{"id":9107,"date":"2026-07-24T12:47:26","date_gmt":"2026-07-24T09:47:26","guid":{"rendered":"https:\/\/dryunusoc.com\/?p=9107"},"modified":"2026-07-24T13:37:53","modified_gmt":"2026-07-24T10:37:53","slug":"quadrilateral-dortlu-boy-uzatma-ameliyati-cerrah-gozunden-kapsamli-rehber","status":"publish","type":"post","link":"https:\/\/dryunusoc.com\/tr\/quadrilateral-dortlu-boy-uzatma-ameliyati-cerrah-gozunden-kapsamli-rehber\/","title":{"rendered":"Quadrilateral (D\u00f6rtl\u00fc) Boy Uzatma Ameliyat\u0131: Cerrah G\u00f6z\u00fcnden Kapsaml\u0131 Rehber"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Boy uzatma cerrahisinde hastalar\u0131m\u0131n en s\u0131k sordu\u011fu sorulardan biri \u015fudur: <br><br>&#8220;<strong>Hocam, hem \u00fcst baca\u011f\u0131m\u0131 hem alt baca\u011f\u0131m\u0131 ayn\u0131 anda uzatabilir miyiz?<\/strong>&#8221; <br><br>Bu sorunun cevab\u0131 evet; bu ameliyata quadrilateral (d\u00f6rtl\u00fc) boy uzatma diyoruz. Ancak bu evet&#8217;in arkas\u0131nda, hasta g\u00fcvenli\u011fini merkeze alan \u00e7ok net kurallar\u0131m var. Bu yaz\u0131da quadrilateral ameliyat\u0131 nas\u0131l planlad\u0131\u011f\u0131m\u0131, hangi hastaya uygulad\u0131\u011f\u0131m\u0131, hangi kombinasyonlar\u0131 neden tercih etti\u011fimi ve s\u00fcre\u00e7te sizi nelerin bekledi\u011fini kendi prati\u011fimden anlataca\u011f\u0131m.<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-text-color has-link-color wp-elements-39ec2fcd7552f12f300842474d2a9ed5\" style=\"color:#045482\"><strong>Quadrilateral Ameliyat Nedir?<\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Klasik boy uzatma ameliyat\u0131nda tek bir kemik b\u00f6lgesi \u00fczerinde \u00e7al\u0131\u015f\u0131r\u0131z: ya \u00fcst bacak (femur) ya alt bacak (tibia). Quadrilateral ameliyatta ise her iki bacakta hem femur hem tibia olmak \u00fczere toplam d\u00f6rt kemi\u011fi ayn\u0131 seansta kesip uzatma s\u00fcrecini d\u00f6rt b\u00f6lgede birden y\u00fcr\u00fct\u00fcr\u00fcz.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bunun hastaya sa\u011flad\u0131\u011f\u0131 temel avantaj \u015fudur: tek b\u00f6lgeden elde edilebilecek uzama s\u0131n\u0131rl\u0131d\u0131r; iki b\u00f6lge birlikte uzat\u0131ld\u0131\u011f\u0131nda toplam 12-15 santimetreye kadar uzama tek bir tedavi s\u00fcrecinde m\u00fcmk\u00fcn olur. \u0130ki ayr\u0131 ameliyat\u0131 aylar arayla yapmak yerine, s\u00fcre\u00e7 tek seferde planlan\u0131r.<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-text-color has-link-color wp-elements-b7b76ea5aee221c850fa0cfd7e127773\" style=\"color:#045482\"><strong><strong>Kimlere Uyguluyorum?<\/strong><\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Quadrilateral ameliyat, herkese \u00f6nerdi\u011fim bir y\u00f6ntem de\u011fildir. Muayenede \u015fu kriterlere bakar\u0131m:<\/strong><br><br><strong>Hedeflenen uzama miktar\u0131:<\/strong> Hedef tek b\u00f6lgenin g\u00fcvenli s\u0131n\u0131r\u0131 i\u00e7indeyse quadrilateral gereksizdir. Tek ameliyatla femurdan Kombine\/LON y\u00f6ntemiyle 10 santimetreye kadar, i\u00e7ten sistemlerle 8-8.5 santimetre civar\u0131nda uzama elde edebiliyoruz. Hedef bunun \u00fczerindeyse quadrilateral se\u00e7ene\u011fini konu\u015furuz.