{"id":3441,"date":"2017-12-19T19:25:12","date_gmt":"2017-12-19T16:25:12","guid":{"rendered":"http:\/\/dralpergokce.com\/?page_id=3441"},"modified":"2018-01-05T18:03:32","modified_gmt":"2018-01-05T15:03:32","slug":"kemik-kiriklari","status":"publish","type":"page","link":"https:\/\/dralpergokce.com\/en\/tedaviler\/kemik-kiriklari\/","title":{"rendered":"Bone Fractures"},"content":{"rendered":"
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Kemik anatomisi<\/strong><\/p>\n

Kemikler v\u00fccuda d\u0131\u015f etkenlere kar\u015f\u0131 koruma sa\u011flayan, hareketlerimize destek olan, etraf\u0131ndaki dokulara tutunma imkan\u0131 veren sert ve sa\u011flam yap\u0131lar\u0131n ad\u0131d\u0131r. Kemiklerin sert yap\u0131s\u0131 i\u00e7eri\u011findeki fosfor, kalsiyum ve manganez sayesindedir. Yeni do\u011fdu\u011fumuzda v\u00fccudumuzda 270 adet bulunurken, yeti\u015fkin oldu\u011fumuzda bu say\u0131 206 adet olur.\u00a0 Kemi\u011fin esnekli\u011fini sa\u011flayan ise h\u00fccreleri ve fibroz dokusudur.<\/p>\n

Kemikler kendi i\u00e7erisinde 3 gruba ayr\u0131l\u0131r.<\/p>\n

Anatomi kemikleri:<\/strong>\u00a0\u0130skelet sistemimiz g\u00f6z \u00f6n\u00fcne al\u0131nd\u0131\u011f\u0131nda kemikler uzun kemikler, k\u0131sa kemikler ve yass\u0131 kemikler olarak gruplan\u0131r.<\/p>\n

Uzun kemikler:<\/strong>\u00a0Boyu kal\u0131nl\u0131\u011f\u0131ndan daha fazla olan kemikler bu gruba girer ve genellikle silindir \u015feklindedir. \u00a0Uzun kemikler kol ve bacak kemikleridir. En uzun kemik ise uyluk kemi\u011fidir.<\/p>\n

Yass\u0131 kemikler:<\/strong>\u00a0Bu kemiklerin geni\u015fli\u011fi uzunluklar\u0131ndan ve kal\u0131nl\u0131klar\u0131ndan daha fazlad\u0131r. Yass\u0131 kemiklere kafa tas\u0131, g\u00f6\u011f\u00fcs ve kaburga kemikleridir.<\/p>\n

    \n
  • G\u00f6r\u00fcn\u00fc\u015f olarak yass\u0131d\u0131rlar.<\/li>\n
  • Yap\u0131lar\u0131nda kemik kanal\u0131 ve sar\u0131 kemik ili\u011fi bulunmaz.<\/li>\n
  • Yap\u0131lar\u0131nda k\u0131rm\u0131z\u0131 kemik ili\u011fi bulunur.<\/li>\n<\/ul>\n

    K\u0131sa Kemikler:<\/strong>\u00a0Bu kemiklerin geni\u015fli\u011fi, boyu ve kal\u0131nl\u0131\u011f\u0131 hemen hemen ayn\u0131d\u0131r. Omurga, el ve ayak kemikleri k\u0131sa kemikler olarak kabul edilir.<\/p>\n

      \n
    • Omurga, el ve ayaklar\u0131 olu\u015fturan kemiklerdir.<\/li>\n
    • Sar\u0131 kemik ili\u011fi ve kemik kanal\u0131 bulunmaz.<\/li>\n
    • Geni\u015flik, kal\u0131nl\u0131k ve uzunluklar\u0131 ayn\u0131d\u0131r.<\/li>\n<\/ul>\n

      Kemik k\u0131r\u0131\u011f\u0131 nedir?
      <\/strong><\/p>\n

      Kemik k\u0131r\u0131\u011f\u0131 kemi\u011fin orijinal \u015feklinden genellikle darbe, bas\u0131n\u00e7 ve travma nedeniyle bazen de kemik erimesi, kemik kanseri ve \u201costeogenesis imperfecta\u201d gibi hastal\u0131klara ba\u011fl\u0131 olarak da olu\u015fabilen kemi\u011fin bir ya da birden \u00e7ok par\u00e7aya ayr\u0131lmas\u0131d\u0131r.<\/p>\n

