2018-2023 yılları arasında necmettin Erbakan üniversitesi Tıp Fakültesi adli Tıp Anabilim dalı tarafından vertebra travmaları nedeniyle maluliyet raporu düzenlenen olguların değerlendirilmesi
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Tarih
2025
Yazarlar
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Necmettin Erbakan Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Sanayi ve teknolojinin bu denli geliştiği, karayolları trafik güvenliğinin ve cezai müeyyidelerin belli bir oranda arttığının düşünüldüğü günümüzde insan gücünün hala geçer akçe olduğu iş kollarında yüksek enerji kullanımının yanında değişken hava koşulları ve trafik yoğunluğuyla birlikte insan davranışlarının tamamen kontrol edilemediği şehir içi ve şehir dışı trafiğinde her geçen gün artan trafik kazaları nedeniyle yalnızca ülkemizde değil tüm dünyada vertebra yaralanmaları büyük oranda artmaya başlamıştır. Bunun sonucunda kişiler ve kurumlar yüksek oranda iş gücü kaybına uğramaktadırlar.
Bu çalışma Necmettin Erbakan Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Dalına vertebra travmaları nedeniyle maluliyet değerlendirmesi için başvurmuş olan hastaların sosyodemografik özellikleri, olay tarihi, olayın meydana geliş şekli, başvuru şekilleri, yaralanma bölgeleri, yaralanma ağırlıkları, ameliyat bilgileri, yaralanması ve bunun sonrasında ortaya çıkan mevcut son durum muayenelerini retrospektif olarak değerlendirerek vertebral kolon yaralanmalarının ortaya çıkardığı iş gücü kaybına yönelik tespitlerde bulunmak ve maluliyet raporu yazımında kullanılan yönetmeliklerin bu tür yaralanmalara yönelik yapılan son durum muayene bulgularına göre ortaya çıkan arızaları değerlendirmede ne ölçüde yeterli olduklarını açıklamayı amaçlamıştır.
Gereç ve Yöntem: Bu çalışma için 01.01.2018 - 31.12.2022 tarihleri içerisinde maluliyet değerlendirmesi için başvurmuş olan 571 olguya ait veriler, hastane otomasyon sistemi ve Necmettin Erbakan Üniversitesi Tıp Fakültesi Adli Tıp Polikliniği arşivinde retrospektif olarak değerlendirilmiştir. Olgular ve adli tıbbi kayıtlardan elde edilen veriler; sosyodemografik özellikleri, olay tarihi, olayın meydana geliş şekli, başvuru şekilleri, yaralanma bölgeleri, yaralanma ağırlıkları, ameliyat bilgileri, yaralanması ve bunun sonrasında ortaya çıkan mevcut son durum muayeneleri hususlarında değerlendirilmiştir. Araştırma sonucu elde edilen veriler bilgisayar ortamında SPSS (Statistical Package for Social Sciences) 18.0 paket programı ile analiz edildi.
Bulgular: Çalışmamıza 571 olgu dahil edilmiştir. Olguların %61,3 (n=350)’i erkek, %38,7 (n=221)’si kadın cinsiyettedir. Olguların yaş ortalaması 39,61±14,86 iken vakaların %26,6’sının 18-27 yaş aralığında olduğu, olayların en sık yaz aylarında (%33,1) ve Ağustos (%13,3) ayında, en az sıklıkta ise kış aylarında (%18,9) meydana geldiği, olaylarda en büyük grubu %97,9 (n=559) ile trafik kazalarının oluşturduğu görülmüştür. Yaralanma özellikleri değerlendirildiğinde; en fazla yaralanmalarının %58,7 (n=335) ile lomber bölgede olduğu, en fazla yaralanan anatomik yapının %53,1 (n=303) oranında vertebra korpusu olduğu ve gelişen kırıkların niteliğine bakıldığında %51,1 (n=292) oranında çökme (kompresyon) kırığı izlendiği, yükseklik kayıp oranları arasında en büyük grubu %15,4 (n=88) ile %0-25 arası yükseklik kaybının oluşturduğu, olguların %73,6 (n=420)’sının konservatif yöntemlerle takip ve edildiği görülmüştür. Klinik muayene bulguları değerlendirildiğinde; motor kayıp gelişme oranı %11,4 (n=65), duyu kaybı gelişme oranı %8,2 (n=47), yürüyüş bozukluğu gelişme oranı %9,6 (n=55), yürüyüşte patoloji gelişmesi ile birlikte yürümeye yardımcı cihaz kullanımına ihtiyaç oranı %7,2 (n=40), parapleji veya tetrapleji görülme oranı %3,0 (n=17), idrar veya gayta inkontinansı görülme oranı %5,8 (n=33) olarak saptanmıştır. Opere edilen olgularda bu bulguların oranı konservatif olarak takip edilen olgulara göre istatistiksel olarak anlamlı yüksek bulunmuştur.
