Düşük Enerjili Kalça Kırıklarında Pelvis BT’nin Tanısal Katkısı: 451 Hastanın Retrospektif Analizi

Öz

Kalça kırıkları, ileri yaşta morbidite ve mortaliteyi artıran önemli bir sağlık sorunudur. Düşük enerjili travma sonrası kalça kırıklarında pelvik yaralanmaların sıklığı sınırlı olmakla birlikte, rutin pelvis bilgisayarlı tomografi (BT) çekiminin gerekliliği tartışmalıdır. 2019-2023 yılları arasında Eskişehir Şehir Hastanesi Acil Servisi’ne başvuran ve kalça kırığı (femoral boyun - trokanter)  tanısı alan 451 hasta retrospektif olarak değerlendirildi. Pelvis BT görüntüleri radyologlar tarafından raporlandı ve  iki ortopedist tarafından bağımsız olarak incelendi. BT çekim oranları ve pelviste patoloji saptanma durumu; yaş, cinsiyet ve kırık alt tiplerine (femur boyun- trokanterik) göre analiz edildi. Hastaların ortalama yaşı 76,2 ± 9,5 yıl olup, %58,5’i kadın, %41,5’i erkekti. Pelvis BT çekilme oranı %36,1 olarak bulundu. BT görüntülemelerinin %99,4’ünde normal bulgular mevcutken, yalnızca 1 hastada (%0,6) pelviste patolojik bulgu saptandı. Femur boyun ve trokanterik kırıklarda BT çekim oranları sırasıyla %41,8 ve %34,6 idi (p=0,185). Kadınlarda BT çekilme oranı erkeklere göre anlamlı olarak daha yüksek bulundu (p=0,023). Yaş ve kırık alt tipinin BT çekim oranı üzerinde anlamlı etkisi saptanmadı. Düşük enerjili kalça kırıklarında rutin pelvis BT çekiminin tanısal katkısı sınırlıdır. BT yalnızca klinik şüphe veya tanısal belirsizlik durumlarında endike olmalıdır. Görüntüleme endikasyonu klinik değerlendirme ve fizik muayene bulgularına dayandırılmalıdır.

Anahtar Kelimeler

• Kalça kırığı
• femur boyun kırığı
• trokanterik kırık
• pelvis
• bilgisayarlı tomografi

The Diagnostic Value of Pelvic CT in Low-Energy Hip Fractures: A Retrospective Analysis of 451 Patients

Öz

Hip fractures are a major health problem that increase morbidity and mortality in the elderly. Although the incidence of concomitant pelvic injuries after low-energy trauma is relatively low, the necessity of routine pelvic computed tomography (CT) remains controversial. A total of 451 patients who were admitted to the Emergency Department of Eskişehir City Hospital between 2019 and 2023 and diagnosed with hip fracture (femoral neck or trochanteric) were retrospectively evaluated. Pelvic CT scans were reported by radiologists and independently reviewed by two orthopedic surgeons. The rates of CT imaging and the presence of pelvic pathology were analyzed according to age, sex, and fracture subtype (femoral neck or trochanteric). The mean age of the patients was 76.2 ± 9.5 years; 58.5% were female and 41.5% were male. The overall rate of pelvic CT imaging was 36.1%. CT findings were normal in 99.4% of the cases, and only one patient (0.6%) had a pathological finding in the pelvis. The CT imaging rates were 41.8% in femoral neck fractures and 34.6% in trochanteric fractures (p = 0.185). Female patients had a significantly higher rate of CT imaging compared to males (p = 0.023). Age and fracture subtype had no significant effect on CT imaging frequency. The diagnostic value of routine pelvic CT in low-energy hip fractures is limited. CT should be performed only in cases of clinical suspicion or diagnostic uncertainty. The indication for imaging should be based on clinical evaluation and physical examination findings.

Anahtar Kelimeler

• Hip fracture
• femoral neck fracture
• trochanteric fracture
• pelvis
• computed tomography

Kaynakça

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