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Kemik kalitesi ve genel sa\u011fl\u0131k:<\/strong> D\u00f6rt b\u00f6lgede e\u015f zamanl\u0131 kemik iyile\u015fmesi, v\u00fccuttan tek b\u00f6lgeye g\u00f6re daha fazla \u015fey ister. Kemik mineral yo\u011funlu\u011fu, kan de\u011ferleri ve genel sa\u011fl\u0131k durumu ameliyata elveri\u015fli olmal\u0131d\u0131r.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>V\u00fccut oranlar\u0131: <\/strong>Muayenede g\u00f6vde, \u00fcst bacak ve alt bacak \u00f6l\u00e7\u00fclerini al\u0131r, oran hesab\u0131 yapar\u0131m. Baz\u0131 hastalarda d\u00f6rt b\u00f6lge uzatmas\u0131 oransal olarak en do\u011fal sonucu verirken, baz\u0131lar\u0131nda tek b\u00f6lge estetik a\u00e7\u0131dan daha do\u011frudur.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Psikolojik haz\u0131rl\u0131k ve s\u00fcre\u00e7 uyumu:<\/strong> Quadrilateral, tek b\u00f6lge ameliyat\u0131na g\u00f6re daha yo\u011fun bir rehabilitasyon ister. Hastan\u0131n bunu bilerek ve isteyerek s\u00fcrece girmesi, ba\u015far\u0131n\u0131n \u00f6n ko\u015fuludur.<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-text-color has-link-color wp-elements-36bfee8383b8e69229dee572175ec01d\" style=\"color:#045482\"><strong><strong><strong>Ameliyat \u00d6ncesi De\u011ferlendirme Nas\u0131l \u0130\u015fler?<\/strong><\/strong><\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Quadrilateral karar\u0131n\u0131 hi\u00e7bir zaman tek g\u00f6r\u00fc\u015fmede vermem. De\u011ferlendirme \u015fu ad\u0131mlardan olu\u015fur:<br><br>\u00d6ncelikle ayr\u0131nt\u0131l\u0131 \u00f6yk\u00fc al\u0131r\u0131m: kronik hastal\u0131klar, kullan\u0131lan ila\u00e7lar, sigara \u00f6yk\u00fcs\u00fc, \u00f6nceki ameliyatlar ve ailedeki kemik hastal\u0131klar\u0131. Ard\u0131ndan uzun kemik r\u00f6ntgenleri ile kemik yap\u0131s\u0131n\u0131, kanal \u00e7aplar\u0131n\u0131 ve b\u00fcy\u00fcme plaklar\u0131n\u0131n kapand\u0131\u011f\u0131n\u0131 do\u011frular\u0131m; \u00e7ivi se\u00e7imi bu \u00f6l\u00e7\u00fcmlere g\u00f6re yap\u0131l\u0131r. Kan tahlilleri, EKG ve anestezi de\u011ferlendirmesi standartt\u0131r; 40 ya\u015f \u00fczeri hastalarda kemik mineral yo\u011funlu\u011fu \u00f6l\u00e7\u00fcm\u00fcn\u00fc mutlaka isterim. Son olarak boy ve segment \u00f6l\u00e7\u00fclerini al\u0131p oran hesab\u0131 yapar, hedeflenen uzaman\u0131n hangi b\u00f6lgelerden, ne kadar al\u0131naca\u011f\u0131n\u0131 hastayla birlikte planlar\u0131m<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bu de\u011ferlendirmenin sonunda \u00fc\u00e7 sonu\u00e7tan biri \u00e7\u0131kar: quadrilateral uygun, tek b\u00f6lge daha do\u011fru, ya da ameliyat \u015fu an \u00f6nerilmez. \u00dc\u00e7\u00fcnc\u00fc sonucu s\u00f6ylemekten \u00e7ekinmem; do\u011fru hasta se\u00e7imi, bu cerrahinin en \u00f6nemli g\u00fcvenlik basama\u011f\u0131d\u0131r.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Kulland\u0131\u011f\u0131m \u00dc\u00e7 Y\u00f6ntem:<\/strong> Kombine\/LON, Fitbone ve Precice 2<br><br>Quadrilateral planlamas\u0131na ge\u00e7meden \u00f6nce, kombinasyonlar\u0131n yap\u0131 ta\u015flar\u0131 olan \u00fc\u00e7 y\u00f6ntemi k\u0131saca tan\u0131tay\u0131m.