Pediatrik Yaş Grubunda Acil Serviste 1 Yılda Tespit Edilen Ekstremite Kırıklarının Etiyoloji ve Epidemiyolojisi: 1878 Çocuk İle Çalışma
<br />
p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 8.0px Helvetica; color: #515151}<br />
Amaç: Hastanemiz acil servisine başvuran çocuk hastalarda kırıkların etiyolojisini ve epidemiyolojisini incelemek.
Materyal ve Metod: Hastanemiz acil servisine 2015 yılı içinde başvuran ve kırık tespit edilen 0-16 yaş arası 1878 hasta geriye dönük olarak değerlendirildi. Hastalar; kırık lokalizasyonu, yaş, cinsiyet, yaralanma mekanizması, mevsimlere göre sıklık ve tedavi yöntemi açısından incelendi.
Bulgular: Hastalarda en çok distal radius kırığı tespit edildi (n=420, %23.5). Erkeklerde görülen kırıkların sıklığının yaşla birlikte arttığı saptandı. Bir yaş altında erkek/kız oranı 1:1 iken; 7-12 yaş arasında 1.7:1; 12-16 yaş arasında 2:1 bulundu. Yaralanmaların en çok evde düşme sonucu olduğu görüldü (%32.4). Hastaların 114’ü (%6.2) ameliyat edildi. Ameliyat edilen hastaların 34’ü (%29) suprakondiler humerus kırığı idi. Kırıkların en çok yaz aylarında meydana geldiği saptandı (n=576, %30.6).
Tartışma: Bölgemizde çocuk kırıkları genelde yaz mevsiminde ve düşme sonucu oluşmakta ve çoğunluğu konservatif yöntemlerle tedavi edilmektedir. Çocuk kırıklarının epidemiyolojisini anlamak önleyici stratejiler geliştirmede önemlidir.
The Etiology And Epidemiology Of Fractures In Children Presenting To The Emergency Room In One Year: Study With 1878 Patients
Objective: To investigate the etiology and epidemiology of fractures in children admitted to the emergency department of our hospital.Material and Methods: We retrospectively evaluated 1878 patients aged between 0-16 years who were admitted to theemergency department in our hospital in 2015 with fractures. Patients examined according to fracture localizations, age, gender, mechanism of injury, frequency according to the season and treatment method.Results: The most common site of involvement was the distal radius (n=420, %23.5). The frequence of fractures was increased by age in boys. In the first year of age boys/girls ratio was 1:1, it was 1,7:1 between 7-12 ages and it was 2:1 between 12-16 ages. Fractures occurred most frequently at home and the most common mechanism was falls on level surface (%32,4). Choice of treatment was surgical methods in 114 patient (%6.2). The most frequently operated fractures were supracondylarhumerus fractures (n=34, %29). Fractures occurred mostly in summer (30,6 %).Discussion: In our area, child fractures generally result from falls on level surface in summer and are mostly treated with conservative methods. Understanding the epidemiology of childhood fractures is important to improve preventive strategies.
<span style="font-size: 18px;"><br />
p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 8.0px Helvetica; color: #515151}<br />
___
- 1. Cheng J.C., Shen W.Y. Limb fracture pattern in different
pediatric age groups: a study of 3,350 children. J Orthop
Trauma. 1993;7:15–22.
- 2. Reed MH. Fractures and dislocations of the extremities
in children. J Trauma 1977;17:351¬4.
- 3. Laffoy M. Childhood accidents at home. Irish Med J
1997; 90: 26-27.
- 4. Nathorst Westfelt JA. Environmental factors in childhood
accidents. A prospective study in Göteborg, Sweden.
Acta Paediatr Scand Suppl. 1982;291:1–75.
- 5. Landin L A. Fracture patterns in children: analysis of
8,682 fractures with special reference to incidence, etiology
and secular changes. Acta Orthop Scand (Suppl
202) 1983; 54: 1-95.
- 6. Wareham K., Johansen A., Stone M. D., Saunders J.,
Jones S., Lyons R. A. Seasonal variation in the incidence
of wrist and forearm fractures, and its consequences. Injury.
2003;34:219–222.
- 7. Hedström EM, Svensson O, Bergström U, Michno P. Epidemiology
of fractures in children and adolescents. Acta
Orthop Scand 2010;81:148-53.
- 8. Cooper C, Dennison EM, Leufkens HGM, Bishop N,
vanStaa TP. Epidemiology of childhood fractures in Britain:
a study using the general practice research database.
J Bone Miner Res 2004;19:1976-81.
- 9. Schalamon J, Dampf S, Singer G, et al. Evaluation of
fractures in children and adolescents in a level 1 trauma
center in Austria. J Trauma 2011;71:19-25.
- 10. Tiderius CJ, Landin L, Duppe H. Decreasing incidence of
fractures in children: an epidemiological analysis of
1,673 fractures in Malmo, Sweden, 1993-1994. Acta Orthop
Scand 1999;70:622-6.
- 11. Masterson E, Borton D, O’Brien T. Victims of our climates.
Injury 1993;24:247-8.
- 12. Atay T, Tomruk Ö, Çetin GN, Baydar ML, Seçkin H. Süleyman
Demirel Üniversitesi Tıp Fakültesi acil servisine
başvuran çocuk kırıklarının epidemiyolojik değerlendirmesi.
Kocatepe Tıp Dergisi 2008;9:17-21.
- 13. Rennie L, Court-Brown CM, Mok JY, Beattie TF. The epidemiology
of fractures in children. Injury 2007;38:913-22.
- 14. Kalenderer Ö, Gürcü T, Reisoğlu A, Ağuş H. Acil servise
kırık nedeniyle başvuran çocuk hastalarda kırıkların sıklık
ve dağılımı. Acta Orthop Traumatol Turc
2006;40:384-7.
- 15. Bailey DA, Wedge JH, McCulloch RG, Martin AD, Bernhardson
SC. Epidemiology of fractures of the distal end
of the radius in children as associated with growth. J
Bone Joint Surg [Am] 1989;71:1225-31.
- 16. Hagino H, Yamamoto K, Teshima R, Kishimoto H, Nakamura
T. Fracture incidence and bone mineral density of
the distal radius in Japanese children. Arch Orthop Trauma
Surg 1990; 109:262-4.
- 17. Ma D, Jones G. The association between bone mineral
density, metacarpal morphometry, and upper limb fractures
in children: a population-based case-control
study. J Clin Endocrinol Metab 2003;88:1486-91.