Çocuk suprakondiler humerus kırıklarında önkol kompartman basınç ölçümü
Loading...
Date
2017
Authors
Toğaç, Soner
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmada Gartland tip III suprakondiler humerus kırığı nedeniyle ameliyat edilen hastaların ameliyat öncesi ve ameliyat sonrası ön kol volar derin kompartman basınçları ölçülerek redüksiyon tipinin, ameliyata kadar geçen sürenin ve ameliyat süresinin kompartman basıncına etkilerini inceledik. Toplam 31 hastanın kayıtları incelenerek değerlendirildi. Hastaların 26'sı erkek 5'i kızdı. Hastaların 11 (%35.5)'ine açık redüksiyon ve perkütan pinleme 20 (%64.5)'sine kapalı redüksiyon ve perkütan pinleme yapıldı.Travma anından ameliyata kadar geçen süre ortalama 20.1±14.3 (6 – 60) saat, ameliyat süresi ortalama 69.7±30.2 (30 – 120) dakikaydı. Hastaların ameliyat öncesi ortalama kompartman basıncı 15.0±5.9 mmHg iken ameliyattan hemen sonra ortalama 27.9±7.5 mmHg (p<0.05) olarak ölçüldü. Ameliyattan hemen sonra ölçülen ortalama kompartman basıncı açık redüksiyon grubunda 31.1±9.0 mmHg, kapalı redüksiyon grubunda ortalama 26.1±6.2 mmHg (p>0.05)idi. Yaralanma anından ameliyata kadar geçen sürenin 12 saati aşmadığı olgularda ameliyat öncesi ortalama kompartman basıncı 12.4±4.8 mmHg, 12 saatten daha uzun bekleyenlerde ortalama 17.7±5.8 mmHg (p<0.05) olarak, ameliyat süresi bir saati aşan olgularda ortalama kompartman basıncı 30.7±8.7 mmHg, bir saatten kısa süren olgularda 25.8±6.1 mmHg (p<0.05) olarak ölçüldü. Ameliyat öncesi kompartman basıncı özellikle yumuşak doku travmasının şiddetini ve bununla ilişkili olarak ödem ek yaralanma gibi kriterleri önceden değerlendirmede kullanılabilir. Bu çalışmanın sonuçları kompartman basınçlarının manipülasyon ve redüksiyonun hemen ardından en yüksek seviyeye geldiğini ortaya koymaktadır. Ameliyat sonrası dönem, hastaların yumuşak doku ödemine ve kompartman sendromuna en duyarlı olduğu ve en yakın izlemeye ihtiyaç duyulduğu dönemdir.
In this study we evaluated the effect of reduction type, preoperative duration time and operation time on the forearm preoperative and postoperative compartment pressures of patients with type 3 supracondylar humerus fractures. A total of 31 patients' records were evaluated. 26 of the patients were male and 5 were female. Percutaneous pinning was performed in 20(%64.5) patients by closed reduction, in 11(%35.5) patients by open reduction. Mean time from trauma to operation was 20.1±14.3(6 – 60) hours and mean operation time was 69.7 ± 30.2 (30 - 120) minutes. Mean preoperative compartment pressure of patients was 15.0 ± 5.9 mmHg and mean early postoperative compartment pressure of patients was 27.9 ± 7.5 mmHg (p <0.05). Average postoperative compartment pressure in open reduction group was 31.1 ± 9.0 mmHg and in closed reduction group was 26.1 ± 6.2 mmHg (p> 0.05). When the duration of surgery is more than 1 hour, the early compartment pressure was 30.7 ± 8.7 mmHg, and when it is less than 1 hour, the early compartment pressure was 25.8 ± 6.1 mmHg (p <0.05). When the time from the onset of injury to surgery was examined, the average preoperative compartmental pressure of those who were operated in the first 12 hours was 12.4 ± 4.8 mmHg, the average preoperative compartmental pressure of those who were operated after 12 hours was 17.7 ± 5.8 mmHg (p <0.05). Preoperative compartment pressures can be used as a quantitative value to determine the severity of soft tissue injury and additional injury criterias like edema. The results of this study show that compartment pressures are at the highest level after manipulation and reduction. Early postoperative period is the time when patients are the most sensitive to soft tissue edema and compartment syndrome and at that period the close follow-up is needed.
In this study we evaluated the effect of reduction type, preoperative duration time and operation time on the forearm preoperative and postoperative compartment pressures of patients with type 3 supracondylar humerus fractures. A total of 31 patients' records were evaluated. 26 of the patients were male and 5 were female. Percutaneous pinning was performed in 20(%64.5) patients by closed reduction, in 11(%35.5) patients by open reduction. Mean time from trauma to operation was 20.1±14.3(6 – 60) hours and mean operation time was 69.7 ± 30.2 (30 - 120) minutes. Mean preoperative compartment pressure of patients was 15.0 ± 5.9 mmHg and mean early postoperative compartment pressure of patients was 27.9 ± 7.5 mmHg (p <0.05). Average postoperative compartment pressure in open reduction group was 31.1 ± 9.0 mmHg and in closed reduction group was 26.1 ± 6.2 mmHg (p> 0.05). When the duration of surgery is more than 1 hour, the early compartment pressure was 30.7 ± 8.7 mmHg, and when it is less than 1 hour, the early compartment pressure was 25.8 ± 6.1 mmHg (p <0.05). When the time from the onset of injury to surgery was examined, the average preoperative compartmental pressure of those who were operated in the first 12 hours was 12.4 ± 4.8 mmHg, the average preoperative compartmental pressure of those who were operated after 12 hours was 17.7 ± 5.8 mmHg (p <0.05). Preoperative compartment pressures can be used as a quantitative value to determine the severity of soft tissue injury and additional injury criterias like edema. The results of this study show that compartment pressures are at the highest level after manipulation and reduction. Early postoperative period is the time when patients are the most sensitive to soft tissue edema and compartment syndrome and at that period the close follow-up is needed.
Description
Keywords
Kompartman basıncı, Suprakondiler humerus kırığı, Kırık redüksiyon, Compartment pressure, Supracondylar humerus fracture, Fracture reduction
Citation
Toğaç, S. (2017). Çocuk suprakondiler humerus kırıklarında önkol kompartman basınç ölçümü. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.