Turkiye Klinikleri Journal of Forensic Medicine and Forensic Sciences

.: ORIGINAL RESEARCH
Adli Tıbbi Sürece Yansıyan Femur-Humerus Kırığı Saptanan Yenidoğanların Retrospektif Değerlendirilmesi: Tanımlayıcı Çalışma
Retrospective Evaluation of Newborns with Femur-Humerus Fractures Reflected in Forensic Medical Process: Descriptive Study
Nicel YILDIZ SİLAHLIa,e, Hızır ASLIYÜKSEKb, Fatih DİKİCİc, Tülin Tiraje CELKANd
aİstanbul Medipol Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları ABD, İstanbul, Türkiye
bİstanbul Üniversitesi-Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Adli Tıp ABD, İstanbul, Türkiye
cAcıbadem Mehmet Ali Aydınlar Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji ABD, İstanbul, Türkiye
dİstinye Üniversitesi Tıp Fakültesi, Çocuk Hematoloji-Onkoloji BD, İstanbul, Türkiye
eAdalet Bakanlığı, Adli Tıp Kurumu, İstanbul, Türkiye
Turkiye Klinikleri J Foren Sci Leg Med. 2022;19(3):203-9
doi: 10.5336/forensic.2022-90315
Article Language: TR
Full Text
ÖZET
 Amaç: Doğum travmaları, doğum eylemi esnasında mekanik etkiler ile ortaya çıkan fiziksel yaralanmalardır. Doğum sırasında karşılaşılan bu durum medikolegal sorunlara neden olmaktadır. Çalışmamızda, yenidoğan döneminde uzun kemik kırığı saptanarak medikolegal sürece konu olmuş olguların özelliklerinin tartışılması amaçlanmıştır. Gereç ve Yöntemler: Adli Tıp Kurumu 7. İhtisas Kurulunda 2018-2020 yılları arasında medikolegal değerlendirme yapılan uzun kemik (femur/humerus) kırığı geliştiği iddiası bulunan olgular (n=23) dâhil edildi. Olguların sosyodemografik ve klinik özellikleri ile kurul kararları retrospektif olarak incelendi. Çalışma izni 01 Aralık 2020 tarih ve 1114 sayılı Adli Tıp Kurumu Bilimsel Araştırma Komisyonundan alındı. Bulgular: Olguların kız/erkek oranı 8/15 idi. On sekiz (%78,2) raporda hekim şikâyeti vardı. Olgularda femur (n=14) ve humerus (n=9) kırıkları saptandı. Olguların gestasyon haftası ortalaması 33 idi. Olguların ortalama doğum tartıları 2.921 (750-5.140 g) g saptandı. Olguların, term/preterm oranı 18/5 saptandı. Humerus ve femur kırığı saptanan 23 olguda da konservatif tedavi uygulanmıştı. Yirmi iki olguda tıbbi uygulama hatası saptanmadı ve kırıklar komplikasyon olarak değerlendirildi. Sonuç: Medikolegal sürece yansıyan uzun kemik kırıklarının tanı ve takip sürecinin uygun şekilde yönetildiği görülmektedir. Süreçte hasta-hekim arasında yaşanan iletişim sorunlarının güven ilişkisini sarstığı görülmektedir. Tıbbi bakım ve tedavi sırasında meydana gelen ve direkt olarak hekimin hatalı bir eylemi sonucu oluşmayan bu durum doğum süreci açısından komplikasyon olarak tanımlanmaktadır.

Anahtar Kelimeler: Doğum; malpraktis; kemik kırıkları
ABSTRACT
 Objective: Birth injuries, are the phisical injuries that can occur with mechanical effects during delivery. This situation encountered during labor causes medicolegal problems. In this study, we aimed to discuss the characteristics of the cases that were subject to the medicolegal process by detecting due to long bone fractures in the neonatal period. Material and Methods: The long bone fracture cases, evaluated for malpractice (n=23) in 7th Specialization Board of the Council of Forensic Medicine (between 2018-2020), were included in the cohort. The sociodemographic and clinical characteristics of the cases and the decisions of the board were reviewed retrospectively. The study permit was obtained from the Scientific Research Commission of the Council of Forensic Medicine, dated December 01, 2020 and numbered 1114. Results: The female/male ratio of the cases was 8/15. In eighteen reports (78.2%), physicians were the subject of complaints. Femoral (n=14) and humeral fractures (n=9) were detected. The mean gestational age was 33 weeks. The mean birth weight was 2,921 (750-5,140 gr) gr. The term/preterm ratio of the cases was 18/5. Conservative treatment was observed all cases with humerus fractures. Medical malpractice was not detected in 22 cases and fractures were evaluated as complications. Conclusion: The diagnosis and follow-up process was appropriately managed in long bone fractures that were reflected in the medicolegal process. Communication problems between the patient and the doctor undermine the trust relationship. This situation, which occurs during medical care and treatment and does not occur directly as a result of the physician's faulty action, is defined as a complication in terms of the birth process.

Keywords: Delivery; malpractice; bone fractures
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