Ekstremitelerde Depremle İlişkili Periferik Sinir Yaralanmalarının Tanımlayıcı Özellikleri ve Yaralanma Paternleri

Year 2024, Volume: 34 Issue: 1, 27 - 31, 29.02.2024

Mehmet Ozel , Mustafa Altıntaş

https://doi.org/10.54005/geneltip.1322059

Abstract

Amaç: Sağlık ekipler tarafından ekstremite ve hayat kurtarma çabalarının önceliklendirilmesi nedeniyle, depremlerden kaynaklanan periferik sinir yaralanmaları (PSY), sıklıkla göz ardı edilmekte veya tedavileri gecikmektedir. Bu nedenle, depreme bağlı PSY'leri tanımlayıcı özellikleri ve yaralanma paternleri açısından inceledik.
Yöntemler: Çalışma, Kahramanmaraş Depremleri sonrasında bir üçüncü basamak hastanede retrospektif olarak yürütüldü. Çalışmaya 06 Şubat ve 28 Şubat 2023 tarihleri arasında hastaneye kabul edilen ve tıbbi kayıtlarına göre PSY tanısı konulan enkaz altında kalan mağdurlar dahil edildi.
Sonuçlar: Çalışmaya 70 hasta ve toplamda 98 ekstremitede PSY olan hastalar dahil edildi ve hastaların yaş ortalaması 22.31±14.91 yıldı. PSY'lerin %77.6'sı (n=76) alt ekstremiteyi (68 peroneal ve 8 siyatik sinir) etkilerken, PSY'lerin %22.4'ü (n=22) üst ekstremiteyi (14 radial sinir, 5 ulnar sinir, 2 median sinir, 1 brakiyal pleksus) etkilediği bulundu. PSY'lerin %45.9'unun (n=45) sağ ekstremitede, %54.1'inin (n=53) sol ekstremitede meydana geldiği saptandı. Hastaların enkaz altında geçirdiği medyan süre 15 saat (IQR 8.75 - 32 saat) idi. PSY olan ekstremitelerin %54.1'inde (n=43) fasiotomi tedavisi uygulandı. Fasiotomiler en sık olarak krus (42.9%), ayak (26.5%) ve uyluk (16.3%) üzerinde gerçekleştirildi.
Tartışma: Bu çalışmada, deprem mağdurlarında PSY'lerin, üst ekstremitelere kıyasla alt ekstremitelerde daha sık meydana geldiğini bulunmuştur. Alt ekstremite PSY'leri genellikle peroneal sinirde, üst ekstremite PSY'leri ise genellikle radial sinirde meydana geldiği bulunmuştur.

Keywords

Ezilme yaralanması, Periferik sinir yaralanması, Deprem, Mağdurlar, Ekstremite

Descriptive Characteristics and Injury Patterns of Earthquake-Related Peripheral Nerve Injuries in the Extremities

Abstract

Background/Aims:Due to the prioritization of limb and life-saving efforts by medical teams, peripheral nerve injuries (PNIs) resulting from earthquakes are frequently overlooked or receive delayed treatment. Thus, we examined earthquake-related PNIs in terms of their descriptive characteristics and injury patterns
Methods: The study was conducted retrospectively in a tertiary hospital after Kahramanmaraş Earthquakes. The study included victims under rubble admitted to the hospital and diagnosed with PNI according to their medical records between 06 February and 28 February 2023.
Results: The study included 70 patients and a total of 98 limbs with PNIs, with a mean patient age of 22.31±14.91 years. 77.6% (n=76) of PNIs involved the lower limb (68 peroneal and 8 sciatic nerves) and 22.4% (n=22) of PNIs involved the upper limbs (14 radial nerves, 5 ulnar nerves, 2 median nerves, 1 brachial plexus). It was found that 45.9% of PNIs (n=45) occurred in the right and 54.1% (n=53) in the left extremities. The median time under the rubble of the patients was 15 hours (IQR 8.75 - 32 hours). Fasciotomy was treated in 54.1% (n=43) of the extremities with PNI. Fasciotomies were most commonly performed on the cruris (42.9%), foot (26.5%), and thigh (16.3%).
Conclusion: This study found that PNIs occurred most frequently in the lower limbs, compared with the upper limbs, among earthquake victims with CLIs. Lower limb PNIs mainly occurred in the peroneal nerve, while upper limb PNIs mainly occurred in the radial nerve.

Keywords

Crush injury, Peripheral nerve injury, Earthquake, Victims, Extremity

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