ﺑﺎ   FIRO روش ﺑﻪ ﻧﻈﺮ ﻣﻲ رﺳﺪ ﻛﻪ ، ﺣﻲﻣﺎﻫﻪ ﭘﺲ از ﻋﻤﻞ ﺟﺮا 21و  3ﻫـﺎي  ﺑـﺮ اﺳﺎس ﭘﻴﮕﻴﺮيﻧﺘﻴﺠﻪ ﮔﻴﺮي:ﺷﻜﺴﺘﮕﻲ داﺧﻞ ﻣﻔﺼﻠﻲ دﻳﺴﺘﺎل رادﻳﻮس ﺳﺎل ﺑﺎ 06روش ﻣﻨﺎﺳﺒﻲ در ﺑﻴﻤﺎران ﻛﻤﺘـﺮ از  ﻛﻴﻨﮓ وﻻرﻻ ﭘﻠﻴﺖ  .ﺑﺎﺷﺪ ﻧﻴﺰ ﻗﺎﺑﻞ ﻗﺒﻮل ﻣﻲ ﻫﻤﺮاه ﭘﻴﻦ و ﭘﻼﺳﺘﺮ و ﮔﭻ ﻛﻮﺗﺎه ﺳﺎﻋﺪpcp  اﺳﺖ. اﮔﺮﭼﻪ ﻧﺘﺎﻳﺞ ﺣﺎﺻﻞ از(c epyt)                Introduction:Distal radius fracturesare one of the most common fractures of the skeletal system that an orthopedic collides with. The treatment of thesefractures has changed over time. Studies show that young people with extra-articular metaphysical fractures with minimal comminutioncan be treated percutaneous pinning, while people over the age of 55 are best treated by plating. Given the high number of patients with this fracture, finding the most appropriate treatment for these patients is important Materials and Methods:In a prospective case-control study, patients with a distal Radius fracture who were admitted to Bahonar Hospital were enrolled during a two-year. After examination, patients were selected according to the choice and experience of ankyl surgeon in two methods: PCP with pins, plasters and short arm castor Volar Locking plate Patients 3 months and 12 months after surgery were evaluated for daily activity, range of motion and radiological findings, grip strength and infection. The data were entered into a checklist and analyzed by statistical tests. The software used was SPSS version 21 Results:In this study, 30 patients were enrolled in each group, which ultimately led patients to study to reach 30 patients for each group. The findings of this study showed that the average ROM in the Locking volar platemethod was generally better than that of the PCP group, although this was not significant in pronationand supination. The ability to perform daily activities was significantly better in the Locking volar plategroup than in the PCP group 12 months after treatment. There was a significant difference between the mean scores of all radiographic variables in the two groups. Conclusion:Based on follow-ups of 3 and 12 months after surgery, it seems that the ORIF method, including theLocking volar plate, is a suitable method in patients less than 60 years old with intraarticularfracture of distal radius (type c). Although the results of the pinning are also acceptable.   

بررسی نتایج درمانی شکستگی های داخل مفصل دیستال رادیوس (Type C) با  روش پلیت لاکینگ ولار نسبت به  pcpهمراه پین و پلاستر و گچ کوتاه ساعد در بخش ارتوپدی بیمارستان باهنر کرمان در سال های96-1394

http://eprints.kmu.ac.ir/29186/1/6810.pdf

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