2023 Kahramanmaraş Depremleri Sonrası Protez Uygulanması Amacıyla Başvuran Ampute Çocukların Değerlendirilmesi

Öz

Ülkemiz tarihindeki en yıkıcı doğal afet olan 2023 Kahramanmaraş depremleri en savunmasız yaş grubunu oluşturan çocuklarda çeşitli travmatik yaralanmalara neden olmuştur. Kalıcı ve uzun dönem etkileri düşünüldüğünde amputasyonlar oldukça önemlidir. Ancak literatürde bu konudaki veriler kısıtlıdır. Bu çalışmada deprem ilişkili ampute çocukların sosyodemografik ve klinik verileri ile protez reçeteleme süreçleri değerlendirilmiştir. Depremle ilişkili uzuv kaybı olan 18 yaş ve altı çocuklar dahil edilmiştir. Hastaların sosyodemografik verileri, birinci derece yakın kayıpları, eşlik eden yaralanmaları, amputasyon ve protezle ilişkili verileri kaydedilmiştir. 86 ampute çocuğun ortanca yaşları 12,0 (min-maks=1-18) idi. Çocukların %87,2’sinde birinci derece yakın kaybı mevcuttu. %53,5’i depremi yaşadıkları yerden farklı bir ilde yaşamaya başlamıştı. Yumuşak doku defekti (n=77), periferik sinir hasarı (n=17), ezilme yaralanması (n=11) eşlik eden en sık yaralanmalardı. Toplam 103 amputasyonun %68,9’u alt ekstremitedeydi. En sık görülen amputasyon seviyeleri sırasıyla transtibial amputasyon (%27,2), transfemoral amputasyon (%24,3), transhumeral amputasyon (%15,5) ve diz dezartikülasyonu (%6,8) idi. Amputasyon sonrası protez uygulanana kadar geçen süre 159,71±46,8 gündü. Toplam 103 ampute uzuv için 81 protez (54 alt ekstremite, 27 üst ekstremite) reçete edildi. Depremle ilişkili amputasyonlar ağır fiziksel ve psikososyal sonuçlara neden olmaktadır. Bu etkileri en aza indirebilmek için ampute çocukların en kısa sürede multidisipliner ekip tarafından çok yönlü bakış açısıyla değerlendirilmesi büyük önem taşımaktadır. Sonuçlarımız gelecekte yaşanacak olası afetlere yönelik hazırlık, müdahale ve iyileştirme politikalarının geliştirilmesine rehberlik edecektir.

Anahtar Kelimeler

• Deprem
• amputasyon
• çocuk
• protez

Evaluation of Pediatric Amputees Admitted for Prosthesis Application After the 2023 Kahramanmaraş Earthquakes

Öz

The 2023 Kahramanmaraş earthquakes, most devastating natural disaster in our history, caused various traumatic injuries in children, who constitute the most vulnerable age group. Given their permanent and long-term effects, amputations are of great importance. However, the literature contains limited data on this subject. In the current study, sociodemographic and clinical data and prosthetic prescribing processes of children with earthquake-related limb loss were evaluated. Children aged 18 years and younger were included. Sociodemographic data, death of first-degree relatives, concomitant injuries, amputations, and prosthesis-related data were recorded. The median age of 86 amputee children was 12.0 (min-max=1-18) years. 87.2% of children had lost their first-degree relative(s). 53.5% had started living in a different province from where they experienced the earthquake. Soft tissue defects (n=77), peripheral nerve injuries (n=17),and crush injuries (n=11) were the most common concomitant injuries. Of the total 103 amputations, 68.9% were in the lower extremity. The most common amputation levels were transtibial amputation (27.2%), transfemoral amputation (24.3%), transhumeral amputation (15.5%), and knee disarticulation (6.8%), respectively. Time from amputation to prosthesis application was 159.71±46.8 days. 81 prostheses (54 lower limbs, 27 upper limbs) were prescribed for 103 amputations. Earthquake-related amputations cause severe physical and psychosocial consequences. It is of great importance that amputee children are evaluated by a multidisciplinary team at the earliest possible time to mitigate these effects. Our results will guide the establishment of policies regarding preparedness, intervention, and recovery for possible future disasters.

Anahtar Kelimeler

• Earthquake
• amputation
• child
• prosthesis

Kaynakça

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