Cukurova University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Adana, Türkiye.
Cukurova University, Faculty of Medicine, Department of Orthopaedics and Traumatology, Adana, Türkiye.
Injury. 2024 Nov;55(11):111920. doi: 10.1016/j.injury.2024.111920. Epub 2024 Sep 24.
Amputations are among the most important traumatic injuries caused by earthquakes. However, data on amputee children and prosthesis application is quite limited in the literature. The aim of the study is to evaluate the injury-related data, stump problems, prosthesis application, difficulties and complications experienced with prosthesis during follow-up of children with 2023 Kahramanmaraş earthquake-related limb loss.
Sociodemographic and injury-related data, pre-amputation and post-amputation interventions, prosthesis application, current prosthetic problems, and revision surgeries of the amputee children were recorded.
Median age of patients (n = 102) admitted to our center was 13.0 years. 67.6 % of patients had one or more concomitant injuries. Median time and number of amputations were 4 (0-57) days and 1 (1-4), respectively. Of the total 120 amputations, 67.5 % (n = 81) were lower extremity amputations. Most common amputation levels were transtibial (29.1 %, n = 35), transfemoral (22.5 %, n = 27), and transhumeral (15.8 %, n = 19). Most amputees (56.8 %) underwent revision surgery after initial amputation. Median duration of time from amputation to prosthesis application was 184 (28-314) days. For 25 prostheses, a socket revision was required. Six patients had surgical revision of the stumps to allow prosthetic fit and mobility (due to bone overgrowth, soft tissue failure, heterotopic ossification).
Limited healthcare facilities, surgeries performed under emergency conditions, accompanying multiple traumas, inadequate follow-up conditions, and additional difficulties arising from the pediatric patient group lead to difficulties in the care of pediatric amputee patients. Our results will guide the care of this vulnerable patient population in the event of a similar unfortunate disaster.
截肢是地震导致的最重要的创伤性损伤之一。然而，文献中关于儿童截肢者和假肢应用的数据非常有限。本研究的目的是评估 2023 年卡赫拉曼马拉什地震相关肢体缺失儿童的损伤相关数据、残端问题、假肢应用、随访期间使用假肢的困难和并发症。
记录了患者的社会人口学和损伤相关数据、截肢前和截肢后的干预措施、假肢应用、目前的假肢问题以及截肢者的修复手术。
纳入本中心的患者（n=102）的中位年龄为 13.0 岁。67.6%的患者有一个或多个合并伤。中位截肢时间和截肢次数分别为 4（0-57）天和 1（1-4）次。在总共 120 例截肢中，67.5%（n=81）为下肢截肢。最常见的截肢部位是胫骨（29.1%，n=35）、股骨（22.5%，n=27）和肱骨（15.8%，n=19）。大多数截肢者（56.8%）在初次截肢后接受了修复手术。从截肢到假肢应用的中位时间为 184（28-314）天。25 例假肢需要进行接受腔修订。6 例患者因骨过度生长、软组织失败、异位骨化等原因进行残端手术以适应假肢的适配性和活动度。
有限的医疗设施、在紧急情况下进行的手术、伴随的多处创伤、不充分的随访条件以及儿科患者群体带来的额外困难，导致了儿童截肢患者护理的困难。我们的研究结果将为类似不幸灾难中这类弱势群体患者的护理提供指导。
