Fuat ULUSOY, Selman Hakkı ALTUNTAŞ, Dudu Dilek YAVUZ, Murat BİLGİN, Mustafa Asım AYDIN

BAŞPARMAK AMPUTASYONLARINDA REPLANTASYON SONUÇLARININ VE REPLANTE EDİLEMEYEN OLGULARDA REKONSTRÜKSİYON SEÇENEKLERİNİN DEĞERLENDİRİLMESİ

Amaç Başparmak elin fonksiyonel kapasitesinin yaklaşık %50’sini içermesi nedeniyle diğer parmaklara kıyasla başparmağın konjenital veya kazanılmış yokluğunda elin pinç ve opozisyon gibi önemli fonksiyonları yeri ne getirilemediği için ciddi bir fonksiyon kaybı oluşur. Başparmak rekonstrüksiyonunda tedavi algoritmaları seviyelere göre farklılaşmakta olup, bununla ilgili ola rak kliniğimizde uygulanan rekonstrüksiyon seçenek lerinin irdelenmesi amaçlanmıştır. Gereç ve Yöntem Kliniğimizde 2010-2020 yılları arasında kazanılmış başparmak defekti olan 50 hasta retrospektif olarak incelendi. Hastalar demografik özellikleri, yaralanma şekli, yaralanma seviyesi, rekonstrüksiyon şekli ve komorbid hastalıklar yönünden değerlendirildi. Elde edilen bulgular tablo haline getirilerek analiz edildi. Bulgular Hastaların ortalama yaşı 43,372(82-4) idi. Erkek-ka dın oranı 3,54(39-11) idi. Vakaların 49 tanesi(%98) kazanılmış(travmatik), 1 tanesi(%2) maligniteye bağlı defekt olarak görüldü. Hastaların başparmak ampu tasyonları, 35’inde Zone1(Distal 1/3), 8’inde Zone 2(Orta 1/3), 7’sinde Zone 3(Proksimal 1/3) seviye sinden idi. Sonuç Başparmaktaki defektin anatomik ve klinik sınıflaması göz önünde bulundurulduğunda merkezimizde yapı lan rekonstrüksiyonlar literatür ile genel olarak para lellik göstermekte olup komplikasyon oranları benzer görülmüştür.

EVALUATION OF REPLANTATION RESULTS IN THUMB AMPUTATIONS AND RECONSTRUCTION OPTIONS IN NON-REPLANTABLE CASES

Objective Because of the thumb contains approximately 50% of the functional capacity of the hand, in the congenital or acquired absence of the thumb compared to the other fingers, a serious loss of function is experienced because the important functions such as pinch and positioning of the hand cannot be performed. Treat ment algorithms in thumb reconstruction vary accor ing to their levels, and it is aimed to examine the reconstruction options applied in our clinic. Materials and Methods 50 patients with acquired thumb defects in our clinic between 2010-2020 were analyzed retrospectively. Patients were evaluated in terms of demographic characteristics, injury type, injury level, reconstruction type and comorbid diseases. The obtained findings were tabulated and analyzed. Results The mean age of the patients was 43.372 (82-4). The male to female ratio was 3.54 (39-11). 49 of the ca ses (98%) were seen as acquired (traumatic), 1 (2) as malignancy related defect. Thumb amputations of the patients were at the level of Zone 1 (Distal 1/3) in 35, Zone 2 (Middle 1/3) in 8, Zone 3 (Proximal 1/3) in 7 cases. Conclusion Considering the anatomical and clinical classification of the thumb defect, the reconstructions performed in our center are generally in line with the literature, and the complication rates were similar.

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