Turkiye Klinikleri Journal of Forensic Medicine and Forensic Sciences

.: ORIGINAL RESEARCH
Travmatik Ekstremite Amputasyonlarının Adli Tıp ve Acil Tıp Açısından Değerlendirilmesi: Tanımlayıcı Çalışma
Evaluation of Traumatic Extremity Amputations from the Perspective of Forensic and Emergency Medicine: A Descriptive Study
Uğur KAYHANa , Hüseyin ALDEMİRb , Şerife ÖZDİNÇb
aAfyonkarahisar Sağlık Bilimleri Üniversitesi Tıp Fakültesi Sağlık Uygulama ve Araştırma Merkezi, Adli Tıp AD, Afyonkarahisar, Türkiye
bAfyonkarahisar Sağlık Bilimleri Üniversitesi Tıp Fakültesi Sağlık Uygulama ve Araştırma Merkezi, Acil Tıp AD, Afyonkarahisar, Türkiye
Turkiye Klinikleri J Foren Sci Leg Med. 2025;22(2):67-73
doi: 10.5336/forensic.2024-106685
Article Language: TR
Full Text
ÖZET
 Amaç: Amputasyonlar sonuçları açısından acil servise başvuran adli olguların önemli bir kısmını oluşturmaktadır. Genellikle iş ve trafik kazaları sonucunda meydana gelmektedir. Çalışma, acil servise başvuran amputasyon vakalarını acil tıp ve adli tıp perspektifinden analiz ederek literatüre katkı sağlamayı, bölgesel yaralanma etiyolojisini ve değerlendirmede dikkat alınması gereken hususları vurgulamayı amaçlamaktadır. Gereç ve Yöntemler: Bu çalışmada, 2019-2024 yılları arasında Afyonkarahisar Sağlık Bilimleri Üniversitesi Hastanesi Acil Servisine başvuran ve adli tıp ana bilim dalına adli raporlama için gönderilen travmatik amputasyon olguları retrospektif olarak analiz edilmiştir. Demografik veriler, yaralanma etiyolojisi, amputasyon tipi, bölgesi ve seviyesi ile ilgili bilgiler toplanmış ve ''Türk Ceza Kanunu'nda Tanımlanan Yaralama Suçlarının Adli Tıp Açısından Değerlendirilmesi'' kılavuzu maddeleri kapsamında değerlendirilmiştir. Bulgular: Çalışmaya dâhil edilen 115 hastanın %66'sı (n=76) acil servise iş kazası nedeniyle başvurmuş, %62,6'sında (n=72) subtotal amputasyon, %71,3'ünde (n=82) ise tek parmak amputasyonu saptanmıştır. 8 vakada (%6,9) organ fonksiyonlarında zayıflama/kayıp kararı verilmiştir. Sonuç: Çalışma, travmatik amputasyon olgularının yalnızca tıbbi tedavi süreçleriyle sınırlı kalmayıp, adli ve fonksiyonel değerlendirmeler açısından da ele alınması gerektiğini ortaya koymuştur. İş kazalarının başlıca neden olarak öne çıkması ve elde önemli fonksiyona sahip işaret parmaklarının sıkça etkilenmesi bu tür kazaların iş güvenliği önlemleriyle önemli ölçüde azaltılabileceğini göstermiştir. Bunun yanı sıra, organ zayıflaması/yitirilmesi değerlendirmelerinde kullanılan adli tıbbi kılavuzların güncellenmesi gerektiği görülmüştür.

Anahtar Kelimeler: Amputasyon; adli tıp; acil tıp; travma; iş kazaları
ABSTRACT
 Objective: Amputations constitute a significant proportion of forensic cases reported in emergency departments due to their outcomes, primarily arising from workplace and traffic accidents. This study aims to contribute to the literature by analyzing amputation cases admitted to emergency departments from the perspectives of emergency and forensic medicine, emphasizing the regional injury etiology and highlighting critical considerations for evaluation. Material and Methods: This retrospective study analyzed traumatic amputation cases admitted to the Emergency Department of Afyonkarahisar Health Sciences University Hospital and referred to the department of forensic medicine for forensic reporting between 2019, and 2024. Data on demographic characteristics, injury etiology, type, region, and level of amputation were collected and evaluated in accordance with the ''Forensic Assessment of Injury Offenses Defined in the Turkish Penal Code'' guidelines. Results: Among the 115 patients included in the study, 66% (n=76) presented to the emergency department due to workplace accidents. Subtotal amputations were observed in 62.6% (n=72) of cases, while single-finger amputations were identified in 71.3% (n=82) of patients. Evidence of organ dysfunction or loss was documented in 8 cases (6.9%). Conclusion: The findings highlight that traumatic amputation cases should be addressed not only within the scope of medical treatment but also from forensic and functional evaluation perspectives. The predominance of workplace accidents as the leading cause, along with the frequent involvement of fingers with critical functional roles, such as the index finger, underscores the importance of enhanced occupational safety measures to reduce these injuries significantly. Additionally, the study emphasizes the need to update forensic medical guidelines used in the evaluation of organ dysfunction and loss.

Keywords: Amputation; forensic medicine; emergency medicine; trauma; occupational accidents
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