      Kemik k\u0131r\u0131\u011f\u0131 \u00e7e\u015fitleri nelerdir?<\/strong><\/p>\n

      Kemik k\u0131r\u0131klar\u0131 4 ana grupta incelenir.<\/p>\n

      K\u0131smi kemik k\u0131r\u0131klar\u0131:<\/strong>\u00a0Bu k\u0131r\u0131klarda kemik b\u00fct\u00fcnl\u00fc\u011f\u00fc k\u0131smi olarak bozulmu\u015ftur ama kemik hala tek par\u00e7ad\u0131r. Yar\u0131m k\u0131r\u0131k ya da \u00e7atlak olarak da adland\u0131r\u0131labilir. Bu k\u0131r\u0131klarda \u00e7evre yumu\u015fak dokular minimal d\u00fczeyde zarar g\u00f6r\u00fcr.<\/p>\n

      Basit kemik k\u0131r\u0131klar\u0131:<\/strong>\u00a0Bu k\u0131r\u0131klarda kemik b\u00fct\u00fcnl\u00fc\u011f\u00fc bozulmu\u015f kemik iki par\u00e7aya ayr\u0131lm\u0131\u015ft\u0131r fakat kemiklerin konumlar\u0131 do\u011fal konumlar\u0131na yak\u0131nd\u0131r ve \u00e7evre yumu\u015fak dokular az zarar g\u00f6rm\u00fc\u015ft\u00fcr.<\/p>\n

      A\u00e7\u0131k kemik k\u0131r\u0131klar\u0131:<\/strong>\u00a0Bu tip kemik k\u0131r\u0131klar\u0131 \u00e7ok ciddidir k\u0131r\u0131lan kemikler birbirinden uzakla\u015f\u0131r k\u0131r\u0131lan kemiklerden en az biri v\u00fccudun d\u0131\u015f\u0131na \u00e7\u0131kar. Bu k\u0131r\u0131klarda cilt b\u00fct\u00fcnl\u00fc\u011f\u00fc bozulur kemi\u011f\u0131n u\u00e7 k\u0131s\u0131mlar\u0131 d\u0131\u015fardan g\u00f6r\u00fclebilir kanama ve enfeksiyon riski bulunur.<\/p>\n

      Par\u00e7al\u0131 kemik k\u0131r\u0131klar\u0131:\u00a0<\/strong>Bu k\u0131r\u0131klarda kemik b\u00fct\u00fcnl\u00fc\u011f\u00fc birden fazla yerden bozulmu\u015ftur. Bu k\u0131r\u0131klara multiple k\u0131r\u0131k da denilebilir. Par\u00e7al\u0131 kemik k\u0131r\u0131klar\u0131 v\u00fccudun neresinde olursa olsun ciddiye al\u0131nmal\u0131d\u0131r.
      <\/strong><\/p>\n

      K\u0131r\u0131lma \u015eekline G\u00f6re Kemik K\u0131r\u0131klar\u0131<\/strong><\/p>\n

