KALÇA KIRIKLI-ÇIKIÐI (PÝPKÝN TÝP-IV) ÝLE BERABER GÖRÜLEN TRAVMATÝK AORT KAPAK RÜPTÜRÜ

Kardiak travmalar, politravmatize hastalarýn takibinde önemli bir klinik problemdir. Politravmatize hastalarda hastane öncesi ölümlerin üçte birini kardiotorasik travmalar oluþturmaktadýr. Kardiak yaralanmalar, hastaneye canlý ulaþan hastalarýn ölüm nedenlerinin de büyük bir çoðunluðunu oluþturmaktadýr. Bu ölümler sýklýkla multi-disipliner yaralanmalarý olan politravmatize hastalarýn acil birimlerde eksik deðerlendirme ve tanýlarý neticesinde olmaktadýr. Burada, araç içi trafik kazasý sonucu kalça kýrýklý çýkýðý (Pipkin Tip-IV) ve ayrýþmamýþ sternum kýrýðý tanýlarý ile yatýrýlan, klinik takibi ve Ortopedik ameliyat hazýrlýklarý sýrasýnda travmatik aort kapak rüptürü tanýsý konan bir olgu sunulmaktadýr.

PIPKIN TYPE IV FRACTURE DISLOCATION OF THE HIP ASSOCIATED WITH A TRAUMATIC AORTIC VALVE RUPTURE

Traumatic aortic valve rupture with resultant aortic insufficiency is a rare complication of blunt trauma. Here reported is a case with a posterior fracture-dislocation of the hip (Pipkin type-IV) and an undisplaced sternum fracture who developed hemodynamic instability in the clinical follow-up and was diagnosed having a traumatic aortic valve rupture using echocardiography. He first was treated with a biological valve replacement. Two weeks later a total hip arthroplasty combined with the osteosynthesis of the posterior wall of the asetabulum was performed. Sternum fracture healed conservatively. In multiply injured patients especially with a blunt thorax trauma hemodyanamic instability despite appropriate fluid replacement should rise the suspicion of cardiac injuries, especially traumatic aortic valve rupture. Echocardiography is a simple but reliable method for the diagnosis.