Motorlu Taşıt Yaralanması Nedeniyle Ekstremite Kırığı Gelişen Çocukların Değerlendirilmesi

Abstract

Amaç: Çocuk Acil Servise motorlu araç kazası nedeniyle başvuran extremite kırığı mevcut olan hastaları, beraberinde ek organ yaralanması olup olmadığını, trvamanın şiddetine göre kırık paternlerini inceleyip değerlendirmeyi amaçladık. Gereç ve Yöntem: Ocak 2015 ve Ocak 2020 tarihleri arasında motorlu araç kazasıyla başvuran ekstremite kırığı olan hastalarda retrospektif olarak yapılmıştır. Veriler IBM SPSS V23 ile analiz edildi. Bulgular: Çalışma süresince Çocuk Acil Servise 205.710 hasta başvurmuş olup, 1.378 (% 0,66)’i motorlu taşıt yaralanmasıdır. Bu olgularında 161 (%0,08)’i ekstremite kırığı nedeniyle değerlendirilmiştir. Olguların yaş ortalaması 133 ay (minimum:3; maksimum:218ay) dır ve 90 (%56) olgu erkektir. Travma şekli daha çok ADTK(%50) idi. %55 i yüksek enerjili travmaydı. Alt extremite kırıklarından en sık görüleni tibia (%26) kırığıydı. Üst extremitede kırıklarından en sık görüleni humerus (%16) ve radius (%16) kırıklarıydı. Pelvis krığı olan hastaların %65 inde başka organ yaralanması vardı.(p<0,05). Hastaların büyük kısmına(%66) tedavide atel uygulanırken, %26 sına cerrahi operasyon yapılmıştır. Femur kırığı olanların %68 ine, tibia kırığı olanların %43 üne cerrahi tedavi uygulandı(p<0,05). Hastaların % 50,3 ü acilden taburcu edildi. Alt extremite kırığı ADTK(%66) ve motosiklet kazası(%60) sonucu daha çok görülürken, Üst extremite kırığı AİTK(%54) sonucu daha çok görüldü(p<0,05). Sonuç: Motorlu taşıt kazalarında extremite kırıklarının incelendiği literatür çok kısıtlı olduğundan, verilerde çok sınırlıdır. Özellikle motorlu araç sonrası gelişen extremite kırıkları sakatlıklar ve ölümlerin önemli bir nedeni ve hastanede kalış ve hastane maliyeti açısından da hem ailelere hem de devlete ağır bir yük oluşturur.

Keywords

• çocuk acil
• motorlu araç yaralanması
• ekstremite kırıkları

Evaluation of Children with Extremity Fracture Occurred as a Result of Motor Vehicle Injury

Abstract

Aim: The aim of the study was to examine and evaluate patients with extremity fractures who admitted to the Pediatric emergency service due to a motor vehicle accident, whether there was any accompanying additional organ injury, and fracture patterns according to the severity of the trauma.

Material and Method: The study was conducted between January 2015 and 2020 retrospectively. Relevant data were analyzed with IBM SPSS V23 statistics.

Results: Of the 205.710 patients who admitted to Pediatric emergency service in the course of this study, 1.378 (0.66%) experienced motor vehicle injuries. 161 (0.08%) of these cases were evaluated on the grounds of extremity fractures. Mean age of the cases were 133 months (minimum: 3, maximum: 2018 months) and 90 (56%) cases were male. Trauma type was mostly outside-vehicle traffic accident (50%). 55% of the cases were severe mechanism of injury. The most common lower extremity fracture type was the tibia (26%) fracture. The most common fractures in the upper extremity were humerus (16%) and radius (16%) fractures. Of the patients with pelvis fracture, 65% had other types of organ injuries (p<0,05). Surgical treatment was admitted to 68% of those with femoral fractures and 43% of those with tibia fractures (p <0.05). While lower extremity fractures were more common in outside-vehicle traffic accident (66%) and motorcycle accident (60%), upper extremity fracture was more common in intra-vehicle traffic accident (54%) (p <0.05).

Conclusion: Since the literature evaluating the extremity fractures in motor vehicle accidents is very limited, relevant data are also very limited. Extremity fractures that occur especially after motor vehicles are an important cause of injuries and deaths, and impose a heavy burden upon both families and the government in terms of hospital stay and hospital costs.

Keywords

• pediatric emergency
• motor vehicle injury
• extremity fractures

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