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Kombine\/LON (Lengthening Over Nail):<\/strong> Kemik kanal\u0131na intramed\u00fcller \u00e7ivi yerle\u015ftirir, uzatmay\u0131 baca\u011f\u0131n d\u0131\u015f\u0131na monte edilen eksternal fiksat\u00f6r \u00fczerinden g\u00fcnl\u00fck milimetrik olarak yapar\u0131z. Uzatma bitti\u011finde fiksat\u00f6r\u00fc \u00e7\u0131kar\u0131r\u0131m; i\u00e7erideki \u00e7ivi kaynama boyunca kemi\u011fi destekler. En ekonomik y\u00f6ntemdir ve femurda tek ameliyatla 10 santimetreye kadar uzama imkan\u0131 sunar. Kar\u015f\u0131l\u0131\u011f\u0131nda, uzatma d\u00f6nemi boyunca d\u0131\u015far\u0131da bir cihaz ta\u015f\u0131n\u0131r ve pin giri\u015f noktalar\u0131 d\u00fczenli bak\u0131m ister.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Fitbone:<\/strong> Uzatma mekanizmas\u0131 \u00e7ivinin i\u00e7indedir; hasta, cilt \u00fczerinden elektronik bir kumanda ile uzatmay\u0131 yapar. D\u0131\u015far\u0131dan g\u00f6r\u00fcnen hi\u00e7bir par\u00e7a yoktur. Konfor a\u00e7\u0131s\u0131ndan b\u00fcy\u00fck avantaj sa\u011flar; maliyeti Kombine\/LON&#8217;un \u00fczerindedir.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Precice 2:<\/strong> Fitbone gibi tamamen i\u00e7ten \u00e7al\u0131\u015f\u0131r; fark, uzatman\u0131n manyetik bir kumanda ile yap\u0131lmas\u0131d\u0131r. \u0130\u00e7ten sistemler aras\u0131nda en y\u00fcksek maliyetli se\u00e7enektir. Fitbone ve Precice 2 ile femurda tek ameliyatta 8-8.5 santimetre civar\u0131nda uzama elde ederiz.<br><br>\u00dc\u00e7 y\u00f6ntemin uzatma h\u0131z\u0131 ve kaynama s\u00fcresi benzerdir; fark konfor, maliyet ve maksimum uzama kapasitesindedir. Quadrilateral ameliyatta bu \u00fc\u00e7 yap\u0131 ta\u015f\u0131n\u0131, birazdan anlataca\u011f\u0131m kurallar \u00e7er\u00e7evesinde kombine ederim.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Uygulama Prensibim:<\/strong> Neden \u0130ki B\u00f6lgede Birden D\u0131\u015f Fiksat\u00f6r Kullanm\u0131yorum?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Quadrilateral ameliyat\u0131 iki konfig\u00fcrasyondan biriyle yapar\u0131m:<\/strong><br><br><strong>Birinci se\u00e7enek:<\/strong> Bir kemik b\u00f6lgesinde Kombine\/LON y\u00f6ntemi, di\u011fer b\u00f6lgede tamamen i\u00e7ten \u00e7al\u0131\u015fan bir sistem (Fitbone veya Precice 2). \u00d6rne\u011fin femurda i\u00e7ten \u00e7ivi, tibiada Kombine\/LON. Bu kombinasyon maliyet ile konforu dengeler.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u0130kinci se\u00e7enek:<\/strong> Her iki b\u00f6lgede de i\u00e7ten sistem. Fitbone + Fitbone, Precice 2 + Precice 2 veya ikisinin kombinasyonu. D\u0131\u015far\u0131dan g\u00f6r\u00fcnen hi\u00e7bir cihaz olmad\u0131\u011f\u0131 i\u00e7in s\u00fcrecin en konforlu halidir.