Etyolojik mekanizmalar�n�n temelinde i� kazas�na ba�l� el yaralanmalar�nda alternatif bir s�n�flama:  �KEYES s�n�flamas�

Ozcelik, Bulent; Ert�rer, Erden; Mersa, Berkan; Purisa, H�srev; Sezer, �lker; Tun�er, Serdar; Kabaka�, Fatih; Kuvat, Samet Vasfi

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Etyolojik mekanizmalar�n�n temelinde i� kazas�na ba�l� el yaralanmalar�nda alternatif bir s�n�flama: �KEYES s�n�flamas� [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2012; 18(1): 49-54 | DOI: 10.5505/tjtes.2012.45656

Etyolojik mekanizmalar�n�n temelinde i� kazas�na ba�l� el yaralanmalar�nda alternatif bir s�n�flama: �KEYES s�n�flamas�

Bulent Ozcelik¹, Erden Ert�rer², Berkan Mersa¹, H�srev Purisa¹, �lker Sezer¹, Serdar Tun�er³, Fatih Kabaka�¹, Samet Vasfi Kuvat⁴
¹�st-el El Cerrahisi, Mikrocerrahi Ve Rehabilitasyon Grubu
²�i�li Etfal E�itim Ve Ara�t�rma Hastanesi, Ortopedi Ve Travmatoloji Klini�i
³�stanbul Bilim �niversitesi T�p Fak�ltesi, Plastik, Rekonstr�ktif Ve Estetik Cerrahi Anabilim Dal�
⁴�stanbul �niversitesi T�p Fak�ltesi, Plastik, Rekonstr�ktif Ve Estetik Cerrahi Anabilim Dal�

AMA�
Bu �al��man�n amac�, etyolojik mekanizmalar�na ba�l� olarak i� kazalar�na ba�l� el yaralanmalar� i�in alternatif bir s�n�flama sistemi ortaya koymakt�r.
GERE� VE Y�NTEM
�ki el cerrahisi �nitesi cerrahlar�nca, Ocak 2005 ile Aral�k 2007 y�llar� aras�nda ameliyat edilen hastalar�n geriye d�n�k olarak analizleri yap�ld�. Hasta dosyalar� retrospektif incelendi ve yaralanmaya neden olan mekanizmalar incelendi. Benzer yaralanma mekanizmalar� ayn� gruplarda s�n�fland�r�ld� ve g�r�lme s�kl�klar� ara�t�r�ld�. Yaralanmalar�n s�n�fland�r�lmas�nda hasarlanan dokular temel al�nd�. Hastaneye yat�r�lan 4120 el cerrahisi hastas�ndan 2188�i (%53,1) i� kazas� sonucu yaralanan olgular idi. Bunlar�n 2063�� erkek (%94,3), 125�i kad�nd� (%6,7). Ortalama ya� 28,2 (da��l�m 15-71 ya�) idi.
BULGULAR
Yaralanmaya neden olan ajanlar�n incelenmesinde 62 ajan belirlendi. Bu ajanlar�n ileri incelemesi ile benzer yaralanmaya neden olan ajanlar �i� kazalar�na ba�l� el yaralanmalar�n�n etyolojik s�n�fland�rmas��na (�KEYES) g�re grupland�r�ld�. Bu gruplar� kesici-delici, kesici-ezici, ezici-delici, ezici-s�k��t�r�c�, ezici-yak�c�, bat�c�, avulziyon, elektrik �arpmas� ve kimyasal yaralanmalar ve di�er yan�klar olu�turdu. Etyolojideki en s�k iki mekanizmay� 744 (%34,0) olgu say�s� ile ezici-s�k��t�r�c� yaralanmalar ile 514 (%23,5) olgu say�s� ile kesici-ezici yaralanmalar olu�turmaktayd�.
SONU�
�KEYES s�n�flamas�n�n literat�rde etyolojik fakt�rlerin s�n�flamas� i�in ortak bir dil olu�turulabilmekte �nemli oldu�una inanmaktay�z.

Anahtar Kelimeler: �� kazalar�na ba�l� el yaralanmalar�, etyolojik s�n�flama.

An alternative classification of occupational hand injuries based on etiologic mechanisms: the ECOHI classification

Bulent Ozcelik¹, Erden Ert�rer², Berkan Mersa¹, H�srev Purisa¹, �lker Sezer¹, Serdar Tun�er³, Fatih Kabaka�¹, Samet Vasfi Kuvat⁴
¹Ist-el Hand Surgery, Microsurgery And Rehabilitation Group
²�i�li Etfal Training And Research Hospital, Orthopedic Clinic And Trauma Clinic
³�stanbul Bilim University, Department Of Plastic, Reconstructive And Aesthetic Surgery
⁴�stanbul University, Department Of Plastic, Reconstructive And Aesthetic Surgery,

BACKGROUND
The aim of this study was to construct an alternative classification system for occupational hand injuries based on etiologic mechanisms and to analyze the injury patterns resulting from various mechanisms.
METHODS
A retrospective analysis of patients operated between January 2005 and December 2007 in two hand surgery units staffed by a team of hand surgeons was made. The patient files were retrospectively examined, and mechanisms causing the injuries were analyzed. Similar mechanisms were classified in the same groups, and the mechanism of injury was matched with type of injury often caused by this mechanism. In the classification of injuries, the tissues that were injured were taken as a basis for classification. 4120 upper extremity injuries were seen in the study hospitals, and 2188 (53.1%) of them were occupational injuries. There were 2063 males (94.3%) and 125 females (6.7%). The mean age was 28.2 (range: 15-71) years.
RESULTS
Examination of the agents causing injury yielded 62 agents. Further examination of these agents showed that the mechanism by which they caused injury was similar in some agents, and these agents were placed in the same groups, which constituted the Etiologic Classification of Hand Injuries (ECOHI) classification. These groups of mechanisms were: cutting-penetrating, cutting-crushing, crushing-penetrating, crushing-compressing, crushing-burning, stinging, avulsing, electrical current, and chemical injuries and miscellaneous burns. The two most common mechanisms were crushing-compressing and cutting-crushing types, constituting 744 (34.0%) and 514 (23.5%) of injuries, respectively.
CONCLUSION
We believe that ECOHI is important to form a common language for the classification of etiologic factors.

Keywords: Occupational hand injuries, etiologic classification.

Bulent Ozcelik, Erden Ert�rer, Berkan Mersa, H�srev Purisa, �lker Sezer, Serdar Tun�er, Fatih Kabaka�, Samet Vasfi Kuvat. An alternative classification of occupational hand injuries based on etiologic mechanisms: the ECOHI classification. Ulus Travma Acil Cerrahi Derg. 2012; 18(1): 49-54

Sorumlu Yazar: Bulent Ozcelik, T�rkiye
Makale Dili: �ngilizce

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