Travmatik asetabulum kırıklarında bilgisayarlı tomografi bulguları

Cerrahi tedavi açısından önemli olması nedeniyle, bilgi-sayarlı tomografi (BT) ile asetabulum kırıklarını saptama- yı ve sınıflandırmayı, pelvisteki diğer travmatik yumuşak doku, eklem ve kemik lezyonlarını göstermeyi amaçladık. Asetabulum ve pelvis kırığı öntanıları ile BT ünitemize acil servisten gönderilen toplam 8 olgu aksiyel BT görün-tüleme ile incelendi. İki olguda (%25) sol, beş olguda (%62,5) sağ, bir olguda (%12,5) her iki asetabulumda kırık saptandı. Dört asetabulumda (%44,4) anterior kolon ve bir aseta-bulumda (%11,1) posterior kolon kırığı, üç asetabu-lumda (%33,3) kompleks ve yıldız şekilli kırık, bir asetabulumda (%11,1) anterior kolon kırığı ve transvers kırık tespit edildi. İki olguda (%25) tek taraflı obturator internus adalesinde kalınlık artışı, iki olguda (%25) femur boyun kırığı, iki olguda (%25) tek taraflı gluteal kaslarda kalınlaşma, bir olguda (%12,5) tek taraflı asetabular eklemde hemartroz, femur başı dislokasyonu ve kemik fragmanlarının mesaneye basısı izlendi. Üç olguda (%37,5) tek taraflı pubis kırığı, 2 olguda (%25) tek taraflı iskium kırığı ve bir olguda (%12,5) iliak kanat kırığı saptandı. BT asetabulum kırıklarını saptamada ve sınıflandırmada, pelvis ve çevresindeki ilave travmatik yumuşak doku, eklem ve kemik patolojilerini göstermede etkin bir radyolojik tanı aracıdır. Bazı travmatik yumuşak doku lezyonlarının başarıyla gösterilebilmesine karşın, kaslar-da kalınlık artışına yol açan kanama ve ödem gibi patolojilerin ayırımı BT ile kesin olarak yapılamamıştır.

Computed tomography findings in traumatic acetabular fractures

Our aim was to detect and classify acetabular fractures with computed tomography (CT), due to the importance of classification in surgical treatment and to demonstrate other traumatic pelvic soft tissue, joint and bone lesions. Eight patients referred to our CT unit from emergency department with the prediagnosis of acetabular and pelvic fractures were examined with axial CT imaging. Left acetabular fracture in two cases (25%), right acetabular fracture in five cases (62.5%), bilateral acetabular fractures in one case (12.5%) were demonstrated. In four acetabuli (44.4%) anterior column fracture, in one acetabulum (11.1%) posterior column fracture, whereas in three acetabuli (33.3%) complex, star shaped fracture and in one acetabulum (11.1%) anterior column fracture associated with transvers fracture were demonstrated. In two cases (25%) unilateral increased thickness of obturator internus muscle, in two cases (25%) femoral neck fracture, in two cases (25%) unilateral increased thickness of gluteal muscles, in one case (12.5%) hemartrosis of acetabular joint, dislocation of femoral head and external pressure of bone fragments to urinary bladder were detected. In three cases (37.5%) unilateral pubis fracture, in two cases (25%) unilateral ischium fracture, in one case (12.5%) iliac fracture were demonstrated. CT is an efficient diagnostic tool to detect and classify acetabular fractures and to demonstrate other traumatic pelvic and neighbouring soft tissue, joint and bone lesions. Despite of its being able to demonstrate the soft tissue lesions mentioned above, differentiation of pathologies causing muscle thickening, like hemorrhage and edema could not be done precisely with CT.

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