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Her iki bacak b\u00f6lgesine birden eksternal fiksat\u00f6r takmay\u0131 ise uygulam\u0131yorum. Bunun nedenleri deneyimle sabittir: d\u00f6rt b\u00f6lgede birden d\u0131\u015f cihaz ta\u015f\u0131yan hastada uyku pozisyonu neredeyse tek se\u00e7ene\u011fe iner, diz-kal\u00e7a-ayak bile\u011fi hareketleri ciddi k\u0131s\u0131tlan\u0131r, pin giri\u015f noktalar\u0131n\u0131n say\u0131s\u0131 artt\u0131\u011f\u0131 i\u00e7in enfeksiyon riski y\u00fckselir ve cihaz y\u00fck\u00fc iyile\u015fmeyi yava\u015flat\u0131r. Bu nedenle quadrilateral ameliyatlar\u0131mda b\u00f6lgelerden en az biri mutlaka i\u00e7ten sistemle uzat\u0131l\u0131r. Bu, pazarl\u0131k konusu yapmad\u0131\u011f\u0131m bir g\u00fcvenlik kural\u0131d\u0131r.<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-text-color has-link-color wp-elements-32871e484c2bf0ea68730dc66c91a4bf\" style=\"color:#045482\"><strong><strong><strong><strong>Ameliyat Nas\u0131l Ge\u00e7er?<\/strong><\/strong><\/strong><\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Quadrilateral ameliyat genel anestezi alt\u0131nda yap\u0131l\u0131r. S\u00fcre, se\u00e7ilen kombinasyona g\u00f6re de\u011fi\u015fir: Kombine\/LON + Fitbone kombinasyonunda yakla\u015f\u0131k 4.5 saat, iki b\u00f6lgede i\u00e7ten sistem (\u00f6rne\u011fin Fitbone + Fitbone) kullan\u0131ld\u0131\u011f\u0131nda yakla\u015f\u0131k 3.5 saat s\u00fcrer. \u0130\u00e7ten sistemlerde fiksat\u00f6r montaj\u0131 olmad\u0131\u011f\u0131 i\u00e7in hem ameliyat hem anestezi s\u00fcresi k\u0131sal\u0131r.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ameliyatta her kemik b\u00f6lgesinde kontroll\u00fc bir kesi (osteotomi) olu\u015fturur ve uzatma sistemlerini yerle\u015ftiririm. Hastalar ameliyat sonras\u0131 ortalama 5-7 g\u00fcn hastanede kal\u0131r; bu s\u00fcrede a\u011fr\u0131 y\u00f6netimi, yara bak\u0131m\u0131 ve fizyoterapist e\u015fli\u011finde ilk ad\u0131mlar at\u0131l\u0131r. Hastalar\u0131m genellikle ikinci veya \u00fc\u00e7\u00fcnc\u00fc g\u00fcnden itibaren y\u00fcr\u00fcte\u00e7 ile destekli y\u00fcr\u00fcmeye ba\u015flar.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Uzatma S\u00fcreci:<\/strong> G\u00fcnde Ka\u00e7 Milimetre?<br><br>Quadrilateral ameliyatta uzatmaya, ameliyattan yakla\u015f\u0131k 7 g\u00fcn sonra ba\u015flar\u0131z. (Tek b\u00f6lge ameliyatlar\u0131nda bu s\u00fcre 5 g\u00fcnd\u00fcr; d\u00f6rt b\u00f6lgede kemi\u011fin iyile\u015fme s\u00fcrecine biraz daha zaman tan\u0131r\u0131m.)<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Uzatma h\u0131z\u0131 her kemik b\u00f6lgesinde g\u00fcnde ortalama 1 milimetredir. Femur ve tibia ayn\u0131 anda uzat\u0131ld\u0131\u011f\u0131 i\u00e7in bacak ba\u015f\u0131na g\u00fcnl\u00fck toplam uzama yakla\u015f\u0131k 2 milimetreye ula\u015f\u0131r \u2014 bu, quadrilateral y\u00f6ntemin zaman avantaj\u0131n\u0131n kayna\u011f\u0131d\u0131r. Ancak bu h\u0131z sabit de\u011fildir: 15 g\u00fcnde bir \u00e7ekti\u011fimiz r\u00f6ntgenlerde yeni kemik olu\u015fumunu de\u011ferlendirir, gerekirse h\u0131z\u0131 d\u00fc\u015f\u00fcr\u00fcr veya k\u0131sa ara veririm. Uzatma h\u0131z\u0131n\u0131 kemi\u011fin biyolojisi belirler, takvim de\u011fil.