Sakrum k�r�klar�n�n 3 boyutlu haritaland�r�lmas�

Oguzkaya, Sinan; G�vercin, Yasin Semih; K�zkapan, Turan Bilge; Eken, Gokay; Arat, Feridun; Misir, Abdulhamit

Cilt : 30 Say� : 12 Y�l : 2024

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Sakrum k�r�klar�n�n 3 boyutlu haritaland�r�lmas� [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2023; 29(2): 247-251 | DOI: 10.14744/tjtes.2022.15163

Sakrum k�r�klar�n�n 3 boyutlu haritaland�r�lmas�

Sinan Oguzkaya¹, Yasin Semih G�vercin², Turan Bilge K�zkapan³, Gokay Eken⁴, Feridun Arat⁵, Abdulhamit Misir⁶
¹�ekirge Devlet Hastanesi, Ortopedi ve Travmatoloji Klini�i, Bursa
²Erciyes �niversitesi T�p Fak�ltesi, Ortopedi ve Travmatoloji Anabilim Dal�, Kayseri
³Ba�ak�ehir �am ve Sakura �ehir Hastanesi, Ortopedi ve Travmatoloji Anabilim Dal�, �stanbul
⁴Uluda� �niversitesi T�p Fak�ltesi, Ortopedi ve Travmatoloji Anabilim Dal�, Bursa
⁵Kayseri �ehir Hastanesi, Ortopedi ve Travmatoloji Anabilim Dal�, Kayseri
⁶Beylikd�z� Medicana International Hastanesi, Ortopedi ve Travmatoloji Klini�i, �stanbul

AMA�: Sakrum k�r�klar� nadir g�r�l�r ve uygun tedavinin belirlenmesi i�in 3 boyutlu k�r�k morfolojisinin detayl� olarak anla��lmas� �artt�r. Mevcut �al��man�n amac� sakrum k�r�klar�nda tekrarlayan k�r�k paternlerinin ortaya koyulmas�, par�alanma alanlar�n�n belirlenmesi ve bilgisayarl� tomografi (BT) bazl� k�r�k haritalar�n�n olu�turulmas�d�r.
GERE� VE Y�NTEM: Travmatik sakrum k�r�� tan�s� alm�� 72 hastan�n BT g�r�nt�leri incelendi. Her k�r�k i�in k�r�k hatlar� belirlendi ve dijital ortamda red�kte edildi. T�m k�r�klar bir �ablonun �zerine s�perpoze edilerek k�r�k haritalar� olu�turuldu. Her k�r�k tipi i�in ayr�ca par�alanma alanlar� ve �s� haritalar� elde edildi.
BULGULAR: �al��maya 40 erkek 32 kad�n hasta dahil edildi (ort. hasta ya�� 46.5�19.9). Elli �� hastada (%73.6) maj�r travma, 19 hastada (%26.4) min�r travma sonras� k�r�k olu�mu�tu. Zon 1 k�r�klarda �o�u k�r�k hatt� vertikal ve ya oblikti (45��ye kadar). Zone 2 k�r�klarda k�r�klar�n S1 ve S2 seviyelerinde yo�unla�t�� g�zlendi. Sa� tarafl� k�r�klarda anterolateral ve posterolateral k�s�mlar g�rece daha az etkilenmi�ti. Zone 3 k�r�klarda k�r�k hatlar� sakral kanal �evresinde ve S1, S2 ve S3 seviyelerinin etraf�nda yo�unla�m��t�. Orta hat ve median sakral krista �o�u zaman korunmu�tu.
TARTI�MA: Sakrum k�r�klar� her k�r�k tipi i�in bir tak�m tekrarlanabilir �zellikler g�stermektedir. Mevcut bulgular; tedavi planlamas�, fiksasyon materyallerinin yerle�tirilmesi, yeni implantlar geli�tirilmesi ve mevcut s�n�flama sistemlerinin modifikasyonu i�in faydal� olabilir.

Anahtar Kelimeler: 3D, haritalama; �s� haritas�; k�r�k paterni; sakrum k�r��.

Fracture lines and comminution zones of traumatic sacral fractures

Sinan Oguzkaya¹, Yasin Semih G�vercin², Turan Bilge K�zkapan³, Gokay Eken⁴, Feridun Arat⁵, Abdulhamit Misir⁶
¹Department of Orthopedics and Traumatology, �ekirge State Hospital, Bursa-T�rkiye
²Department of Orthopedics and Traumatology, Erciyes University Faculty of Medicine, Kayseri-T�rkiye
³Department of Orthopedics and Traumatology, Ba�aksehir Pine and Sakura State Hospital, �stanbul-T�rkiye
⁴Department of Orthopedics and Traumatology, Uluda� University Faculty of Medicine, Bursa-T�rkiye
⁵Department of Orthopedics and Traumatology, Kayseri City Hospital, Kayseri-T�rkiye
⁶Department of Orthopedics and Traumatology, Beylikd�z� Medicana International Hospital, �stanbul-T�rkiye

BACKGROUND: Sacral fractures are uncommon and understanding three-dimensional morphology is needed to obtain proper treatment. The purpose of this study was to identify the repeatable fracture patterns and comminution zones for traumatic sacral fractures and create fracture maps.
METHODS: Computerized tomography images of 72 patients with traumatic sacral fracture were included in the study. For each fracture, fracture lines were identified and digitally reduced. All fractures were superimposed over a template and fracture maps; comminution zones and heatmaps were created for each zone.
RESULTS: There were 40 males and 32 females with a mean age of 46.5�19.9. Fifty-three (73.6%) patients sustained major trauma, and 19 (26.4%) had minor trauma. There were 37 (51.4%) Zone 1, 22 (30.6%) Zone 2, and 13 (18.1%) Zone 3 fractures. Each Denis zone showed certain fracture patterns. In Zone 1 fractures, most of the fracture lines were vertical and oblique (up to 45�) orientation on both sides. In Zone 2 fractures, fracture lines were concentrated on the S1 and S2 levels. Anterolateral and posterolateral parts of the sacrum were less affected in right-side fractures. In Zone 3 fractures, fractures were concentrated in S1, S2, and S3 levels around the sacral canal. The median sacral crest and midline remained mostly unaffected.
CONCLUSION: Sacral fractures showed specific repeatable patterns for each zone. These findings may be helpful for pre-operative planning, placement of fixation material, design of new implants, and modification of current fracture-classification systems.

Keywords: 3D, fracture pattern; heatmap; mapping; sacral fracture.

Sorumlu Yazar: Sinan Oguzkaya, T�rkiye
Makale Dili: �ngilizce

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