Yanık Sonrası Kemik ve Kas Sistemindeki Değişiklikler

Op. Dr. Sami Apak1
Op. Dr. Mehmet Onur Gülseren2

1Eskişehir Şehir Hastanesi, Çocuk Cerrahisi Kliniği, Eskişehir, Türkiye
2Balıkesir Devlet Hastanesi, Genel Cerrahi Kliniği, Balıkesir, Türkiye

ÖZET

Önemli yanık yaralanmaları, vücutta sürekli yapılıp yıkılan ve ömür boyu yeniden şekillenen kemiklerde değişikliklere neden olmaktadır. Yanık sonrası inflematuvar fazda üretilen sitokinler, katekolaminler ve kortizon kemik rezorbsiyonundan sorumludurlar. Ayrıca paratiroit bezinin baskılanması, D vitamini yetersizliği ve uzun süre hareketsizlik kemiklerde osteoporoz oluşturmaktadır. Son yıllarda RANK/RANKL/OPG sinyal sisteminin keşfi ile kemiklerdeki osteoporozun daha iyi anlaşılmasını sağlamıştır. Eklemlerde hareket kısıtlılığından eklem köprüleşmesine kadar ilerleyen ve nedeni hala anlaşılamayan hetetropik ossifikasyon da, yanık yaralanmalarından sonra eklemlerde işlev bozukluğu yapması ve tedavisinin zor olması nedeniyle önemlidir. Yanığın şiddetine ve lokalizasyonuna bağlı olarak, osteomiyelit, kırık, eklem çıkıklığı, septik artrit, büyümede gecikme, postür bozukluğu ve extremite kaybına neden olan bir çok değişikliklere neden olmaktadır.

Anahtar Kelimeler: Yanık üniteleri; Yanıklar

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