Abdominal Subkutan Yağ Doku Kalınlığının Pelvik Travma Üzerine Etkisi

Amaç: Obezite dünya genelinde çok önemli bir sağlık problemidir. Güncel literatürde travmalara bağlı hasara obezitenin etkisi araştırılmaktadır. Hasta kilosunun, travmanın şiddeti ile beraber komplikasyonları arttırdığı söylenmektedir. Obez hastalarda travma sonrası ekstremite kırıklarının daha sık görüldüğü öne sürülmektedir. Literatürde pelvik travmalara obezitenin etkisi çeşitli çalışmalarla araştırılmıştır. Ancak asetabuler fraktür ve eşlik eden femur başı fraktürlerine obezitenin etkisini araştıran benzer bir çalışma bulunamamıştır. Bu çalışmada amacımız; asetabulum fraktürü olan erişkin olgularda, eşlik eden femur başı fraktürünün görülme sıklığını belirlemek ve bu birlikteliğe abdominal subkutan yağ doku kalınlığının etkisi olup olmadığını araştırmaktır. Materyal ve Metot: Travma nedeniyle hastanemizde çekilen pelvik tomografiler retrospektif olarak yeniden değerlendirilerek, asetabulum fraktürü olan olgular saptandı. Bu olgular, izole asetabulum fraktürü olanlar ve asetabulum ile femur başı fraktürü birlikte görülenler olarak iki ayrı gruba ayrıldı. Tüm olguların abdominal subkutan yağ doku kalınlıkları tomografik olarak ölçüldü. İki grup arasında subkutan yağ doku kalınlığı açısından istatistiksel anlamlı farklılık olup olmadığı araştırıldı. Bulgular: Toplam 95 olguda asetabuler fraktür bulundu. Olguların 22’sinde (%23,2) femur başı impaksiyon fraktürü eşlik etmekteydi. Kalan 73 olguda (%76,8) femur başı normaldi. Ortalama abdominal subkutan yağ doku kalınlığı; izole asetabuler fraktür olan olgularda 24,4 (±9,2) mm, eşlik eden femur başı fraktürü olan olgularda 30,4 (±8) mm idi. Abdominal subkutan yağ doku kalınlığı, femur başı ve asetabulum fraktürü birlikte görülen olgularda istatistiksel olarak anlamlı derecede daha fazlaydı (p=0,006). Sonuç: Asetabulum fraktürüne ek olarak femur başı fraktürü izlenen olgularda abdominal subkutan yağ doku kalınlığı belirgin daha fazla bulunmuştur. Abdominal subkutan yağ birikiminin, travmanın şiddetini arttırarak femur başı fraktürü gelişimi riskini, dolayısıyla morbiditeyi arttıran bir risk oluşturduğu söylenebilir

Anahtar Kelimeler:

asetabulum; femur fraktürü; subkutan yağ

The Effect of Abdominal Subcutaneous Fat Tissue Thickness in Pelvic Trauma

Aim: Obesity is a very important health problem throughout the world. The effect of obesity on trauma-related injuries is being investigated in contemporary literature. The weight of the patient is said to increase complications with the severity of trauma. The effect of obesity on pelvic trauma has been investigated in various studies in the literature. However, no similar study investigating the effect of obesity on acetabular fractures and accompanying femoral head fractures has been found. Our aim in this study is to determine the incidence of accompanying femoral head fractures in adult cases with acetabulum fracture and to investigate whether abdominal subcutaneous fat tissue thickness has an effect on this co-existence. Material and Method: Pelvic CT scans taken in our hospital due to trauma were retrospectively reevaluated and cases with acetabulum fracture were detected. These cases were divided into two separate groups: those with isolated acetabulum fractures and those with acetabulum-and accompanying femoral head fractures. Abdominal subcutaneous fat tissue thicknesses of all cases were measured via CT scan. It has been investigated whether there is a statistically significant difference between the two groups in terms of subcutaneous fat tissue thickness. Results: A total of 95 acetabular fractures were detected. In 22 cases (23.2%), femoral head impaction fracture was present in addition to acetabulum fracture. In the remaining 73 cases (76.8%), the femur head was normal. The average abdominal subcutaneous fat tissue thickness was 24.4 (±9.2) mm in isolated acetabular fracture cases, and 30.4 (±8) mm in cases with acetabulum and accompanying femoral head fractures. Abdominal subcutaneous fat thickness was significantly higher in patients with femoral head fracture in addition to acetabulum (p=0.006). Conclusion: It’s possible to say that abdominal subcutaneous fat accumulation increases the risk of femoral head fracture development by increasing the severity of trauma, thus increasing the morbidity.

Keywords:

acetabulum; femur fracture; subcutaneous fat,

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