Nuriza ZAMİRBEKOVA, Fatma Çuhadar ERDAL, Mustafa ARICAN

Köpekte multipl (çoklu) kırık olgusu

Bu olgunun materyalini Veteriner Fakültesi Cerrahi Anabilim Dalıküçük hayvan kliniğine getirilen melez, 10 aylık, 8 kg ağırlığındadişi bir köpek oluşturdu. Yapılan klinik muayenede her iki arka eks-tremitede krepitasyon ve dislokasyon, sol arka ekstremitede para-liz tablosu, kalçada asimetri ve şiddetli ağrı tespit edildi. Pelvis veekstremitelerin radyografik muayenesinde sağ corpus ilium’da oblikkırık, sağ ve sol pubiste ve ischium’da kırık, sol sakro-iliac eklemdeluksasyon tespit edildi. Sağ femur ve tibia’nın diafizinde oblik kırıkve sol femur’da Salter Harris tip IV kırığı ve ön sol articulatio cubitiluksasyonu belirlendi. Laboratuvar sonuçlarına göre hastada şiddetlimetabolik asidozis (pH 7.107), baz açığı, lökositozis, hiperlaktatemitespit edildi. Gerekli sıvı ve medikal sağaltıma başlanıldı. Hastanıngenel durumu ve vital bulguları stabil hale geldikten sonra operas-yon yapıldı. Operatif olarak corpus ilium kırığına lateralden yaklaşıl-dı. Kırık fragmentleri kemik forsepsleri ile karşı karşıya getirildiktensonra laterale rekonstrüksiyon plağı yerleştirildi. Her iki arka eks-tremitenin femur kırıklarına operatif olarak cranio-lateral yaklaşım-la kilitli kompresyon plağı kullanılarak fikse edilidi. Tibia kırığınacranio-medial yönden yaklaşılarak 8 delikli kilitli kompresyon plağı(LCP) yerleştirildi. A.cubiti’ye lateral’den yaklaşılıp eklemin redüksi-yonu sağlandıktan sonra humerus’un lateral condylus’una ve caputradii'ye kanselöz vida konuldu. Hasta postoperatif olarak 4 hafta bo-yunca takip edilip taburcu edildi. Çoklu kırık olgularında öncelikleolgunun genel yaşam fonksiyonları yerine getirildikten sonra, kırıkdeğerlendirme kriterlerine (mekanik, biyolojik ve klinik) uygun sı-nıflandırmalar yapılarak operatif işleme karar verilir.

A dog with multiple fracture

Aim: The material of this case was a mixed breed female dog ap- proximately 10 months old, weighing 8 kg, brought to the surgery clinic. In the clinical examination was shown crepitation, dislocation, asymmetry and severe pain in both hind legs and paralysis in the left hind. Radiography of the pelvis and extremities revealed oblique fracture in the right corpus ilium, right and left pubis and ischium fractures, luxation in the left sacroiliac joint. Oblique fracture in the diaphysis of the right femur and tibia, Salter Harris type IV fracture in the left femur and elbow luxation in the left forelimb was also ob- served. According to laboratory results, severe metabolic acidosis, base deficit, leukocytosis and hyperlactatemia were determined. The fluid and medical treatment was started immediately. The dog was initially stabilized in the intensive care unit before surgery. Surgical approaches for corpus ilium fracture was performed laterally. A lat- eral reconstruction plate was placed. The femoral fractures of both hind limbs were approached cranio-laterally. Fixation of the right and left femur fractures was achieved with locking compression plate. Locking compression plate with 8-hole was placed for the tibia fracture fixation by cranio-medial approach. Two cancelous screw was placed into the lateral condyle of the humerus and the caput of the radius for elbow. Post-operative observation of the patient was carried out for 4 weeks and discharged postoperatively. In multiple fracture cases, the operative procedure is decided by making classi- fications according to the fracture evaluation criteria (mechanical, biological and clinical) after providing life functions.

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