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Uzatma d\u00f6nemi, hedefe ba\u011fl\u0131 olarak genellikle 1.5-3 ay s\u00fcrer. Bu d\u00f6nemde fizyoterapi pazarl\u0131ks\u0131zd\u0131r: d\u00f6rt b\u00f6lgede birden uzayan kas ve tendonlar\u0131n esnekli\u011fini korumak, s\u00fcrecin en kritik i\u015fidir. Fizyoterapiye uyumu zay\u0131f hastalarda eklem sertli\u011fi riski belirgin artar; bu y\u00fczden programa uyumu ameliyat karar\u0131 kadar ciddiye al\u0131r\u0131m.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Kaynama ve Normal Hayata D\u00f6n\u00fc\u015f<\/strong><br><br>Hedeflenen uzamaya ula\u015f\u0131ld\u0131\u011f\u0131nda Kombine\/LON uygulanan b\u00f6lgedeki fiksat\u00f6r\u00fc \u00e7\u0131kar\u0131r\u0131z; kemik i\u00e7indeki \u00e7ivi kaynama boyunca deste\u011fe devam eder. Yeni kemi\u011fin tam olgunla\u015fmas\u0131, uzama miktar\u0131na g\u00f6re 12-15 ay al\u0131r.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Desteksiz y\u00fcr\u00fcy\u00fc\u015fe ge\u00e7i\u015f r\u00f6ntgen bulgular\u0131na g\u00f6re kademeli yap\u0131l\u0131r. Masa ba\u015f\u0131 i\u015flere d\u00f6n\u00fc\u015f uzatma d\u00f6neminde k\u0131s\u0131tl\u0131 olarak m\u00fcmk\u00fcnd\u00fcr; d\u00fczenli \u00e7al\u0131\u015fma hayat\u0131na d\u00f6n\u00fc\u015f genellikle 6. ay civar\u0131ndad\u0131r. Hafif sporlara 8-12 ay, a\u011f\u0131r sporlara 12-15 ay aral\u0131\u011f\u0131nda, mutlaka r\u00f6ntgen kontrol\u00fc ve onay\u0131mla d\u00f6n\u00fcl\u00fcr.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u00c7ivilerin \u00e7\u0131kar\u0131lmas\u0131 konusundaki yakla\u015f\u0131m\u0131m: Kombine\/LON \u00e7ivileri iste\u011fe ba\u011fl\u0131 \u00e7\u0131kar\u0131labilir. Fitbone ve Precice 2 \u00e7ivilerini ise iyile\u015fme tamamland\u0131ktan sonra \u00e7\u0131karmay\u0131 \u00f6neririm; bu sistemler MR ile tam uyumlu olmad\u0131\u011f\u0131 i\u00e7in \u00e7ivinin uzun vadede v\u00fccutta kalmas\u0131n\u0131 tercih etmiyorum.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Prati\u011fimden Bir \u00d6rnek<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Hedefi 13 santimetre olan bir hastam\u0131 \u00f6rnek vereyim. \u0130lk muayenede \u00f6l\u00e7\u00fcmler, tek b\u00f6lgeden bu hedefe ula\u015f\u0131lamayaca\u011f\u0131n\u0131 g\u00f6steriyordu. Oran hesab\u0131nda hem femur hem tibia uzatmas\u0131n\u0131n do\u011fal bir sonu\u00e7 verece\u011fini g\u00f6rd\u00fck ve s\u00fcreci quadrilateral olarak planlad\u0131k: bir b\u00f6lgede i\u00e7ten sistem, di\u011ferinde Kombine\/LON.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Uzatma d\u00f6nemini iki haftada bir r\u00f6ntgen kontrolleriyle takip ettik; kemik olu\u015fumunun yava\u015flad\u0131\u011f\u0131 bir d\u00f6nemde h\u0131z\u0131 ge\u00e7ici olarak d\u00fc\u015f\u00fcrd\u00fck \u2014 bu t\u00fcr ayarlamalar ba\u015far\u0131s\u0131zl\u0131k de\u011fil, s\u00fcrecin do\u011fru y\u00f6netildi\u011finin i\u015faretidir. Fizyoterapi program\u0131na uyumu y\u00fcksek olan hastam, uzatma bitti\u011finde hedefledi\u011fi 13 santimetreye ula\u015ft\u0131; kaynama d\u00f6neminin sonunda desteksiz y\u00fcr\u00fcy\u00fc\u015fe ge\u00e7ti ve bug\u00fcn g\u00fcnl\u00fck ya\u015fam\u0131n\u0131 hi\u00e7bir k\u0131s\u0131tlama olmadan s\u00fcrd\u00fcr\u00fcyor.