Acil servise başvuran ayak ve ayak bileği travmalı hastalarda tedavi seçeneklerinin X-ray ve bilgisayarlı tomografi bulgularına göre karşılaştırılması

Year 2025, Volume: 3 Issue: 3, 122 - 129, 29.10.2025

Burcu Özen Karabulut , Mehmet Reşit Öncü

https://doi.org/10.61845/agrimedical.1787537

Abstract

Amaç: Bu çalışmada, ayak ve/veya ayak bileği travması ile acil servise başvuran hastalarda direkt radyografi (X-ray) ve bilgisayarlı tomografinin (BT) patolojik bulguları saptamadaki farklılıklarının, tedavi gereksinimi ve değişimini öngörmedeki rolü araştırıldı.
Gereçler ve Yöntemler: Çalışma, Van Yüzüncü Yıl Üniversitesi Tıp Fakültesi Acil Servisi’nde 1 Ocak 2017–31 Aralık 2019 tarihleri arasında gerçekleştirildi. Ayak ve/veya ayak bileği travması olan hastaların BT ve X-ray sonuçları ile klinik verileri retrospektif olarak değerlendirildi.
Bulgular: Görüntüleme sonuçlarına göre hastaların %8,9’unda yalnızca BT’de, %24,9’unda ise hem X-ray hem BT’de patoloji saptanırken geri kalan grupta görüntüleme sonuçları normaldi. Hem X-ray hem BT’de patoloji bulunan olgularda Glasgow Koma Skoru ortalaması daha düşük saptandı (p=0,018). Yalnızca BT’de patoloji tespit edilen olgular, daha sık alçı/atel ile tedavi edilirken; her iki görüntülemede patoloji saptananlarda cerrahi girişim oranı anlamlı olarak daha yüksekti (p<0,001). Ayrıca sadece BT’de patoloji saptanan olgularda tedavi değişikliği gereksinimi diğer gruplara göre belirgin şekilde fazlaydı (p<0,001).
Sonuç: Acil serviste ayak ve ayak bileği travmalarının yönetiminde doğru görüntüleme yönteminin seçilmesi, tanısal doğruluğu artırarak uygun tedaviye yön vermede kritik bir rol oynar. Özellikle X-ray ile saptanamayan patolojilerin BT ile ortaya konması, başvuru anında uygulanacak tedavi seçeneğinin belirlenmesinde yol gösterici olmasının yanı sıra tedavi değişikliği gereksinimini öngörmede de önemli katkı sağlayabilir.

Keywords

Acil servis , Ayak travması , Ayak bileği travması , Radyografi , Bilgisayarlı tomografi

Ethical Statement

Çalışma için Van Yüzüncü Yıl Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu’ndan 12/02/2021 tarihli ve 2021/02-10 sayılı onay alındı. Araştırma Helsinki Bildirgesi ilkelerine uygun olarak yürütüldü ve hastaların kişisel verileri gizlilik ilkesi çerçevesinde korundu.

Supporting Institution

Bu çalışma için herhangi bir mali destek alınmamıştır. Yazarların çıkar çatışması bulunmamaktadır.

Comparison of treatment options based on X-ray and computed tomography findings in patients presenting to the emergency department with foot and ankle trauma

Abstract

Aim: This study investigated the differences between direct radiography (X-ray) and computed tomography (CT) in detecting pathological findings in patients presenting to the emergency department with foot and/or ankle trauma and evaluated their role in predicting treatment requirements and modifications.
Materials and Methods: The study was conducted at the Emergency Department of Van Yüzüncü Yıl University Faculty of Medicine between January 1, 2017, and December 31, 2019. CT and X-ray results, along with clinical data of patients with foot and/or ankle trauma, were retrospectively analyzed.
Results: Imaging revealed pathology only on CT in 8.9% of cases, on both CT and X-ray in 24.9%, while the remaining patients had normal imaging results. The mean Glasgow Coma Scale score was significantly lower in patients with pathology detected on both modalities (p = 0.018). Patients with CT-only findings were more frequently treated with splinting/casting, whereas surgical intervention rates were significantly higher in those with pathology on both imaging modalities (p < 0.001). Furthermore, the need for treatment modification was markedly greater in patients with CT-only pathology compared to other groups (p < 0.001).
Conclusion: In the management of foot and ankle trauma in the emergency setting, selecting the appropriate imaging modality plays a critical role in enhancing diagnostic accuracy and guiding proper treatment. Particularly, CT is valuable in detecting injuries missed by X-ray, not only informing initial treatment decisions at admission but also providing important predictive value for subsequent treatment modifications.

Keywords

Emergency department , Foot trauma , Ankle trauma , Radiography , Computed tomography

Ethical Statement

The study was approved by the Van Yüzüncü Yıl University Non-Interventional Clinical Research Ethics Committee (Date: 12/02/2021, Decision No: 2021/02-10). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Supporting Institution

Financial Disclosure The authors received no financial support for the research, authorship and publication of this article.

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