ORTOPEDÝK TRAVMALARLA BÝRLÝKTE BULUNAN DAMAR YARALANMALARININ TEDAVÝSÝ

Son 22 yýlda kliniðimizde tedavisi yapýlan 120 ortopedik travma ile birlikte oluþan damar yaralanmasý olgusu geriye dönük olarak incelendi. Yaralanmalarýn 757 (%62.5) alt ekstremitede, 45'i (%37.5) üst ekstremitedeydi. Fizik muayene ile damar yaralanmasý tanýsý ve lokalizasyonu kesinleþen olgular doðrudan ameliyata alýndý, þüpheli olgularda ek incelemeler yapýldý. Sonuç olarak ortopedik travma ile birlikte oluþan her türden arter yaralanmasýnda erken taný konulmasý, agresif debridmandan sonra primer anastomoz veya safen ven interpozisyonu yapýlmasý, ven yaralanmasý eþlik eden aðýr doku hasarý bulunan olgularda hiç çekinmeden fasiotomi yapýlmasý baþarýnýn temelini oluþturur. Damar yaralanmasý tanýsý kesin olan olgularda ilave hiçbir vasküler inceleme yapýlmadan ameliyata gidilmesi en doðru seçimdir.

MANAGEMENT OF VASCULAR INJURIES WITH CONCOMITANT ORTHOPEDIC TRAUMA

One-hundred twenty patients who sustained vascular injuries together with orthopedic trauma in the last 22 years in our department were reviewed retrospectively. Seventy-Jive (%62.5) injuries involved the lower limbs, and forty-five (%37.5) injuries involved the upper limbs. In cases whose vascular injuries and locations were detected with physical examination definitely had been operated directly, on the other hand additional diagnostic modalities were used in doubtful cases. As a conclusion, the following approaches are clinical landmarks for a successful outcome in vascular injuries associated with orthopedic trauma: Early diagnosis, primary anastomosis or saphenous vein interposition after aggressive debridmant, performing fascia tomies liberally in cases with serious tissue injuries together with vein injury. It is obvious to operate immediately without any diagnostic tool when the diagnosis is certain by physical examination.