Füsun ŞAHİN, Dalgıç Serap YÜCEL, Figen YILMAZ, Ernur ERGÖZ, KADRİYE BANU KURAN

El rehabilitasyonu için başvuran falanks kırıklı hastaların özellikleri ve rehabilitasyon sorunları

Amaç: Elde falanks kırığı olan hastalarda demografik ve mesleki profiller, yaralanma nedenleri ve tipleri ve uygulanan rehabilitasyon sonuçları değerlendirildi. Çalışma planı: Falanks kırığı nedeniyle el rehabilitasyon ünitesine başvuran 62 hasta (54 erkek, 8 kadın; ort. yaş 28±13; dağılım 4-59) çalışmaya alındı. Toplam 91 parmakta yaralanma vardı. Hastalar demografik özellikler, yaralanma nedeni ve yeri, ameliyat tipi, ameliyat ile rehabilitasyon arasındaki süre ve takip süresi açısından değerlendirildi. Rehabilitasyon sonunda ilgili eklem ve parmak için hareket açıklıkları Strickland-Glogovac sınıflandırmasına göre değerlendirildi. Sonuçlar: Hastaların büyük çoğunluğunda yaralanma iş kazası sonucu meydana gelmişti. Diğer büyük grubu oluşturan öğrencilerde ise kırıklar sportif yaralanma veya düşme sonucu oluşmuştu. Altmış hasta (%96.8) sağ elini ağırlıklı olarak kullanmaktaydı. Kırıklar 29 hastada (%46.8) aktif olarak kullanılan elde idi. Hastaların büyük çoğunluğu (n=45) ilkokul mezunu idi. En sık yaralanma mekanizması ağır iş makinesinde yaralanma idi (n=18). En çok etkilenen parmak üçüncü parmak (n=25, %27.5), en çok etkilenen falanks da proksimal falankstı (n=59, %56.7). Hastaların sadece 27’sinin (%43.6) yeterli takibi vardı. Ortalama takip süresi 79.7±46.6 gün (dağılım 30-254 gün) idi. Rehabilitasyon sonunda hareket açıklığı, ilgili eklem için başparmakta 45.0±22.9°, diğer parmaklarda 31.3±22.5°; parmağın tümü için ise başparmakta 63.3±16.1°, diğer parmaklarda 122±60.3° bulundu. Çıkarımlar: Çalışmamız falaks kırıklarının tedavi ve rehabilitasyonu ile ilgili, özellikle tedavi ve takipte yaşanan sorunlar üzerine yararlı bulgular ortaya koymuştur.

Anahtar Kelimeler:

El baş parmağı, Hareket açıklığı, eklem, Rehabilitasyon, El parmağı yaralanmaları

Demographic features and difficulties in rehabilitation in patients referred to hand rehabilitation unit for phalangeal fractures

Objectives: We evaluated demographic and occupational features of patients with phalangeal fractures of the hand, etiologies and types of injuries, and the results of rehabilitation. Methods: The study included 91 fingers of 62 patients (54 males, 8 females; mean age 28±13 years; range 4 to 59 years) who were referred to our hand rehabilitation unit for phalangeal fractures. Demographic features, the cause and localization of injury, the type of surgery, time from surgery to rehabilitation, and the follow-up period were determined. At the end of rehabilitation, range of motion (ROM) of the phalangeal joint and total ROM of the injured fingers were assessed using the Strickland-Glogovac rating system. Results: A great majority of injuries were caused by work accidents, followed by sport injuries and falls occurring in students. Sixty patients (96.8%) were right–handed. The fractures occurred in the dominant hand in 29 patients (46.8%). The majority of patients (n=45) were primary school graduates. The most common mechanism of injury was accidents related to heavy work machinery (n=18). The most commonly injured finger and the phalanx were the third finger (n=25, 27.5%) and the proximal phalanx (n=59, 56.7%), respectively. Only 27 patients (43.6%) had a sufficient follow-up with a mean of 79.7±46.6 days (range 30 to 254 days). Following rehabilitation, the mean ROM and the total ROM were 45.0±22.9° and 63.3±16.1° for the injured joint and the thumb, and 31.3±22.5° and 122±60.3° for the injured joint and the other fingers, respectively. Conclusion: Our data provide important insight into appropriate treatment and rehabilitation of phalangeal fractures, in particular, shortcomings in the treatment and follow-up.

Keywords:

Thumb, Range of Motion, Articular, Rehabilitation, Finger Injuries,

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