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Motorlu Taşıt Yaralanması Nedeniyle Ekstremite Kırığı Gelişen Çocukların Değerlendirilmesi

Yıl 2021, Cilt 9, Sayı 2, 66 - 72, 31.08.2021
https://doi.org/10.21765/pprjournal.973133

Öz

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.

Kaynakça

  • 1.Pratt SG, Bell JL. Analytical observational study of nonfatal motor vehicle collisions and incidents in a light-vehicle sales and service fleet. Accid Anal Prev. 2019;129:126-135.
  • 2.The top 10 causes of death: the 10 leading causes of death in the world, 2000 and 2011. Geneva (Switzerland): World Health Organization; updated 2013 (accessed 2011 June 9); Available: www.who.int/mediacentre/factsheets/fs310/en/index.html
  • 3.Rubin G, Peleg K, Givon A, et al. Upper extremity fractures among hospitalized road traffic accident adults. Am J Emerg Med. 2015;33(2):250-253.
  • 4. Ngunde PJ, Akongnwi ACN, Mefire CA, et al. Prevalence and pattern of lower extremity injuries due to road traffic crashes in Fako Division, Cameroon. Pan Afr Med J. 2019 30;32:53
  • 5. Craig, A., Tran, Y., Guest, R, et al. 2016. Psychological impact of injuries sustained in motor vehicle crashes: systematic review and meta-analysis. BMJ open, 6(9), e011993.
  • 6. Wang H, Zhou Y, Liu J, et al. Traumatic fractures as a result of motor vehicle collisions in children and adolescents. Int Orthop. 2018;42(3):625-630.
  • 7. Omoke N, Ekumankama FO. Incidence and Pattern of Extremity Fractures seen in Accident and Emergency Department of a Nigerian Teaching Hospital. Niger J Surg.2020 ;26(1):28-34.
  • 8. Carson S, Woolridge DP, Colletti J, et al. Pediatric upper extremity injuries. Pediatr Clin North Am. 2006 ;53(1):41-67, v.
  • 9. Srinivasan S, Chang T. Diagnosis and management of motor vehicle trauma in children: an evidence-based review. Pediatr Emerg Med Pract. 2013;10(8):1-26
  • 10. Kuppermann N, Holmes JF, Dayan PS, Hoyle JD Jr, Atabaki SM, Holubkov R, et al. Pediatric Emergency Care Applied Research Network (PECARN). Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009 3;374(9696):1160-70.
  • 11. Drucker NA, McDuffie L, Groh E, et al. Physical Examination is the Best Predictor of the Need for Abdominal Surgery in Children Following Motor Vehicle Collision. J Emerg Med. 2018;54(1):1-7.
  • 12. Nuñez-Samudio V, Jaramillo-Morales J, Landires I. Prevalence and characteristics of child victims in motor vehicle collisions in Panama. Traffic Inj Prev. 2016 18;17(4):391-3
  • 13. Wang H, Zhou Y, Liu J, et al .Injury. Traumatic skull fractures in children and adolescents: A retrospective observational study. 2018 ; 49(2):219-225
  • 14. Uslu MM, Uslu R. Extremity fracture characteristics in children with impulsive/hyperactive behavior. Arch Orthop Trauma Surg. 2008;128(4):417-21.
  • 15. Joeris A, Lutz N, Wicki B, et al. An epidemiological evaluation of pediatric long bone fractures - a retrospective cohort study of 2716 patients from two Swiss tertiary pediatric hospitals. BMC Pediatr. 2014 20;14:314
  • 16. Lempesis V, Rosengren BE, Nilsson JÅ, et al. Time trends in pediatric fracture incidence in Sweden during the period 1950-2006. Acta Orthop. 2017 ;88(4):440-445.
  • 17. Naranje SM, Erali RA, Warner WC Jr,et al. Epidemiology of Pediatric Fractures Presenting to Emergency Departments in the United States. J Pediatr Orthop. 2016 ;36(4):e45-8.
  • 18. Loder RT, O'Donnell PW, Feinberg JR. Epidemiology and mechanisms of femur fractures in children. J Pediatr Orthop. 2006;26(5):561-6.
  • 19. Engström Z, Wolf O, Hailer YD. Epidemiology of pediatric femur fractures in children: the Swedish Fracture Register. BMC Musculoskelet Disord. 2020 1;21(1):796
  • 20. Zwingmann J, Aghayev E, Südkamp NP, et al. Pelvic Fractures in Children Results from the German Pelvic Trauma Registry: A Cohort Study. Medicine (Baltimore). 2015;94(51):e2325.
  • 21. Niedzielski KR, Guzikiewicz N, Małecki K,et al. Pelvic fractures in children and adolescents in polytrauma and high-energy injuries. Ortop Traumatol Rehabil. 2013;15(1):41-8.
  • 22. Hermans E, Cornelisse ST, Biert J, et al. Paediatric pelvic fractures: how do they differ from adults? Journal of Children's Orthopaedics 2017 11:1, 49-56
  • 23. A. Gänsslen, N. Heidari, A.M. WeinbergFractures of the pelvis in children: a review of the literature .Eur J Orthopaed Surg Traumatol,2013, pp. 1-5
  • 24. Turgut A, Kalenderer O, Gunaydin B,et al. Demographic Characteristics of Paediatric Pelvic Fractures: 10-Years' Experience of Single Paediatric Orthopaedics Clinic. Eurasian J Med. 2015;47(2):130-134.)
  • 25. Chotai N, Alazzawi S, Zehra SS, et al. Paediatric pelvic fractures: A review of 2 cohorts over 22 years. Injury. 2018;49(3):613-617.
  • 26. Tosounidis, T. H., Sheikh, H., & Giannoudis, P. V. (2015). Pelvic Fractures in Paediatric Polytrauma Patients: Classification, Concomitant Injuries and Early Mortality. The open orthopaedics journal, 9, 303–312.
  • 27. Shaath MK , Koury KL , Gibson PD , et al. Associated injuries in skeletally immature children with pelvic fractures. J Emerg Med, 51 2016, pp. 246-251
  • 28. Landy DC, Norton RA, Barkin JA, et al. Upper extremity fractures in pedestrian versus motor vehicle accidents: an underappreciated concern. Iowa Orthop J. 2010;30:99-102.
  • 29. Odatuwa-Omagbemi DO. Open fractures: epidemiological pattern, initial management and challenges in a sub-urban teaching hospital in Nigeria. Pan Afr Med J. 2019;33:234

