Kliniğimizde el bilek voler düzeyde primer tamir edilen arteriyel yaralanmaların orta ve geç dönem açıklık oranlarının klinik ve radyolojik değerlendirme sonuçları
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
ÖZET Kliniğimizde El Bilek Voler Düzeyde Primer Tamir Edilen Arteriyel Yaralanmaların Orta ve Geç Dönem Açıklık Oranlarının Klinik ve Radyolojik Değerlendirme Sonuçları Amaç: Literatürde el bileği düzeyinde arter onarımına ilişkin orta -uzun dönem klinik ve radyolojik değerlendirme sonuçlarını karşılaştıran az sayıda çalışma vardır ve çoğu yirmi yıldan daha öncesinde yapılmıştır. Çalışmamızın amacı; el bileği düzeyinde arter yaralanmalarının gelişen mikrocerrahi tekniklerle orta-uzun dönem arteriyel açıklık oranını belirlemek, birden fazla anket ve radyolojik değerlendirme kullanarak, yaralı elin fiziksel işlevi ve semptomlarını incelemekti. Materyal ve Metot:13 yıllık retrospektif çalışmamızda; kliniğimize el bileği düzeyinde arter yaralanması sebebiyle acil başvuran ve primer uc uca onarımı yapılan 50 olgu çalışmaya dahil edildi. Hastalar Allen testi destekli Renkli Doppler Ultrasonografi ile akım değerlendirmesi, QuickDASH Skoru, preoperatif ve postoperatif VAS skoru, memnuniyet ve soğuk intoleransı değerlendirmesi için geri çağrıldı. Bulgular: Genel patens oranımız %90,6'dır. Etyolojinin %62'si cam kesisiydi. Yaş arttıkça Arteryel patensin düştüğü istatiksel olarak anlamlıydı(p=0.004). Olgularımızın %62'sinde soğuk intoleransı mevcuttu ve hepsinde arterler patentti. Hastalarımızdan hiçbiri kötü memnuniyet bildirmedi. Hastalarımızın klinik skorları QuickDASH 11.083±13.526 (Ortalama±Standart sapma) , Preoperatif VAS 6.282±3.34 (Ortalama±Standart sapma ), Postoperatif VAS 0.8±1.436(Ortalama±Standart sapma ) idi. Arteri patent olanlarda memnuniyet daha iyiydi ve bu korelasyon istatiksel açıdan anlamlıydı(p=0,006). Soğuk intoleransı olanlarda QuickDASH skorunun yüksekliği istatiksel olarak anlamlıydı(p=0.010). Postoperatif VAS skorlarının Preoperatif VAS skorlarına göre düşüklüğü istatistiksel olarak anlamlıydı. (p<0,001). Sol Ulnar Arter Anastomoz distalinde blokaj sonrası istatiksel anlamlı olarak artan Pick Sistolik akım hızının klinikte azalan Postoperatif VAS skoruyla anlamlı korelasyon saptadık. (p=0.038). Sol ulnar arter anastomoz bölgesinde blokaj sonrası istatistiksel olarak anlamlı artan end diyastolik akım hızının klinikte artan memnuniyet skoruyla anlamlı korelasyon saptadık (p =0.046). Sonuç: Akut yaralanmış el bileği düzeyi arteriyel onarımları gelişen mikrocerrahi tekniklerle %90 patent oranına ulaşmıştır. Soğuk intoleransı hastalarda fonksiyonel bozulma ile ilişkilidir. Arterleri patent bulunan hastalarda daha iyi memnuniyet olduğu kaydedilmiştir. Anahtar Kelimeler: Arteriyel yaralanma, el bileği, fonksiyonel sonuçlar, ön kol, patens, soğuk intoleransı, radyolojik değerlendirme
ABSTRACT Clinical and Radiological Evaluation Results of Mid- and Late-Term Aperture Rates of Primary Repaired Arterial Injuries at the Wrist Volar level Aim:There are few studies in the literature comparing the mid-long term clinical and radiological evaluation results of arterial repair at the wrist level and most of them were made more than twenty years ago . The aim of our study; To determine the mid-long term arterial patency rate of arterial injuries at the wrist level by developing microsurgical techniques,of the injured hand using multiple questionnaires and radiological evaluations,physical function and symptoms was to examine. Material and Method:In our 13-year retrospective study; Fifty patients who applied to our clinic urgently with a wrist-level arterial injury and underwent primary end-to-end repair were included in the study. The patients were recalled for flow evaluation, QuickDASH Score, preoperative and postoperative VAS score, satisfaction and cold intolerance evaluation with Allen test-supported Color Doppler Ultrasonography. Results: Our general patency rate was 90.6%. 62% of the etiology was glass cut. It was statistically significant that arterial patency decreased with increasing age.