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ORIJINAL ARAŞTIRMA

Travmatik Periferik Sinir Yaralanmaları: 328 Vakanın Retrospektif Analizi
Traumatic Peripheral Nerve Injuries: A Retrospective Analysis of 328 Cases
Received Date : 08 Feb 2022
Accepted Date : 14 May 2022
Available Online : 13 Jun 2022
Doi: 10.31609/jpmrs.2022-88827 - Makale Dili: TR
J PMR Sci. 2023;26(1):36-42
ÖZET
Amaç: Bu araştırmanın amacı, elektromiyografi ile değerlendirilen ve ekstremite travması ile ilişkili travmatik periferik sinir yaralanması (TPSY) olan hastaların etiyolojik ve epidemiyolojik verilerini analiz etmektir. Gereç ve Yöntemler: Bu araştırma, retrospektif ve kesitsel olarak dizayn edildi. Eylül 2016 ile Kasım 2021 arası 3. basamak bir hastanenin ortopedik rehabilitasyon ünitesinde TPSY tanısıyla rehabilitasyon programı uygulanan erişkin hastalar araştırmaya dâhil edildi. Değerlendirme parametreleri yaralanma mekanizması, sinirlerin yaralanma sıklığı, şiddeti ve yaralanma ilişkili kemik kırığıydı. Bulgular: Üç yüz yirmi sekiz hastada toplam 540 TPSY tespit edildi. Hastaların ortalama yaşı 29,20 idi. TPSY’nin en sık nedeni ateşli silah yaralanması (ASY) (%57,9) idi. TPSY’lerin %44,8’i yalnızca üst ekstremitede, %51,5’i yalnızca alt ekstremitede, %3,7’si ise hem üst hem de alt ekstremitede tespit edildi. Peroneal sinir en sık yaralanan sinirdi (%19,1). Üst ekstremitede en sık yaralanan sinirler radial, ulnar ve median sinirler iken; alt ekstremitede en sık yaralanan sinirler peroneal, tibial ve siyatik sinirdi. Yüz yetmiş altı (%53,7) hastada tek sinirde yaralanma saptanırken; 152 (%46,3) hastada çoklu sinir yaralanması mevcuttu. Yaralanan sinirlerin %75’inde parsiyel tutulum, %25’inde ise total tutulum tespit edildi. 226 (%68,9) hastada TPSY ile ilişkili anatomik bölgede kırık saptandı Sonuç: TPSY genç, üretken popülasyonu etkileyebilen bir sorundur. Özellikle kemik kırıklarının eşlik ettiği ASY’de, peroneal ve radiyal sinir başta olmak üzere ilişkili olabilecek sinir yaralanmaları gözden kaçırılmamalıdır.
ABSTRACT
Objective: This study aimed to analyze the etiological and epidemiological data of patients with traumatic peripheral nerve injury (TPNI) associated with extremity trauma evaluated by electromyography (EMG). Material and Methods: This study was designed as retrospective and cross-sectional. Adult patients who underwent a rehabilitation program with the diagnosis of TPNI in the Orthopedic Rehabilitation Unit of a tertiary hospital between September 2016 and November 2021 were included. Evaluation parameters were injury mechanism, frequency and severity of nerve injury, and injury-related bone fracture. Results: In 328 patients, 540 TPNIs were detected. The mean age of the patients was 29.20. The most common cause of TPNIs was gun-shot wounds (57.9%). Forty-four-point-eight percent of TPNIs were detected only in the upper extremity, 51.5% in the lower extremity only, and 3.7% in both upper and lower extremities. The peroneal nerve was the most frequently injured nerve (19.1%). The most frequently injured nerves in the upper extremity were radial, ulnar, and median nerves while that in the lower extremity were peroneal, tibial, and sciatic nerves. A single nerve injury was detected in 176 (53.7%) patients and multiple nerve injuries were present in 152 (46.3%) patients. Partial involvement was detected in 75% of the injured nerves and total involvement in 25%. Fractures were detected in the anatomical region associated with TPNIs in 226 (68.9%) patients. Conclusion: TPNI is a problem that can affect young, productive population. Especially for gun-shot wounds accompanied by fractures, related nerve injuries particularly in peroneal and radial nerves should not be overlooked.
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