Clinical Results of Minor Upper Extremity Replantation and Revascularisation Patients in Comparison to the Literature: A Clinical Study
Yükleniyor...
Dosyalar
Tarih
2015
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Turgut Özal Tıp Merkezi Dergisi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Öz: Amaç: Üst ekstremite minör replantasyon ve revaskülarizasyon uygulanan hastaların klinik sonuçlarının değerlendirilip literatür ile karşılaştırılması amaçlandı. Gereç ve Yöntem: Kliniğimizde 2008-2011 tarihleri arasında üst ekstremitelerin\'de travma sonucu total veya subtotal amputasyon oluşan 30 hastanın 35 parmağı ameliyat edildi. Total ampute 15 hastanın 15 parmağına replantasyon, ve subtotal ampute 15 hastanın 20 parmağına revaskülarizasyon yapıldı. Tedavi edilen tüm hastaların erken dönem sonuçları ile ortalama 17 ay (6 ay - 3.5 yıl) izlenen 28 hastanın 30 parmağı retrospektif olarak incelendi. Bulgular: Erken dönem sonuçlar incelendiğinde, yaşama oranları; replantasyon yapılan parmaklarda %93,3, revaskülarizasyon yapılan parmaklarda %80 olarak saptandı. Zon iki seviyesindeki yaralanmalarda yaşama oranı %66,6 iken zon 3 seviyesindeki yaralanmalarda %92,3 idi. Giyotin tipi yaralanmalarda ise %100 yaşama oranı mevcut iken, ezilme- avülsiyon tipi yaralanmalarda %68,8 olarak bulundu. Yaralanma şekillerine göre fonksiyonel sonuçlar Chen kriterlerine göre değerlendirildiğinde, giyotin tipi kesi ile yaralanan olguların %89.9\'unda çok iyiiyi, ezilme ve avulsiyon tipi kesi ile yaralanan olguların %33,3\'ünde çok iyi-iyi, %44.4\'ünde orta sonuç bulundu. Yapılan istatiksel değerlendirmede giyotin tipi kesilerle yaralanan olguların tedavi sonrası distal parçalarda yaşama oranları ve fonksiyonel sonuçlarının ezilme ve avulsiyon tipi yaralanmalara göre anlamlı olarak daha iyi olduğu bulundu. Sonuç: Minör replantasyon ve revaskülarizasyon uygulamaları teknik olarak zor ve donanımlı ekip gerektirmektedir. Replantasyon sonuçlarımız literatürle uyumlu olup daha geniş serili çalışmaların gerektiği kaçınılmazdır
Abstract: Objectives: To evaluate the minor upper extremity replantation and revascularisation cases and to compare the clinical results with those in the literature. Materials and Methods: Our study covers upper extremity trauma repair operations of 35 fingers of 30 patients who recieved treatment in our clinic betwen 2008 and 2011 date. The total number of amputated fingers that underwent replantation was 15 (of 15 patients) while 20 fingers of 15 patients underwent revascularisation operation for amputated fingers. We have conducted a retrospective study of the early period results of patients, who have been followed for an average of 17 months (6 months - 3.5 years). Results: The survival rate for replantation cases was 93.3%; this rate was 80% for revascularised fingers. The survival rate for zone 2 injuries was 66.6%; the survival rate for zone 3 injuries was 92.3%. The survival rate for guillotine type injuries was 100% of the; this rate was 68.8% for crush and avulsion type injuries. The evaluation of functional results based on Chen criterion and in terms of injury patterns has shown that 89.9% of guillotine-type incision patients showed very good results while 33.3% of the crush and avulsion type injury patients returned with very good results as 44.4% of these patients showed moderate results. The statistical evaluation of the functional outcomes of the distal parts showed better improvemnet in guillotine-type injuries compared to crush and avulsion type injuries. Conclusions: Minor replantation and revascularisation operations are difficult and require various equipments. Our results are compatible with the literature in terms of the large replantation series
Abstract: Objectives: To evaluate the minor upper extremity replantation and revascularisation cases and to compare the clinical results with those in the literature. Materials and Methods: Our study covers upper extremity trauma repair operations of 35 fingers of 30 patients who recieved treatment in our clinic betwen 2008 and 2011 date. The total number of amputated fingers that underwent replantation was 15 (of 15 patients) while 20 fingers of 15 patients underwent revascularisation operation for amputated fingers. We have conducted a retrospective study of the early period results of patients, who have been followed for an average of 17 months (6 months - 3.5 years). Results: The survival rate for replantation cases was 93.3%; this rate was 80% for revascularised fingers. The survival rate for zone 2 injuries was 66.6%; the survival rate for zone 3 injuries was 92.3%. The survival rate for guillotine type injuries was 100% of the; this rate was 68.8% for crush and avulsion type injuries. The evaluation of functional results based on Chen criterion and in terms of injury patterns has shown that 89.9% of guillotine-type incision patients showed very good results while 33.3% of the crush and avulsion type injury patients returned with very good results as 44.4% of these patients showed moderate results. The statistical evaluation of the functional outcomes of the distal parts showed better improvemnet in guillotine-type injuries compared to crush and avulsion type injuries. Conclusions: Minor replantation and revascularisation operations are difficult and require various equipments. Our results are compatible with the literature in terms of the large replantation series
Açıklama
Anahtar Kelimeler
Kaynak
Turgut Özal Tıp Merkezi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
22
Sayı
4
Künye
DOĞAN S,ERTEM K,KARAKAPLAN M,SEVİMLİ R,ARI B,YILMAZ Ö (2015). Clinical Results of Minor Upper Extremity Replantation and Revascularisation Patients in Comparison to the Literature: A Clinical Study . İnönü Üniversitesi Turgut Özal Tıp Merkezi Dergisi, 22(4), 243 - 248.