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bu \u00f6rnekte alt\u0131n\u0131 \u00e7izmek istedi\u011fim nokta \u015fu: sonucu belirleyen tek \u015fey ameliyat de\u011fildi. Do\u011fru planlama, iki haftada bir takip ve hastan\u0131n fizyoterapiye g\u00f6sterdi\u011fi disiplin, en az cerrahi kadar rol oynad\u0131.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Riskler Konusunda D\u00fcr\u00fcst Olal\u0131m<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Quadrilateral ameliyat, tek b\u00f6lge ameliyat\u0131na g\u00f6re daha kapsaml\u0131 bir cerrahidir ve a\u011fr\u0131, kas-tendon gerginli\u011fi, eklem hareket k\u0131s\u0131tl\u0131l\u0131\u011f\u0131 gibi zorluklar d\u00f6rt b\u00f6lgede birden ya\u015fan\u0131r. Bu riskleri y\u00f6netmenin \u00fc\u00e7 arac\u0131 vard\u0131r: do\u011fru hasta se\u00e7imi, do\u011fru y\u00f6ntem kombinasyonu ve disiplinli takip. En az bir b\u00f6lgede i\u00e7ten sistem zorunlulu\u011fum, uzatma h\u0131z\u0131n\u0131 kemi\u011fe g\u00f6re ayarlamam ve iki haftada bir r\u00f6ntgen takibim bu y\u00f6netimin par\u00e7alar\u0131d\u0131r. Do\u011fru planlanan ve do\u011fru takip edilen quadrilateral ameliyatlarda hastalar\u0131m hedefledikleri uzamaya ula\u015farak normal ya\u015famlar\u0131na d\u00f6nmektedir.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>\u0130yile\u015fmeyi H\u0131zland\u0131ran ve Yava\u015flatan Fakt\u00f6rler<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Kemik kaynamas\u0131 yaln\u0131zca ameliyathanede belirlenmez; hastan\u0131n g\u00fcnl\u00fck tercihleri s\u00fcreci do\u011frudan etkiler.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Sigara, listenin ba\u015f\u0131ndad\u0131r. Nikotin damarlar\u0131 daraltarak kemi\u011fe giden kan ak\u0131\u015f\u0131n\u0131 azalt\u0131r; sigara i\u00e7en hastalarda kaynama belirgin yava\u015flar ve kaynamama riski artar. Quadrilateral gibi d\u00f6rt b\u00f6lgede iyile\u015fme isteyen bir cerrahide bu etki katlan\u0131r. Hastalar\u0131mdan ameliyat \u00f6ncesinde sigaray\u0131 b\u0131rakmalar\u0131n\u0131 ve kaynama tamamlanana kadar t\u00fcm nikotin \u00fcr\u00fcnlerinden uzak durmalar\u0131n\u0131 isterim.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Beslenme ikinci b\u00fcy\u00fck fakt\u00f6rd\u00fcr. Yeni kemik \u00fcretimi i\u00e7in protein, kalsiyum ve D vitamini gerekir; D vitamini d\u00fczeyini ameliyat \u00f6ncesi kontrol eder, gerekiyorsa takviye ba\u015flar\u0131m. Dengeli beslenen hastalarla yetersiz beslenenler aras\u0131ndaki kaynama fark\u0131n\u0131 r\u00f6ntgenlerde a\u00e7\u0131k\u00e7a g\u00f6r\u00fcr\u00fcz.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Uyku ve fizyoterapi disiplini kalan iki ba\u015fl\u0131kt\u0131r. Kemik yap\u0131m\u0131 b\u00fcy\u00fck \u00f6l\u00e7\u00fcde dinlenme s\u0131ras\u0131nda ger\u00e7ekle\u015fir; d\u00fczenli uyku, s\u00fcrecin g\u00f6r\u00fcnmez destek\u00e7isidir. Fizyoterapi ise kaslar\u0131n ve eklemlerin uzamaya e\u015flik etmesini sa\u011flar \u2014 program\u0131 aksatan hastada eklem sertli\u011fi, aksatmayanda ak\u0131c\u0131 bir iyile\u015fme g\u00f6r\u00fcr\u00fcm.