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

Yıl 2021, Cilt 9, Sayı 2, 66 - 72, 31.08.2021
https://doi.org/10.21765/pprjournal.973133

Öz

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.

Kaynakça

  • 1.Pratt SG, Bell JL. Analytical observational study of nonfatal motor vehicle collisions and incidents in a light-vehicle sales and service fleet. Accid Anal Prev. 2019;129:126-135.
  • 2.The top 10 causes of death: the 10 leading causes of death in the world, 2000 and 2011. Geneva (Switzerland): World Health Organization; updated 2013 (accessed 2011 June 9); Available: www.who.int/mediacentre/factsheets/fs310/en/index.html
  • 3.Rubin G, Peleg K, Givon A, et al. Upper extremity fractures among hospitalized road traffic accident adults. Am J Emerg Med. 2015;33(2):250-253.
  • 4. Ngunde PJ, Akongnwi ACN, Mefire CA, et al. Prevalence and pattern of lower extremity injuries due to road traffic crashes in Fako Division, Cameroon. Pan Afr Med J. 2019 30;32:53
  • 5. Craig, A., Tran, Y., Guest, R, et al. 2016. Psychological impact of injuries sustained in motor vehicle crashes: systematic review and meta-analysis. BMJ open, 6(9), e011993.
  • 6. Wang H, Zhou Y, Liu J, et al. Traumatic fractures as a result of motor vehicle collisions in children and adolescents. Int Orthop. 2018;42(3):625-630.
  • 7. Omoke N, Ekumankama FO. Incidence and Pattern of Extremity Fractures seen in Accident and Emergency Department of a Nigerian Teaching Hospital. Niger J Surg.2020 ;26(1):28-34.
  • 8. Carson S, Woolridge DP, Colletti J, et al. Pediatric upper extremity injuries. Pediatr Clin North Am. 2006 ;53(1):41-67, v.
  • 9. Srinivasan S, Chang T. Diagnosis and management of motor vehicle trauma in children: an evidence-based review. Pediatr Emerg Med Pract. 2013;10(8):1-26
  • 10. Kuppermann N, Holmes JF, Dayan PS, Hoyle JD Jr, Atabaki SM, Holubkov R, et al. Pediatric Emergency Care Applied Research Network (PECARN). Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009 3;374(9696):1160-70.
  • 11. Drucker NA, McDuffie L, Groh E, et al. Physical Examination is the Best Predictor of the Need for Abdominal Surgery in Children Following Motor Vehicle Collision. J Emerg Med. 2018;54(1):1-7.
  • 12. Nuñez-Samudio V, Jaramillo-Morales J, Landires I. Prevalence and characteristics of child victims in motor vehicle collisions in Panama. Traffic Inj Prev. 2016 18;17(4):391-3
  • 13. Wang H, Zhou Y, Liu J, et al .Injury. Traumatic skull fractures in children and adolescents: A retrospective observational study. 2018 ; 49(2):219-225
  • 14. Uslu MM, Uslu R. Extremity fracture characteristics in children with impulsive/hyperactive behavior. Arch Orthop Trauma Surg. 2008;128(4):417-21.
  • 15. Joeris A, Lutz N, Wicki B, et al. An epidemiological evaluation of pediatric long bone fractures - a retrospective cohort study of 2716 patients from two Swiss tertiary pediatric hospitals. BMC Pediatr. 2014 20;14:314
