Turkiye Klinikleri Journal of Pediatrics

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Çocukluk Çağı Fiziksel Travmaların Nedenleri ve Sonuçları: Adli Olguların Retrospektif İncelenmesi
Causes and Consequences of Childhood Physical Traumas: Retrospective Analysis of Forensic Cases
Büşra BAYDEMİR KILINÇa , Ahmet Nezih KÖKb , Mustafa Talip ŞENERb
aErzurum Adli Tıp Grup Başkanlığı, Erzurum, Türkiye
bAtatürk Üniversitesi Tıp Fakültesi, Adli Tıp ABD, Erzurum, Türkiye
Turkiye Klinikleri J Pediatr. 2023;32(2):75-82
doi: 10.5336/pediatr.2023-97105
Article Language: TR
Full Text
ÖZET
 Amaç: Fiziksel travmalar, çocukluk çağında mortalite ve morbiditenin önemli sebeplerinden biridir. Travmalara bağlı kalıcı hasarlar, birey ve toplum açısından büyük kayıplar oluşturmaktadır. Travmaların sebeplerini ve şiddetini belirlemek, farkındalığını ve önlenebilirliğini artırmada önemlidir. Çalışmamızda çocukluk çağında adli değerlendirmesi yapılan çok merkezli olguları yara iyileşme süreç sonunda sunarak, travmatik lezyonları travmanın nedenlerini, şiddetini, engellilik durumunu belirlemeyi ve çözüm önerilerini sunmayı amaçladık. Gereç ve Yöntemler: 1 Ocak 2016-31 Aralık 2018 tarihleri arasında Atatürk Üniversitesi Tıp Fakültesi Adli Tıp Ana Bilim Dalına başvuran 1.418 pediyatrik yaş grubunda fiziksel travma olguları, yaş, cinsiyet, travma nedeni, travmatik lezyon, yaralanma şiddeti ve engellilik durumu incelendi. Travmanın ağırlığı Yaralanma Şiddeti Skoru ve engellilik durumu ise Çocuklar İçin Özel Gereksinim Raporuna göre belirlendi. Bulgular: Fiziksel travma olgularının %77,2'si (n=1.095) erkek çocuk, %22,8'i (n=323) kız çocuktu. Travmaların %88,6'sı (n=1.256) künt, %8,3'ü (n=118) penetran ve %3,1 termal yaralanmaya (n=44) bağlı gelişmişti. Künt travmaların %70'i (n=879) darp, %24'ü (n=307) trafik kazaları idi. Künt travmalarda majör yaralanmalar kemik kırıkları ve yaşamsal tehlike oluşturan lezyonlar en çok bebeklik ve oyun çağında, düşme ve ev kazalarına bağlı yaralanmalarda daha sık meydana geldiği bulundu. Fiziksel travmaların %2,1'inde (n=30) engellilik oluştuğu belirlendi. Kalıcı hasarların en sık trafik kazasına (n=20) bağlı ortaya çıkan ekstremite ve periferik sinir problemleri kaynaklı fonksiyon bozuklukları olduğu bulundu. Sonuç: Bulgularımıza göre çocukluk çağında majör travmaların en sık sebebi düşme ve ev kazalarıdır. Trafik kazaları ise kazanılmış engelliliğin en sık sebebidir. Çocukların yaşam ortamlarının güvenliği için koruyucu önlemlerin alınması ile fiziksel travmalar ve bunlara bağlı kazanılmış engellilik önlenebilir.

Anahtar Kelimeler: Adli olgular; çocuk; fiziksel travma; engellilik
ABSTRACT
 Objective: Physical traumas are one of the important causes of mortality and morbidity in childhood. Permanent disabilities resulting from traumas constitute significant losses for the individual and society. Identifying the causes and severity of traumas are important in raising awareness and preventability. In our study by presenting the multicenter cases with forensic assessment at the end of the wound healing process, we aimed to determine the causes of traumas, traumatic lesions, trauma severity, and permanent damage, and offer solutions. Material and Methods: 1,418 pediatric trauma cases admitted to the Forensic Medicine Department of Atatürk University between the 1st of January 2016 and 31st December 2018 were analyzed in terms of age, gender, causes of trauma, traumatic lesion, the severity of the injury, and the status of permanent disability. The severity of trauma was determined by the Injury Severity Score and the status of permanent disability was determined according to the Special Needs Report for Children. Results: 77.2% (n=1,095) of physical trauma cases were male and 22.8% (n=323) were female. 86.6% (n=1,256) of the traumas were blunt, 8.3% (n=118) were penetrating and 3.1% (n=44) were due to the thermal injury. 70% (n=879) of blunt traumas were beating and 24% (n=307) were traffic accidents. It was found that major injuries, bone fractures, and life-threatening injuries in blunt traumas occur more frequently due to falls and home accidents mostly in infancy and playing age. Disability was determined in 2.1% (n=30) of physical trauma cases. It was found that permanent damages are the dysfunctions caused by extremity and peripheral nerve problems which occur most frequently due to traffic accidents (n=20). Conclusion: According to our findings, the most common causes of major injuries in childhood are falls and home accidents. Traffic accidents are the most common cause of acquired disability. By taking protective measures to ensure the safety of children's living environments, physical traumas and the development of acquired disability can be prevented.

Keywords: Forensic cases; child; physical trauma; disability
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