Gebelerde Travmaya Bağlı Tibia Kırıklarının Analizi

Abstract

Amaç: Bizim hastanemiz ilimizdeki en kapsamlı kadın hastalıkları ve doğum kliniğine sahiptir ve travmalı gebelerin tedavisi hastanemizde yoğun bir şekilde yapılmaktadır. Bu yüzden bu çalışmada özellikle tibia kırığı olan gebeleri, bu gebelerin tedavisini ve anne bebek sağlığı açısından sonuçlarını değerlendirmeyi amaçladık. Materyal ve Metot: Bu çalışma Ocak 2017 ile Ekim 2019 arasında retrospektif olarak planlandı. Hastanemizde travma sonrası tibia kırığı olan ve ameliyat edilen gebe hastalar dahil edildi. Hastaların demografik özellikleri, ameliyat sırasındaki verileri ve maternal-fetal sonuçları analiz edildi. Bulgular: Çalışma kriterlerine uyan onbir gebe tespit edildi. Hastalardan ikisinde araç içi trafik kazası sonrası tibia kırığı olurken diğer dokuz hastada düşme sonrası tibia kırığı olduğu saptandı. Tibia kırığı nedeniyle cerrahi tedavi uygulanan onbir gebenin hiçbirinde travma veya ortopedik ameliyat nedenli gebelik komplikasyonu tespit edilmedi. Sonuç: Gebe hastalarda travma sonrası non-obstetrik nedenli ameliyat durumları multidisipliner bir yaklaşım ve deneyimli bir ekip ile komplikasyon oranı çok azaltılarak yönetilebilir. Çalışmamızda gösteriyor ki gebe hastalarda tibia kırığı nedenli ameliyatlar maternal/ fetalmortalite ve morbidite gelişmeden deneyimli bir ekiple başarılı şekilde tedavi edilebilir.

Keywords

• gebelik
• tibia kırığı; gebelerde operasyon
• gebelik, tibia kırığı; gebelerde operasyon

Analysis of Tibial Fractures and Treatment After Trauma in Pregnant Women

Abstract

Aim: Our hospital has the most comprehensive obstetrics clinic in our province, and the treatment of pregnant women with trauma is performed intensively in our hospital. In this study, we aimed to evaluate pregnant women with tibial fractures, the treatment of these pregnant women, and their maternal and fetal health outcomes. Material and Method: This study was conducted as a retrospective trial between January 2017 and October 2019. Pregnant women with tibia fractures who were operated on in our hospital were included. Their demographic features, data during surgery, and maternal-fetal outcomes were analyzed. Results: Eleven patients who met the study criteria were identified. Two patients had a tibia fracture after a traffic accident, and the other nine patients had a tibia fracture after a fall. None of the eleven pregnant women who underwent surgical treatment for tibial fractures had pregnancy complications due to trauma or orthopedic surgery. Conclusion: Posttraumatic non-obstetric surgery conditions in pregnant patients can be managed with a multidisciplinary approach and an experienced team by reducing the complication rate. Our study shows that tibial fracture operations in pregnant patients can be successfully treated with a professional team before maternal/fetal mortality and morbidity develops.

Keywords

• pregnancy
• tibia fracture
• surgery in pregnant women

References

1. 1. Barraco RD, Chiu WC, Clancy TV, Como JJ, Ebert JB, Heis LW, et al. Practice management guidelines for diagnosing and managing injury in the pregnant patient: the EAST Practice Management Guidelines Work Group. Journal of Trauma and Acute Care Surgery. 2010;69(1):211–4.
2. 2. D’Amico CJ. Trauma in pregnancy. Top Emerg Med. 2002;24:26–39.
3. 3. Flik K, Kloen P, Toro JB, Urmey W, Nijhuis JG, Helfet DL. Orthopaedic trauma in the pregnant patient. JAAOSJournal of the American Academy of Orthopaedic Surgeons. 2006;14(3):175–82.
4. 4. Sorbi, F, Sisti G, Tommaso M, Fambrini M. Traumatic tibia and fibula fracture in a 36 weeks’ pregnant patient: a case report. Ochsner Journal. 2013;13(4):547–9.
5. 5. Reston VA. ACR-SPR practice parameter for imaging pregnant or potentially pregnant adolescents and women with ionizing radiation. American College of Radiology. 2013.
6. 6. Gjelsteen AC, Ching BH, Meyerman MW, Prager DA, Murphy TF. Berkey BD, et al. CT, MRI, PET, PET/CT, and ultrasound in the evaluation of obstetric and gynecologic patients. Surgical Clinics of North America. 2008;88(2):361–90.
7. 7. Kress HG. Effects of general anesthetics on second Messenger systems. European Journal of Anaesthesiology. 1995;12(1):83–97.
8. 8. Reitman EP. Flood. Anesthetic considerations for non-obstetric surgery during pregnancy. British Journal of Anesthesia. 2011;107(1):72–8.

9. 9. El-Kady D, Gilbert WM, Xing G, Smith LH. Association of maternal fractures with adverse perinatal outcomes. American Journal of Obstetrics and Gynecology. 2006;195(3):711–6.
10. 10. Ali J, Yeo A, Gana T. J, McLellan B. A. Predictors of fetal mortality in pregnant trauma patients. Journal of Trauma and Acute Care Surgery. 1997;42(5):782–5.
11. 11. Niall P, Mcgoldrick C, Green N, Burke C, Mccormack QD. Pregnancy and the orthopedic patient. Orthopedics and Trauma. 2012;26(3):212–9.