Sonuç: Benzer vertebra arızalarına farklı oranlar tayin eden yönetmeliklerin standardize edilmesi, birbirlerine karşı avantajlı ve dezavantajlı oldukları noktalar tespit edilerek yaş ve mesleki değerlendirmenin kombine edilmesinin yanı sıra arıza listelerinin genel hatlarıyla değil daha ayrıntılı şekilde ilgili branşlar ile iş birliği yapılarak hazırlanması sonucunda ortaya çıkacak yeni bir yönetmeliğin faydalı olacağı düşünülmüştür. Kişilerin son durum muayenelerinin de sistematik bir şekilde yapılması gerektiği, muayenede bulunan hekimler ile maluliyet hakkında aydınlatıcı eğitim toplantıları yapılmasıyla arızaların cetvellere uygun şekilde tanımlanmasının faydalı olacağı kanaatindeyiz.
Objectives: In today's world where industry and technology have developed so much, and highway traffic safety and penal sanctions are thought to have increased to a certain extent, in business lines where manpower is still a currency, high energy consumption, variable weather conditions and traffic density, and human behavior cannot be completely controlled in urban and intercity traffic, due to increasing traffic accidents, vertebral injuries have begun to increase significantly not only in our country but all over the world. As a result, individuals and institutions experience a high loss of labor. This study aimed to determine the loss of work force caused by vertebral column injuries by retrospectively evaluating the sociodemographic characteristics, date of the incident, how the incident occurred, application methods, injury areas, injury severity, surgery information, injury and the current latest examinations of the patients who applied to the Department of Forensic Medicine, Faculty of Medicine, Necmettin Erbakan University for disability evaluation due to vertebral traumas and to explain to what extent the regulations used in writing disability reports are sufficient in evaluating the disabilities that occur according to the latest examination findings for such injuries. Materials and Methods: For this study, data belonging to 571 cases who applied for disability assessment between 01.01.2018 - 31.12.2022 were evaluated retrospectively in the hospital automation system and the archives of Necmettin Erbakan University Faculty of Medicine Forensic Medicine Polyclinic. Data obtained from cases and forensic medical records were evaluated in terms of sociodemographic characteristics, date of incident, how the incident occurred, application methods, injury areas, injury severity, surgery information, injury and the current latest status examinations that occurred afterwards. The data obtained as a result of the research were analyzed in a computer environment with SPSS (Statistical Package for Social Sciences) 18.0 package program. Findings: 571 cases were included in our study. 61.3% (n=350) of the cases were male and 38.7% (n=221) were female. While the mean age of the cases was 39.61±14.86, it was seen that 26.6% of the cases were between the ages of 18-27, the incidents occurred most frequently in the summer months (33.1%) and August (13.3%), and least frequently in the winter months (18.9%), and the largest group of incidents was traffic accidents with 97.9% (n=559). When the injury characteristics were evaluated; It was seen that the most injuries were in the lumbar region with 58.7% (n=335), the most injured anatomical structure was the vertebral body with 53.1% (n=303), and when the nature of the fractures that developed was examined, compression fractures were observed with 51.1% (n=292), the largest group among the height loss rates was height loss between 0-25% with 15.4% (n=88), and 73.6% (n=420) of the cases were followed up with conservative methods. When the clinical examination findings were evaluated; The rate of motor loss was 11.4% (n=65), the rate of sensory loss was 8.2% (n=47), the rate of gait disturbance was 9.6% (n=55), the rate of need for walking aids due to pathology in walking was 7.2% (n=40), the rate of paraplegia or tetraplegia was 3.0% (n=17), and the rate of urinary or fecal incontinence was 5.8% (n=33). The rate of these findings in operated cases was found to be statistically significantly higher than in conservatively followed cases. Conclusion: It is thought that a new regulation that will emerge as a result of standardizing the regulations that assign different rates to similar vertebral failures, determining the points where they are advantageous and disadvantageous against each other and combining age and professional assessment, as well as preparing the failure lists in more detail rather than in general terms in cooperation with the relevant branches, will be beneficial. We believe that the latest status examinations of individuals should also be carried out systematically, and that it will be beneficial to define the failures in accordance with the tables by holding enlightening training meetings about disability with the physicians who perform the examination.