  • 16. Lempesis V, Rosengren BE, Nilsson JÅ, et al. Time trends in pediatric fracture incidence in Sweden during the period 1950-2006. Acta Orthop. 2017 ;88(4):440-445.
  • 17. Naranje SM, Erali RA, Warner WC Jr,et al. Epidemiology of Pediatric Fractures Presenting to Emergency Departments in the United States. J Pediatr Orthop. 2016 ;36(4):e45-8.
  • 18. Loder RT, O'Donnell PW, Feinberg JR. Epidemiology and mechanisms of femur fractures in children. J Pediatr Orthop. 2006;26(5):561-6.
  • 19. Engström Z, Wolf O, Hailer YD. Epidemiology of pediatric femur fractures in children: the Swedish Fracture Register. BMC Musculoskelet Disord. 2020 1;21(1):796
  • 20. Zwingmann J, Aghayev E, Südkamp NP, et al. Pelvic Fractures in Children Results from the German Pelvic Trauma Registry: A Cohort Study. Medicine (Baltimore). 2015;94(51):e2325.
  • 21. Niedzielski KR, Guzikiewicz N, Małecki K,et al. Pelvic fractures in children and adolescents in polytrauma and high-energy injuries. Ortop Traumatol Rehabil. 2013;15(1):41-8.
  • 22. Hermans E, Cornelisse ST, Biert J, et al. Paediatric pelvic fractures: how do they differ from adults? Journal of Children's Orthopaedics 2017 11:1, 49-56
  • 23. A. Gänsslen, N. Heidari, A.M. WeinbergFractures of the pelvis in children: a review of the literature .Eur J Orthopaed Surg Traumatol,2013, pp. 1-5
  • 24. Turgut A, Kalenderer O, Gunaydin B,et al. Demographic Characteristics of Paediatric Pelvic Fractures: 10-Years' Experience of Single Paediatric Orthopaedics Clinic. Eurasian J Med. 2015;47(2):130-134.)
  • 25. Chotai N, Alazzawi S, Zehra SS, et al. Paediatric pelvic fractures: A review of 2 cohorts over 22 years. Injury. 2018;49(3):613-617.
  • 26. Tosounidis, T. H., Sheikh, H., & Giannoudis, P. V. (2015). Pelvic Fractures in Paediatric Polytrauma Patients: Classification, Concomitant Injuries and Early Mortality. The open orthopaedics journal, 9, 303–312.
  • 27. Shaath MK , Koury KL , Gibson PD , et al. Associated injuries in skeletally immature children with pelvic fractures. J Emerg Med, 51 2016, pp. 246-251
  • 28. Landy DC, Norton RA, Barkin JA, et al. Upper extremity fractures in pedestrian versus motor vehicle accidents: an underappreciated concern. Iowa Orthop J. 2010;30:99-102.
  • 29. Odatuwa-Omagbemi DO. Open fractures: epidemiological pattern, initial management and challenges in a sub-urban teaching hospital in Nigeria. Pan Afr Med J. 2019;33:234

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Orjinal Araştırma Makaleleri
Yazarlar

İlknur FİDANCI (Sorumlu Yazar)
Gazı University
0000-0002-8640-297X
Türkiye


Okşan DERİNÖZ-GÜLERYÜZ
GAZI UNIVERSITY
0000-0001-7348-0656
Türkiye


Işıl Seren OĞUZ
GAZI UNIVERSITY
0000-0003-2431-5384
Türkiye

Destekleyen Kurum -
Proje Numarası -
Yayımlanma Tarihi 31 Ağustos 2021
Kabul Tarihi 30 Ağustos 2021
Yayınlandığı Sayı Yıl 2021, Cilt 9, Sayı 2

Kaynak Göster

Vancouver Fidancı İ. , Derinöz-güleryüz O. , Oğuz I. S. Evaluation of Children with Extremity Fracture Occurred as a Result of Motor Vehicle Injury. Pediatric Practice and Research. 2021; 9(2): 66-72.