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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 295 - 295
1 Mar 2004
Daglar B Bayrakci K Gurkan I Ozdemir G Gunel U
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Aims: To investigate the clinical importance of the fracture of lumbar vertebral transverse processes and to þnd out if any correlations exists between the side and the level of the transverse processes fractures and speciþc intraabdominal organ injuries. Methods: 106 patients, sustained different kinds of trauma between January 2000 and January 2001, were included in the study. All patients were operated for intra abdominal causes. Of these 62 (%58) had one or more fractured lumbar transverse processes documented (group I) and remaining 44 had not (group II). Age, gender, additional skeletal and intra abdominal injuries, ISS, laboratory tests results at presentation, transfusion needs and the end results were compared using SPSS 10,0 package. Results: Patients with transverse process fractures were older (38 versus 27, p=0,001). Trauma causes, ISS, additional systemic traumas, skeletal traumas were not different between groups (p values are; 0,148, 0,125, 0,423, 0,673 respectively). However, hemoglobin levels, intra abdominal organ injuries, total hospital stay and end results were signiþcantly different in group I (p= 0,005, 0,042, 0,002 and 0,012). Left sided fractures were well correlated with the spleen, and right sided fractures were similarly correlated with the presence of hepatic injuries. Conclusions: Although lumbar transverse process fractures do not directly relate with vertebral stability, the presence of such a fracture should alert physicians. Especially in multiply injured patients, lumbar vertebra transverse process fracture predisposes more serious intra or retroperitoneal organ injuries.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 349 - 349
1 Mar 2004
Daglar B Bayrakci K Gurkan I Tasbas B Gunel U
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Aims: To compare clinical results of three different þxation combinations used for the treatment of ipsilateral hip and femoral diaphysial fractures. Methods: Between March 1999 and May 2001, 17 patients with ipsilateral hip and femur diaphysis fractures treated either by using cannulated screws for hip and plate-screw osteosynthesis for diaphysis (GroupI, 5 patients), dynamic hip screw for hip and plate-screws for diaphysis (Group II, 4 patients) and cannulated screws for hip and retrograde intramedullary nailing for diaphysis (Group III, 8 patients). Mean follow up was 24,4 months (16–33). All data retrospectively reviewed and compared using SPSS 10,0 package. Results: Age, sex, Injury Severity Scores, additional traumas, causes of trauma, þrst hemoglobine levels and complications were not different for either three groups. However, Group III had much lower operation times, perioperative transfusion needs and healing times for the diaphysial fractures compared to Groups I and II. All varus angulations at hip fractures observed in Groups I and III. We did not observe any avascular necrosis of the femoral head at latest follow up in either groups. Conclusions: All above mentioned þxation combinations can be used for the treatment of this difþcult fracture combination. However, by using retrograde nailing for the diaphysis and cannulated screws for the hip fracture, one can decrease operation times, blood transfussion needs and time to full weight bearing without increasing complications. We propose that, retrograde nailing combined with percutaneous screws should be the choice of treatment with decreased soft tissue dissection, accelerated rehabilitation and possible increased rate of healing.