Objectives: In today's world where industry and technology have developed so much, and highway traffic safety and penal sanctions are thought to have increased to a certain extent, in business lines where manpower is still a currency, high energy consumption, variable weather conditions and traffic density, and human behavior cannot be completely controlled in urban and intercity traffic, due to increasing traffic accidents, vertebral injuries have begun to increase significantly not only in our country but all over the world. As a result, individuals and institutions experience a high loss of labor. This study aimed to determine the loss of work force caused by vertebral column injuries by retrospectively evaluating the sociodemographic characteristics, date of the incident, how the incident occurred, application methods, injury areas, injury severity, surgery information, injury and the current latest examinations of the patients who applied to the Department of Forensic Medicine, Faculty of Medicine, Necmettin Erbakan University for disability evaluation due to vertebral traumas and to explain to what extent the regulations used in writing disability reports are sufficient in evaluating the disabilities that occur according to the latest examination findings for such injuries. Materials and Methods: For this study, data belonging to 571 cases who applied for disability assessment between 01.01.2018 - 31.12.2022 were evaluated retrospectively in the hospital automation system and the archives of Necmettin Erbakan University Faculty of Medicine Forensic Medicine Polyclinic. Data obtained from cases and forensic medical records were evaluated in terms of sociodemographic characteristics, date of incident, how the incident occurred, application methods, injury areas, injury severity, surgery information, injury and the current latest status examinations that occurred afterwards. The data obtained as a result of the research were analyzed in a computer environment with SPSS (Statistical Package for Social Sciences) 18.0 package program. Findings: 571 cases were included in our study. 61.3% (n=350) of the cases were male and 38.7% (n=221) were female. While the mean age of the cases was 39.61±14.86, it was seen that 26.6% of the cases were between the ages of 18-27, the incidents occurred most frequently in the summer months (33.1%) and August (13.3%), and least frequently in the winter months (18.9%), and the largest group of incidents was traffic accidents with 97.9% (n=559). When the injury characteristics were evaluated; It was seen that the most injuries were in the lumbar region with 58.7% (n=335), the most injured anatomical structure was the vertebral body with 53.1% (n=303), and when the nature of the fractures that developed was examined, compression fractures were observed with 51.1% (n=292), the largest group among the height loss rates was height loss between 0-25% with 15.4% (n=88), and 73.6% (n=420) of the cases were followed up with conservative methods. When the clinical examination findings were evaluated; The rate of motor loss was 11.4% (n=65), the rate of sensory loss was 8.2% (n=47), the rate of gait disturbance was 9.6% (n=55), the rate of need for walking aids due to pathology in walking was 7.2% (n=40), the rate of paraplegia or tetraplegia was 3.0% (n=17), and the rate of urinary or fecal incontinence was 5.8% (n=33). The rate of these findings in operated cases was found to be statistically significantly higher than in conservatively followed cases. Conclusion: It is thought that a new regulation that will emerge as a result of standardizing the regulations that assign different rates to similar vertebral failures, determining the points where they are advantageous and disadvantageous against each other and combining age and professional assessment, as well as preparing the failure lists in more detail rather than in general terms in cooperation with the relevant branches, will be beneficial. We believe that the latest status examinations of individuals should also be carried out systematically, and that it will be beneficial to define the failures in accordance with the tables by holding enlightening training meetings about disability with the physicians who perform the examination.
Açıklama
Anahtar Kelimeler
Adli Tıp, Forensic Medicine, omurga, vertebrae, yaralanma, injury, maluliyet., disability.
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Kaya, M. (2025). 2018-2023 yılları arasında necmettin Erbakan üniversitesi Tıp Fakültesi adli Tıp Anabilim dalı tarafından vertebra travmaları nedeniyle maluliyet raporu düzenlenen olguların değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Adli Tıp Anabilim Dalı, Konya.