<\/p>\n\n\n\n<h4 class=\"wp-block-heading has-text-color has-link-color wp-elements-925efd9220b65ca4f0ef2c1a91e94cd8\" style=\"color:#045482\"><strong><strong><strong><strong><strong><strong>Quadrilateral Ameliyat Fiyatlar\u0131<\/strong><\/strong><\/strong><\/strong><\/strong><\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Fiyat, se\u00e7ilen y\u00f6ntem kombinasyonuna g\u00f6re belirlenir. Birlikte \u00e7al\u0131\u015ft\u0131\u011f\u0131m merkezin g\u00fcncel quadrilateral paket aral\u0131klar\u0131 \u015f\u00f6yledir:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Fitbone + Kombine\/LON:<\/strong> 77.000 &#8211; 79.000 USD<br><strong>Precice 2 + Kombine\/LON:<\/strong> 80.000 &#8211; 82.000 USD<br><strong>Fitbone + Fitbone:<\/strong> 105.000 &#8211; 107.000 USD<br><strong>Precice 2 + Fitbone:<\/strong> 109.000 &#8211; 111.000 USD<br><strong>Precice 2 + Precice 2:<\/strong> 113.000 &#8211; 115.000 USD<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bu paketlere ameliyat \u00f6ncesi tetkikler, ameliyathane ve hastane masraflar\u0131, 5-7 g\u00fcn hastanede kal\u0131\u015f, ila\u00e7lar, fizyoterapist deste\u011fi, y\u00fcr\u00fcte\u00e7 ve koltuk de\u011fne\u011fi gibi medikal ekipmanlar, VIP transferler ve Kombine\/LON uygulanan paketlerde fiksat\u00f6r \u00e7\u0131karma ameliyat\u0131 dahildir. Kesin fiyat, muayene ve planlama sonras\u0131nda yaz\u0131l\u0131 teklif olarak payla\u015f\u0131l\u0131r; gizli \u00fccret uygulanmaz.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-link-color wp-elements-b1cc4963b4560f032198450819071a90\" style=\"color:#08659b\">S\u0131k Sorulan Sorular<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<details class=\"wp-block-details is-layout-flow wp-block-details-is-layout-flow\"><summary>Quadrilateral ameliyatla ka\u00e7 santim uzayabilirim?<\/summary>\n<p class=\"wp-block-paragraph\">\u0130ki b\u00f6lgenin birlikte uzat\u0131lmas\u0131yla toplam 12-15 santimetreye kadar uzama m\u00fcmk\u00fcnd\u00fcr. Size \u00f6zel g\u00fcvenli hedefi, muayene ve r\u00f6ntgen de\u011ferlendirmesi sonras\u0131nda birlikte belirleriz.<\/p>\n<\/details>\n\n\n\n<details class=\"wp-block-details is-layout-flow wp-block-details-is-layout-flow\"><summary>\u0130ki ayr\u0131 ameliyat m\u0131, quadrilateral mi daha iyi?<\/summary>\n<p class=\"wp-block-paragraph\">\u0130kisi de ge\u00e7erli yollard\u0131r. Quadrilateral tek anestezi, tek iyile\u015fme s\u00fcreci ve daha k\u0131sa toplam tedavi s\u00fcresi sunar; iki ayr\u0131 ameliyat ise y\u00fck\u00fc zamana yayar. Karar; sa\u011fl\u0131k durumunuza, hedefinize ve ya\u015fam plan\u0131n\u0131za g\u00f6re verilir.<\/p>\n<\/details>\n\n\n\n<details class=\"wp-block-details is-layout-flow wp-block-details-is-layout-flow\"><summary>Ameliyat ka\u00e7 saat s\u00fcr\u00fcyor?<\/summary>\n<p class=\"wp-block-paragraph\">Kombinasyona g\u00f6re yakla\u015f\u0131k 3.5 ile 4.5 saat aras\u0131nda.<\/p>\n<\/details>\n\n\n\n<details class=\"wp-block-details is-layout-flow wp-block-details-is-layout-flow\"><summary>D\u00f6rt kemik ayn\u0131 anda k\u0131r\u0131l\u0131nca y\u00fcr\u00fcyebilecek miyim?