Çivilemede Korkulu Rüya Emboliden Nasıl Kaçarım? Politravmadada Çivi Zamanlaması ve Oymasız Çivileme

Hakan Eskara

Sancaktepe Şehit Prof. Dr. İlhan Varank EAH, Ortopedi ve Travmatoloji, İstanbul, Türkiye

Eskara H. Çivilemede Korkulu Rüya Emboliden Nasıl Kaçarım? Politravmada Çivi Zamanlaması ve Oymasız Çivileme. Açan AE, Tokyay A, editör. Alt Ekstremitede İntramedüller Çivileme ve Komplikasyonları. 1. Baskı. Ankara: Türkiye Klinikleri; 2024.p.183-190

ÖZET

Yağ embolisi uzun kemik ve pelvis kırıklarından sonra değişken oranda ortaya çıkabilmektedir. Hasta- ların çoğunda yağ embolisi herhangi bir semptom göstermez. Politravma hastalarında yüksek oranda yağ embolisi gelişebilmektedir. Yağ embolisi kemik iliğinin intravazasyonundan kaynaklanır ve genel- likle uzun kemiklerin oyma ve çivileme işlemi ile ortaya çıkmaktadır. Yağ embolisi sendromu ise yağ embolisinin nadir fakat gelişmesi mümkün olan bir sonucudur. Yağ embolisi sendorumu, mekanik ven- tilasyon ihtiyacına sebep olabilen solunum yetmezliği ve akut solunum sıkıntısı sendromuna (ARDS) gidebilmektedir. Çoklu yaralanması olan hastalarda, erken cerrahi tespit ile yağ embolisi sendromu insidansında azalma elde edilebilmektedir. Yağ embolisi sendromuna bağlı gelişen ARDS’de yüksek oranda ölüm oranı bildirildiği için en iyi çözümün önleme olduğu açıktır. Politravma hastalarında cerrahi tedavi yöntemin seçimi ve zamanı tartışma konusu olmaya devam etmektedir. Oymalı ve oyma- sız çivileme yönteminin birbirine üstünlükleri olsa da çoklu yaralanması olan hastalarda uzun kemik kırıklarının tedavisinde ana yöntem kapalı intramedüller çivileme ile erken fiksasyon olmaya devam etmektedir.

Anahtar Kelimeler: Yağ embolisi; Çoklu travma; Oymasız çivileme

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