Çoklu Travmalı Hastalarda Vertebra Kırıkları Ve Birlikte Gözlenen Yaralanmaların Değerlendirilmesi

Öz

Bu çalışmada, acil servise çoklu travma nedeniyle başvuran hastalarda vertebra kırığı ve eşlik eden yaralanmalar değerlendirilmiştir. Çalışmada, 2000-2008 yılları arasında çoklu travma nedeni ile acil servise başvuran ve vertebra kırığı nedeni ile tedavi edilen 90 hasta ( 67 erkek (%74.4) , 23 kadın (%25.6) ; ort.yaş 31.2±9.2; dağılım 20- 63) değerlendirildi. Değerlendirmeye demografik özellikler, eşlik eden yaralanmalar, travma mekanizması, kırık seviyesi ve tipi ile tedavi şekli dahil edildi. Vertebra kırık tipleri Denis sınıflamasına göre sınıflandırıldı. Denis sınıflamasına göre, 54 hastada (%60) kompresyon kırığı, 32’sinde (%35.5) burst kırığı, 3’ünde (%3.3) fleksiyon-distraksiyon tipi yaralanma,1 ’inde(%1.2) ise kırıklı çıkık saptandı. En sık yaralanmanın 65 kırık (%56.6) ile torakolomber bileşke bölgesinde olduğu görülmektedir. Hastaların 72’sinde (%80) tek seviyede, 14’ünde(%15.5) iki seviyede, 4’ünde (%4.5) üç seviyede vertebra kırığı vardı. Kırık nedeni, 50 olguda trafik kazası (% 55.6), 35 olguda yüksekten düşme (%38.9), 5 olguda (%5.5) ise direkt travma idi. 35 hastada (%38.8) başka bölgelerde kırıklar görüldü; en sık rastlananı 8 olguda (% 8.8) görülen femur cisim ve boyun kırığı kırığıydı. Ortopedik patolojilerin dışında 43 hastada (%47.6) kafa travması ve/veya diğer organ yaralanması vardı. Çoklu travma sonrasında acil servise başvuran her hastaya spinal travma varmış gibi davranılmalıdır. Vertebra patolojisi saptanan hastalar başka bölgelerde kırıklar ve eşlik eden yaralanmalar açısından detaylı olarak değerlendirilmelidir.

Anahtar Kelimeler

• oklu travma
• vertebra kırığı
• eşlik eden yaralanma.

Evaluatıon Of Vertebral Fractures And Asso¬cıated Injurıes In Multıple Trauma Patıents

Öz

In this study, we evaluated the vertebra fractures and associated injuries in patients who were applied to emergency service because of multiple trauma. The study included 90 patients ( 67 men (%74.4), 23 women (%25.6); mean age 31.2±9.2 years ; range 20 to 63 years) who applied to Emergency Service because of multiple trauma and treated for vertebra fractures from 2000 to 2008. Evaluations included demographic features of patients, associated injuries, trauma mechanisms .fracture levels , types and treatment modalities. The types of fractures were assessed according to the Denis classification. According to Denis classification, the types of fractures were classified as follows: compression fractures (n=54, 60.0%), burst fractures (n=32 , 35.5%), flexion-distraction (n= 3, 3.3%) and fracture-dislocation (n=1, 1.2%). The most common localization was the thoracolumbar spine with 65 fractures (56.6%). Involvement was at one level in 72 patients (80% ), two levels in 14 patients (15.5% ) and three levels in 4 patients (4.5% ).The causes of fractures were traffic accidents in 50 patients (55.6% ), fall from high places in 35 patients (38.9% ) and direct trauma in 5 patients (5.5% ). Associated fractures were detected in 35 patients (38.8% ); the most common being femur diaphysis and collum fractures in 8 patients (8.8% ). Apart from orthopedic problems, 43 patients (47.6% ) had head trauma and/or other organ injuries. Every patient presenting with a multiple trauma should be regarded as having a spinal trauma. When a vertebra fracture is detected, investigation should be extended for involvement at other levels fractures and associated injuries.

Anahtar Kelimeler

• Multiple trauma
• vertebra fracture
• associated injuries.

Kaynakça

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