Pediatrik suprakondiler humerus kırığı hastalarında farklı fonksiyonel skorlama sistemleri uygulamalarının karşılaştırması
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Tarih
2023
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Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Dirsek ekleminin kırık sonrası normal fonksiyonlarını yeniden kazanması klinik açıdan önemlidir. Detaylı ve iyi tasarlanmış analiz ve değerlendirme yöntemleri ile kaybedilen veya kazanılan fonksiyonlar dolayısı ile yaşam kalitesi belirlenmeye çalışılır. Çalışmamızda, pediatrik dirsek kırığı olan hastalarda farklı fonksiyonel skorlama sistemlerinin klinikte uygulaması üzerine karşılaştırma yaparak daha etkin veya duyarlı skorlama sisteminin hangisi olacağını belirlenmeye çalışılmıştır. Ayrıca kullanılan skorlama sistemlerinin çocuklar tarafından ne ölçüde cevaplanabilir olduğunu belirlenmeye çalışılmıştır. Çalışmamıza 18 erkek 11 kadın olmak üzere 29 hasta katılmıştır. Hastaların; eklem hareket açıklığı (EHA), ağrı ve fonksiyonel kapasitelerinin değerlendirilmesi postoperatif 8 ve 12. haftalarda yapılmıştır. Ağrı değerledirmesinde 12. hafta da VAS aktivite skorlarının, 8. hafta ölçülen VAS aktivite skorlarına kıyasla anlamlı düzeyde azaldığı gözlenmiştir(p<0,001). Postoperatif dirsek fleksiyon ve ekstansiyon kaybı değerlerinin değerlendirilmesinde 12. haftada anlamlı düzeyde iyileşme olduğu gözlenmiştir(p<0,001). Hastaların pasif ekstansiyon, aktif supinasyon ve pronasyon derecelerinin ortalamasının 8. ve 12. haftada benzer düzeyde olduğu gözlenmiştir(p>0,05). Flynn kriteri kozmetik değerinde 8. haftada %100 mükemmel değere ulaşıldığı, fonksiyonel değerde ise 12. haftada %84 mükemmel değere ulaşıldığı gözlenmiştir. Quick DASH anketi ve MAYO Dirsek Performans Skorunun korelasyon analizine göre 8. hafta Quick DASH puanı ile 12. Hafta Quick DASH puanı arasında pozitif yönde çok güçlü istatistiksel olarak anlamlı bir korelasyona rastlanmıştır(p<0,001). Mayo dirsek performans skorunun 8. hafta ile 12. hafta puanı arasında pozitif yönde orta düzeyde istatistiksel olarak anlamlı bir korelasyona rastlanmıştır(p=0,042). Mayo dirsek performans skorunun 8.ve 12. hafta puanı ile Quick DASH anketinin 8. Ve 12. hafta puanları arasında istatistiksel olarak anlamlı bir korelasyona rastlanamamıştır. Değerlendirmeler sonucunda 3 farklı ankete göre de fonksiyonel sonuçlarda iyileşme olduğunu görmekteyiz. Ancak pediatrik disek kırıkları için daha farklı anketlerin geliştirilmesi gerektiğini düşünmekteyiz.
It is clinically important for the elbow joint to regain its normal functions after a fracture. With detailed and well-designed analysis and evaluation methods, it is tried to determine the lost or gained functions, and therefore the quality of life. In our study, it was tried to determine which would be the more effective or sensitive scoring system by comparing the application of different functional scoring systems in the clinic in patients with pediatric elbow fractures. It was also tried to determine the extent to which the scoring systems used could be answered by children. 29 patients, 18 males and 11 females, participated in our study. Range of motion (ROM), pain and functional capacity of the patients were evaluated at 8 and 12 weeks postoperatively. In pain assessment, it was observed that VAS activity scores at the 12th week decreased significantly compared to the VAS activity scores measured at the 8th week (p<0.001). In the evaluation of postoperative elbow flexion and extension loss values, a significant improvement was observed at the 12th week (p<0.001). It was observed that the mean of passive extension, active supination and pronation degrees of the patients were similar at the 8th and 12th weeks (p>0.05). In the cosmetic value of Flynn criterion, 100% excellent value was reached at 8 weeks, and 84% excellent value was reached in functional value at 12 weeks. According to the correlation analysis of the Quick DASH questionnaire and the MAYO Elbow Performance Score, very strong in the positive dırection statistically significant correlation was found between the 8th week Quick DASH score and the 12th week's Quick DASH score (p<0.001). A moderately statistically significant in the positive dırection correlation was found between the 8th week and 12th week score of the Mayo elbow performance score (p=0.042). No statistically significant correlation was found between the 8th and 12th week scores of the Mayo elbow performance score and the 8th and 12th week scores of the Quick DASH questionnaire. As a result of the evaluations, we see that there is an improvement in functional results according to 3 different questionnaires. However, we think that different questionnaires should be developed for pediatric dissect fractures.
It is clinically important for the elbow joint to regain its normal functions after a fracture. With detailed and well-designed analysis and evaluation methods, it is tried to determine the lost or gained functions, and therefore the quality of life. In our study, it was tried to determine which would be the more effective or sensitive scoring system by comparing the application of different functional scoring systems in the clinic in patients with pediatric elbow fractures. It was also tried to determine the extent to which the scoring systems used could be answered by children. 29 patients, 18 males and 11 females, participated in our study. Range of motion (ROM), pain and functional capacity of the patients were evaluated at 8 and 12 weeks postoperatively. In pain assessment, it was observed that VAS activity scores at the 12th week decreased significantly compared to the VAS activity scores measured at the 8th week (p<0.001). In the evaluation of postoperative elbow flexion and extension loss values, a significant improvement was observed at the 12th week (p<0.001). It was observed that the mean of passive extension, active supination and pronation degrees of the patients were similar at the 8th and 12th weeks (p>0.05). In the cosmetic value of Flynn criterion, 100% excellent value was reached at 8 weeks, and 84% excellent value was reached in functional value at 12 weeks. According to the correlation analysis of the Quick DASH questionnaire and the MAYO Elbow Performance Score, very strong in the positive dırection statistically significant correlation was found between the 8th week Quick DASH score and the 12th week's Quick DASH score (p<0.001). A moderately statistically significant in the positive dırection correlation was found between the 8th week and 12th week score of the Mayo elbow performance score (p=0.042). No statistically significant correlation was found between the 8th and 12th week scores of the Mayo elbow performance score and the 8th and 12th week scores of the Quick DASH questionnaire. As a result of the evaluations, we see that there is an improvement in functional results according to 3 different questionnaires. However, we think that different questionnaires should be developed for pediatric dissect fractures.
Açıklama
Anahtar Kelimeler
Fizyoterapi ve Rehabilitasyon, Physiotherapy and Rehabilitation