<\/summary>\n<p class=\"wp-block-paragraph\">Evet. Hastalar\u0131m ameliyattan birka\u00e7 g\u00fcn sonra y\u00fcr\u00fcte\u00e7 ile destekli y\u00fcr\u00fcmeye ba\u015flar. Uzatma d\u00f6nemi boyunca destekli y\u00fcr\u00fcy\u00fc\u015f s\u00fcrer; desteksiz y\u00fcr\u00fcy\u00fc\u015fe kaynaman\u0131n ilerlemesiyle kademeli ge\u00e7ilir.<\/p>\n<\/details>\n\n\n\n<details class=\"wp-block-details is-layout-flow wp-block-details-is-layout-flow\"><summary>Fiyat bilgisi alabilir miyim?<\/summary>\n<p class=\"wp-block-paragraph\">Yukar\u0131daki paket aral\u0131klar\u0131 g\u00fcncel fiyatlar\u0131m\u0131z\u0131 yans\u0131t\u0131r; kesin rakam, se\u00e7ilen kombinasyona ve ki\u015fisel plana g\u00f6re muayene sonras\u0131nda netle\u015fir. Detayl\u0131 teklif i\u00e7in ileti\u015fim sayfas\u0131 \u00fczerinden bize ula\u015fabilirsiniz.<\/p>\n<\/details>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Bu yaz\u0131 bilgilendirme ama\u00e7l\u0131d\u0131r; ki\u015fisel de\u011ferlendirme ve tedavi planlamas\u0131 i\u00e7in muayene gereklidir.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Boy uzatma cerrahisinde hastalar\u0131m\u0131n en s\u0131k sordu\u011fu sorulardan biri \u015fudur: &#8220;Hocam, hem \u00fcst baca\u011f\u0131m\u0131 hem alt baca\u011f\u0131m\u0131 ayn\u0131 anda uzatabilir miyiz?&#8221; Bu sorunun cevab\u0131 evet; bu ameliyata quadrilateral (d\u00f6rtl\u00fc) boy uzatma diyoruz. Ancak bu evet&#8217;in arkas\u0131nda, hasta g\u00fcvenli\u011fini merkeze alan \u00e7ok net kurallar\u0131m var. Bu yaz\u0131da quadrilateral ameliyat\u0131 nas\u0131l planlad\u0131\u011f\u0131m\u0131, hangi hastaya uygulad\u0131\u011f\u0131m\u0131, hangi kombinasyonlar\u0131 [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":9143,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"yasr_overall_rating":0,"yasr_post_is_review":"","yasr_auto_insert_disabled":"","yasr_review_type":"","footnotes":""},"categories":[4],"tags":[],"class_list":["post-9107","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"acf":[],"yasr_visitor_votes":{"stars_attributes":{"read_only":false,"span_bottom":false},"number_of_votes":0,"sum_votes":0},"_links":{"self":[{"href":"https:\/\/dryunusoc.com\/tr\/wp-json\/wp\/v2\/posts\/9107","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dryunusoc.com\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/dryunusoc.com\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/dryunusoc.com\/tr\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/dryunusoc.com\/tr\/wp-json\/wp\/v2\/comments?post=9107"}],"version-history":[{"count":17,"href":"https:\/\/dryunusoc.com\/tr\/wp-json\/wp\/v2\/posts\/9107\/revisions"}],"predecessor-version":[{"id":9189,"href":"https:\/\/dryunusoc.com\/tr\/wp-json\/wp\/v2\/posts\/9107\/revisions\/9189"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/dryunusoc.com\/tr\/wp-json\/wp\/v2\/media\/9143"}],"wp:attachment":[{"href":"https:\/\/dryunusoc.com\/tr\/wp-json\/wp\/v2\/media?parent=9107"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/dryunusoc.com\/tr\/wp-json\/wp\/v2\/categories?post=9107"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/dryunusoc.com\/tr\/wp-json\/wp\/v2\/tags?post=9107"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}