El rehabilitasyon ünitesinde izlenen el yaralanmalý pediyatrik hastalarýn özellikleri

AMAÇ
Kliniðimizce 1998 yýlýndan beri tedavi edilen, el rehabilitasyon polikliniðine el yaralanmasý nedeniyle baþvurmuþ olan pediyatrik yaþ grubundaki hastalarýn özelliklerinin belirlenmesidir.
GEREÇ VE YÖNTEM
Hastalar retrospektif olarak taranarak 0-16 yaþ arasýndakiler çalýþmaya alýndý (178 hasta; 126 erkek [%70,8], 52 kýz (%29,2); ort. yaþ 10,33±4,45; daðýlým 0-16). Demografik veriler, yaralanma nedeni-yeri, ameliyat-rehabilitasyon arasýndaki süre (hafta), takip süresi (hafta) kaydedildi.
BULGULAR
Rehabilitasyona baþvurma süresi ortalama 5,4±0,7 haftaydý. Sadece 99 hasta (%55,6) dört haftadan uzun (20,8±22,2) bir süre izlenebilmiþti. Yaralanma þekli hastalarýn 133’ünde (%74,7) kaza, 29’unda kasýtlý (%16,3), 15’inde doðumsal (%8,4) nedenliydi. Kaza sonucu olanlarýn 109’u (%61,2) ev, 53’ü (%29,8) ev dýþý kazalardandý. En fazla görülen ev kazasý cam kesiði, en fazla görülen çevre yaralanmasý düþme idi. Yaralanma yeri sýklýk sýrasýyla, bilek, metakarp, proksimal falanks, önkol, dirsek, pleksus, orta-falanks, üst-kol, tüm el, omuz, tüm kol ve bilateral el þeklindeydi. En sýk 4. parmak yaralanmýþtý. En çok görülen yaralanma tipi, fleksör tendon kesisi (%44,5), sinir kesisi, arter yaralanmasý, fraktür ve yanýk kontraktürü idi.
SONUÇ
Poliklinik verilere göre çocuklarda el yaralanmalarýnýn en çok erkeklerde meydana geldiði, evde cam kesmesi sonucu fleksör tendonlarý ilgilendirir þekilde olduðu, en sýk yaralanma düzeyinin bilek, en sýk yaralanan parmaðýn 4. parmak olduðu, þehir dýþýndan baþvurular nedeniyle hasta takibinin yetersiz kaldýðý söylenebilir.

Characteristics of pediatric hand injuries followed up in a hand rehabilitation unit

BACKGROUND
To establish the characteristics of patients in pediatric age who have been referred to hand rehabilitation center since 1998.
METHODS
The patients were screened retrospectively and those within 0-16 age range were included into the study (178 patients; 126 males [70.8%], 52 females [29.2]; mean age 10.33±4.45; range 0 to 16 years). Demographic data, causes and locations of injury and follow-up period (week) were recorded.
RESULTS
Mean duration of application for rehabilitation was 5.4±0.7 weeks. Only 99 (55.6%) patients could be followed-up for a period more than 4 weeks (20.8±22.2 weeks). Types of injuries were categorized as accidental (n=133; 74.7%), intentional (n=29; 16.3%) and congenital (n=15; 8.4%). Accidents were related to domestic (n=109; 61.2%) and environmental causes (n=53; 29.8%). The most frequent domestic accident was glass injury and fall accident. The regions in order of decreasing frequency were wrists, metacarpal bones, proximal phalanges, forearms, elbows, plexus, mid-phalanges, total hands, shoulders, total arm and bilateral hands. Fourth digit was the most frequently injured digit. The most common types of injuries were as followings: flexor tendon cut (44.5%), nerve cut and arterial injuries, fractures and burn contractures.
CONCLUSION
Hand injuries occurred mostly in male children, the most frequent type injury was accidental domestic injury of the wrist flexor tendon caused by broken glass fragments and the most frequently injured digit was the 4th and adherence of the patients to the follow-up protocol was unsatisfactory since majority of referrals were out-of-towners.