Erken Tanı Konulması Gereken Bir Kırık: Kollum Femoris Kırığı

Öz

Femur boyun kırığı genç yetişkinlerde sıklıkla yüksek enerjili travmalarla karşımıza çıkar. Bu kırıklar yüksek insidansda avasküler nekroz ve kaynamama oranlarıyla ilişkilidirler. Komplikasyonların önlenmesi için erken teşhis vazgeçilmezdir. Çalışmamızda ilk planda radyolojik bulgularla saptanamayan fakat ilerleyen günlerdeki klinik takiplerde femur boyun kırığı saptanan olgu sunularak konunun önemi vurgulanmıştır. Araç içi trafik kazasıyla acil servise başvuran 36 yaşındaki kadın hastanın sağ kalçasında hassasiyet saptandı. Konvansiyel röntgenografide ve bilgisayarlı tomografide kırık saptanmadı. Klinik takiplerinde aksiyel planda bilgisayarlı tomografide kırık tam olarak saptanamamasına rağmen radyografide kırık saptandı. Genç yaş femur boyun kırıklarında tedavide anahtar nokta erken teşhis ve erken tedavidir. Aksi durumda femur başı avasküler nekrozu ve kaynamama kaçınılmaz olacaktır. Akut ağrılı bir kalçada kırık şüphesi var ise manyetik rezonans görüntüleme ve sintigrafi gibi ileri tetkikler kırığı mükemmel şekilde gösterirler.

Anahtar Kelimeler

• Femur boyun kırığı, erken tanı

A Fracture Need for Early Diagnosis: Femoral Neck Fracture

Abstract

In young adults, femoral neck fractures are usually result from high-energy trauma. These fractures are associated with a higher incidence of avascular necrosis and nonunion rates. Early diagnosis is essential to prevent complications. We present a fracture of femoral neck that could be detected by radiological findings in the first clinical setting but it was detected in the following days and the importance of the issue presented is emphasized. A 36-year-old female patient admitted to the emergency department following a traffic accident.On examination the hip was tender on the right side. There was no fracture on axial plane computed tomography and conventional radiography. Despite computed tomography, fracture could not be detected but in clinical follow-up fracture was seen in plain radiography. For femoral neck fractures in younger patients, early diagnosis and early treatment is the key point. Otherwise, nonunion and avascular necrosis of the femoral head would be inevitable. If the diagnosis of a hip fracture is questionable in an acutely painful hip, bone scanning and magnetic resonance imaging have shown excellent sensitivity in identifying these injuries.

Keywords

• Femoral neck fracture, early diagnosis

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