        \n
      1. Enine do\u011fru k\u0131r\u0131klar:<\/strong>\u00a0K\u0131r\u0131k a\u00e7\u0131s\u0131 kemi\u011fin uzunlamas\u0131na dik \u015fekilde olu\u015fan k\u0131r\u0131klard\u0131r.<\/li>\n
      2. Av\u00fclsiyon k\u0131r\u0131klar:<\/strong>\u00a0Kemi\u011fin bir b\u00f6l\u00fcm\u00fcnden bir miktar kemik par\u00e7as\u0131n\u0131n kopup ayr\u0131ld\u0131\u011f\u0131 k\u0131r\u0131klard\u0131r.<\/li>\n
      3. Spiral k\u0131r\u0131klar:<\/strong>\u00a0Kemik dokusunda olu\u015fan b\u00fck\u00fclmeli k\u0131r\u0131klard\u0131r.<\/li>\n
      4. E\u011fik k\u0131r\u0131klar:<\/strong>\u00a0Kemi\u011fin uzunlamas\u0131na \u00e7apraz bir \u015fekilde olu\u015fan kemik k\u0131r\u0131klar\u0131d\u0131r.<\/li>\n
      5. E\u011fik Ayr\u0131lm\u0131\u015f:<\/strong>\u00a0Kemi\u011fin uzunlamas\u0131na \u00e7apraz bir \u015fekilde olu\u015fan ayn\u0131 zamanda kemiklerinde birbirinden bir miktar uzakla\u015ft\u0131\u011f\u0131 kemik k\u0131r\u0131klar\u0131d\u0131r.<\/li>\n
      6. Par\u00e7al\u0131 k\u0131r\u0131klar:<\/strong>\u00a0Kemi\u011fin k\u0131r\u0131l\u0131rken 2 den fazla par\u00e7a ayr\u0131ld\u0131\u011f\u0131 bazen kemi\u011fin bir k\u0131sm\u0131n\u0131n ufaland\u0131\u011f\u0131 kemik k\u0131r\u0131klar\u0131d\u0131r.<\/li>\n
      7. Segmental k\u0131r\u0131klar:<\/strong>\u00a0Par\u00e7al\u0131 k\u0131r\u0131klar\u0131n farkl\u0131 bir \u015feklidir ve par\u00e7al\u0131 k\u0131r\u0131ktan fark\u0131 kemik ufalanmas\u0131n\u0131n olmad\u0131\u011f\u0131 k\u0131r\u0131klard\u0131r.<\/li>\n
      8. A\u00e7\u0131k k\u0131r\u0131klar:<\/strong>\u00a0Kemi\u011fin k\u0131r\u0131l\u0131p bir ya da bir den fazla par\u00e7as\u0131n\u0131n cilt d\u0131\u015f\u0131na \u00e7\u0131kt\u0131\u011f\u0131 k\u0131r\u0131klard\u0131r.<\/li>\n
      9. K\u0131smi k\u0131r\u0131k:<\/strong>\u00a0Kemikte olu\u015fan yar\u0131m k\u0131r\u0131klard\u0131r kemik b\u00fct\u00fcnl\u00fc\u011f\u00fcn\u00fc bozmayacak \u015fekilde olu\u015furlar.<\/li>\n<\/ol>\n

        \"\"<\/p>\n

        Kemik k\u0131r\u0131\u011f\u0131 belirtileri nelerdir?<\/strong><\/p>\n

        Kemik k\u0131r\u0131klar\u0131 \u00e7e\u015fitli gruplara ayr\u0131ld\u0131\u011f\u0131 gibi k\u0131r\u0131k belirtileri de de\u011fi\u015fiklik g\u00f6sterir. Par\u00e7al\u0131 ve a\u00e7\u0131k k\u0131r\u0131klarda hareket kayb\u0131 olup, hareketle ve ya hareketsiz \u015fiddetli a\u011fr\u0131 hissi, b\u00f6lgesel \u015fi\u015flikler, \u00f6dem ve kanama gibi belirgin belirtiler olurken, basit ve k\u0131smi k\u0131r\u0131klarda \u015fikayetler daha hafiftir. \u015eekil bozuklu\u011fu olu\u015fmayabilir. A\u00e7\u0131k ve par\u00e7al\u0131 k\u0131r\u0131klara g\u00f6re basit ve k\u0131smi k\u0131r\u0131klarda hareket ve i\u015flev kayb\u0131 daha az olur.<\/p>\n

