Vefa ÇAKMAK, Sefa TÜRKOĞLU, Mert ÖZEN, Pınar ÇAKMAK

Künt göğüs travmasında sternoklaviküler eklem mesafelerinin genişlemesi

Amaç: Bu çalışmanın amacı, künt göğüs travması olan hastalarda travma bulguları ile sternoklaviküler eklem (SKE) mesafeleri arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntem: Mayıs 2019 - Eylül 2019 tarihleri arasında künt göğüs travması olan 19-88 yaş arası 102 hastanın (78 erkek, 24 kadın) Toraks Bilgisayarlı tomografi (BT) görüntüleri retrospektif olarak değerlendirildi. Kosta kırığı, kostal kartilaj kırıkları ve diğer travma bulguları değerlendirildi. SKE mesafeleri, koronal reformat BT görüntülerinde alt, orta ve üst segmentlerde ölçüldü. Kostal ve kostal kartilaj kırıkları olan hastalarda travma sonrası SKE genişlemesi değerlendirildi. Ek olarak, SKE ve diğer travma sonrası bulguların varlığı karşılaştırıldı. Bulgular: 1-4. kosta kırığı varlığında, ipsilateral SKE'nin üst ve orta kesimlerinde istatistiksel olarak anlamlı bir genişleme saptandı. Hemotoraks, pnömotoraks ve duvar amfizemi için, ipsilateral SKE’nin üst kesimindeki 2 mm veya daha fazla genişlemesi kontralateral eklem ile karşılaştırıldığında istatistiksel olarak anlamlı bulundu. SKE'nin koronal düzlemde ölçümleri için gözlemciler arası uyum, 0.921 ile 0.961 (%95 CI) arasında değişen bir ICC skoru ile mükemmel olarak bulundu. Sonuç: Göğüs duvarının üst kısmındaki kaburga kırıklarında ipsilateral SKE mesafelerinin genişlemesi, SKE'nin travmada göğüs duvarına gelen enerjinin emiliminde önemli bir rol oynadığını göstermektedir.

Widening of sternoclavicular joint distances in blunt chest trauma

Purpose: Blunt chest trauma has high mortality and morbidity rates. The aim of this study was to evaluate the relationship between trauma findings and sternoclavicular joint (SCJ) distances in patients with blunt chest trauma. Materials and Methods: Between May 2019- September 2019, Thorax Computed Tomography (CT) images of 102 patients (78 males, 24 females, aged 19-88 years) with blunt chest trauma were evaluated retrospectively. Rib fractures, costal cartilage fractures and other signs of trauma were evaluated. SCJ distances were measured at the inferior, mid, and superior segments in the coronal reformatted CT images. Post-traumatic SCJ expansion was evaluated in patients with rib and costal cartilage fractures. Additionally, SCJ and the presence of other post-traumatic signs were compared. An inter-observer reliability analysis with Intraclass correlation coefficient (ICC) scores with 95% CIs were calculated. Results: In the presence of fractures of 1st to 4th ribs a statistically significant widening of superior and mid segments of the ipsilateral SCJs were detected. A 2-mm or greater difference of widening of the superior segment of the ipsilateral SCJ compared to the contralateral joint was found statistically significant for hemothorax, pneumothorax, and wall emphysema. The inter-observer agreement was excellent for the measurements of the SCJ on coronal plane, having an ICC score ranging from 0.921 to 0.961 (95% CI). Conclusion: The expansion of the ipsilateral SCJ distances in rib fractures in the upper part of the chest wall shows that SCJ performs an important role in the absorption of energy to the chest wall.

Keywords:

Computed tomography, Sternoclavicular Joint, Rib fractures, Thoracic Injuries,

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