(p=0.004). Cold intolerance was present in 62% of our cases and the arteries were patent in all of them. None of our patients reported poor satisfaction. Clinical scores of our patients QuickDASH 11.083±13.526 (mean±standard deviation) , Preoperative VAS 6.282±3.34 (mean±standard deviation ), Postoperative VAS 0.8±1.436(It was mean±standard deviation). Satisfaction was better in patients with patent arteries and this correlation was statistically significant (p=0.006).High QuickDASH score was statistically significant in those with cold intolerance (p=0.010). The decrease in postoperative VAS scores compared to preoperative VAS scores was statistically significant (p<0.001). We found a statistically significant increase in Pick Systolic flow velocity after blockade in the distal Left Ulnar Artery Anastomosis and a significant correlation with the clinically decreased Postoperative VAS score. (p=0.038). We found a statistically significant increase in end diastolic flow velocity after blockade in the left ulnar artery anastomosis region and a significant correlation with the increased satisfaction score in the clinic.(p =0.046). Conclusion: Acutely injured wrist level arterial repairs have reached 90% patent rate with improved microsurgical techniques.Cold intolerance is associated with functional impairment in patients. Better satisfaction has been noted in patients with patented arteries. Keywords: Arterial injury, wrist, functional outcomes, forearm, patency, cold intolerance, radiological evaluation
ABSTRACT Clinical and Radiological Evaluation Results of Mid- and Late-Term Aperture Rates of Primary Repaired Arterial Injuries at the Wrist Volar level Aim:There are few studies in the literature comparing the mid-long term clinical and radiological evaluation results of arterial repair at the wrist level and most of them were made more than twenty years ago . The aim of our study; To determine the mid-long term arterial patency rate of arterial injuries at the wrist level by developing microsurgical techniques,of the injured hand using multiple questionnaires and radiological evaluations,physical function and symptoms was to examine. Material and Method:In our 13-year retrospective study; Fifty patients who applied to our clinic urgently with a wrist-level arterial injury and underwent primary end-to-end repair were included in the study. The patients were recalled for flow evaluation, QuickDASH Score, preoperative and postoperative VAS score, satisfaction and cold intolerance evaluation with Allen test-supported Color Doppler Ultrasonography. Results: Our general patency rate was 90.6%. 62% of the etiology was glass cut. It was statistically significant that arterial patency decreased with increasing age.(p=0.004). Cold intolerance was present in 62% of our cases and the arteries were patent in all of them. None of our patients reported poor satisfaction. Clinical scores of our patients QuickDASH 11.083±13.526 (mean±standard deviation) , Preoperative VAS 6.282±3.34 (mean±standard deviation ), Postoperative VAS 0.8±1.436(It was mean±standard deviation). Satisfaction was better in patients with patent arteries and this correlation was statistically significant (p=0.006).High QuickDASH score was statistically significant in those with cold intolerance (p=0.010). The decrease in postoperative VAS scores compared to preoperative VAS scores was statistically significant (p<0.001). We found a statistically significant increase in Pick Systolic flow velocity after blockade in the distal Left Ulnar Artery Anastomosis and a significant correlation with the clinically decreased Postoperative VAS score. (p=0.038). We found a statistically significant increase in end diastolic flow velocity after blockade in the left ulnar artery anastomosis region and a significant correlation with the increased satisfaction score in the clinic.(p =0.046). Conclusion: Acutely injured wrist level arterial repairs have reached 90% patent rate with improved microsurgical techniques.Cold intolerance is associated with functional impairment in patients. Better satisfaction has been noted in patients with patented arteries. Keywords: Arterial injury, wrist, functional outcomes, forearm, patency, cold intolerance, radiological evaluation
Açıklama
Anahtar Kelimeler
Ortopedi ve Travmatoloji, Orthopedics and Traumatology