        Kemik k\u0131r\u0131klar\u0131n\u0131n te\u015fhisi<\/strong><\/p>\n

          \n
        • A\u00e7\u0131k k\u0131r\u0131klarda cilt d\u0131\u015f\u0131na kemik par\u00e7alar\u0131 \u00e7\u0131kar rahatl\u0131kla g\u00f6r\u00fclebilir.<\/li>\n
        • K\u0131r\u0131k b\u00f6lgesinde kanamaya ba\u011fl\u0131 morarma olu\u015fur.<\/li>\n
        • K\u0131r\u0131k kapal\u0131 ise k\u0131r\u0131k b\u00f6lgesinde \u015fi\u015fme meydana gelir.<\/li>\n
        • K\u0131r\u0131k b\u00f6lgesinde deformiteye ba\u011fl\u0131 \u015fekil bozuklu\u011fu olu\u015fur.<\/li>\n
        • K\u0131r\u0131k b\u00f6lgesinde temasa ba\u011fl\u0131 hassasiyet artar ve hasta ac\u0131 hisseder elle muayene s\u0131ras\u0131nda k\u0131r\u0131k anla\u015f\u0131labilir.<\/li>\n
        • El ve parmaklar gibi hareketli eklemlerde hareket kabiliyeti ciddi \u015fekilde azal\u0131r ve a\u011fr\u0131l\u0131 olur.<\/li>\n
        • K\u00fc\u00e7\u00fck eklemlerdeki k\u0131r\u0131klarda eklemin simetrisi bozulur.<\/li>\n<\/ul>\n

          T\u00fcm bu belirtilere ra\u011fmen t\u00fcm k\u0131r\u0131klarda r\u00f6ntgen \u00e7ekilerek kemiklerin yeni konumu ve kemikte olu\u015fan deformiteler r\u00f6ntgen \u00e7ekilerek tespit edilmelidir. K\u0131r\u0131\u011fa ba\u011fl\u0131 \u015fi\u015fme ve morarma fazla ise \u00e7evre yumu\u015fak dokular\u0131n hasar boyutu i\u00e7in MR \u00e7ekilmesi gerekebilir.<\/p>\n

          Kemik k\u0131r\u0131\u011f\u0131 \u00f6nleyici tedbirler nelerdir?<\/strong><\/p>\n

            \n
          • K\u0131r\u0131klar\u0131n bir \u00e7o\u011fu trafik kazalar\u0131ndan dolay\u0131 olu\u015fur ara\u00e7 i\u00e7inde mutlaka emniyet kemeri tak\u0131lmal\u0131d\u0131r.<\/li>\n
          • Kemik erimesi olan ki\u015filer yo\u011fun fiziki aktivite ve egzersizlerden ka\u00e7\u0131nmal\u0131d\u0131r.<\/li>\n
          • D\u00fc\u015fme, \u00e7arpma gibi tehlikeler bar\u0131nd\u0131ran spor faaliyetleri (futbol, kayak, bisikler, motosiklet) yapanlar mutlaka yapt\u0131kalr\u0131 faaliyete uygun koruyucu ekipman kullanmal\u0131d\u0131r.<\/li>\n
          • Y\u00fcr\u00fcy\u00fc\u015f\u00fc zorla\u015ft\u0131ran kayma, tak\u0131lma gibi olumsuz durumlara sebebiyet verecek ayakkab\u0131 se\u00e7imleri yap\u0131lmamal\u0131d\u0131r.<\/li>\n
          • Sigara ve alkol t\u00fcketimi m\u00fcmk\u00fcn oldu\u011funda azalt\u0131lmal\u0131.<\/li>\n
          • Ev i\u00e7i korunma \u00f6nlemleri olarak \u0131slak zeminlerin (k\u00fcvet, du\u015fakabin vb)etraf\u0131nda tutunma aparatlar\u0131 bulunmal\u0131.<\/li>\n
          • Kemik yap\u0131s\u0131n\u0131 g\u00fc\u00e7lendiren kalsiyum ve D vitamini takviyesi yap\u0131lmal\u0131.<\/li>\n<\/ul>\n

            Kemik k\u0131r\u0131klar\u0131nda ilk yard\u0131m tedbirleri nelerdir?<\/strong><\/p>\n

              \n
            • Bir kaza esnas\u0131nda \u00f6nce en hayati k\u0131r\u0131\u011fa m\u00fcdahale edilmelidir.<\/li>\n
            • K\u0131r\u0131k olu\u015fan ki\u015fi bulundu\u011fu yerden hareket ettirilmemelidir.<\/li>\n
            • El, kol ve bilek gibi bir b\u00f6lgede k\u0131r\u0131k varsa k\u0131r\u0131k \u00e7evresinde varsa saat bileklik gibi tak\u0131lar \u00e7\u0131kar\u0131lmal\u0131d\u0131r.<\/li>\n
            • A\u00e7\u0131k k\u0131r\u0131k varsa kan kayb\u0131n\u0131 azaltma ve enfeksiyon kapmas\u0131n\u0131 \u00f6nlemek i\u00e7in temiz bir bezle k\u0131r\u0131k \u00fczeri kapat\u0131lmal\u0131 d\u0131r.<\/li>\n
            • El, kol ve ayak gibi b\u00f6lgelerde olu\u015fan k\u0131r\u0131klarda sarg\u0131 yap\u0131lacaksa parmaklar a\u00e7\u0131k b\u0131rak\u0131lmal\u0131d\u0131r. Parmaklar arac\u0131l\u0131\u011f\u0131yla doku rengi ve hastan\u0131n tepkileri kontrol edilebilir.<\/li>\n
            • Uzun kemiklerde olu\u015fan k\u0131r\u0131klarda ilk yard\u0131m ekibi gelene kadar ve ya hastaneye gidilene kadar k\u0131r\u0131k kemikler alttan ve \u00fcstten sar\u0131larak sabitlenmelidir.<\/li>\n<\/ul>\n

              S\u0131k kar\u015f\u0131la\u015f\u0131lan kemik k\u0131r\u0131klar\u0131?<\/strong><\/p>\n

              V\u00fccudumuzda 206 kemik bulunur ve bu kemiklerin her birinin k\u0131r\u0131lma ihtimali vard\u0131r. Baz\u0131 kemikler konum ve i\u015flevlerinden dolay\u0131 k\u0131r\u0131lmaya daha m\u00fcsaittir.<\/p>\n

              K\u00f6pr\u00fcc\u00fck kemi\u011fi k\u0131r\u0131klar\u0131:<\/strong>\u00a0k\u00f6pr\u00fcc\u00fck kemi\u011fi \u00fcst g\u00f6\u011f\u00fcs kafesi ve k\u00fcrek aras\u0131ndad\u0131r ve boyu uzundur. Temel g\u00f6revi kollarla v\u00fccudun ba\u011flant\u0131s\u0131n\u0131 sa\u011flamakt\u0131r. Yeti\u015fkinlere g\u00f6re \u00e7ocuklarda daha \u00e7ok<\/p>\n

              k\u0131r\u0131lma olur ama \u00e7ocuklar da\u00a0 yeti\u015fkinlere g\u00f6re daha h\u0131zl\u0131 iyile\u015fir.\u00a0 K\u00f6pr\u00fcc\u00fck kemi\u011fi k\u0131r\u0131ld\u0131\u011f\u0131nda kollar hareket ettirilemez ve g\u00f6\u011f\u00fcs, omuz b\u00f6lgesinde \u015fi\u015flik olu\u015fur.<\/p>\n

              Kol k\u0131r\u0131klar\u0131:<\/strong>\u00a0En s\u0131k kar\u015f\u0131la\u015f\u0131lan k\u0131r\u0131k kol k\u0131r\u0131klar\u0131d\u0131r. Yeti\u015fkinlerde olu\u015fan toplam k\u0131r\u0131klar\u0131n yar\u0131s\u0131 kollarda olu\u015fan k\u0131r\u0131klard\u0131r.\u00a0 Kollar denge organ\u0131 olarak kullan\u0131ld\u0131\u011f\u0131 i\u00e7in darbe, d\u00fc\u015fme gibi bir \u00e7ok durumda v\u00fccudu korumak i\u00e7in kollar\u0131m\u0131z\u0131 siper ederiz darbe, bas\u0131n\u00e7, \u00e7arpma gibi durumlar kol kemiklerinin k\u0131r\u0131lmas\u0131na sebep olabilir.<\/p>\n

              El bile\u011fi K\u0131r\u0131klar\u0131:<\/strong>\u00a0El bile\u011fi hareketli eklemlerden biridir. Zorlama, d\u00fc\u015fme, \u00e7arpma travma ya da spor kazalar\u0131 sonucu el bile\u011fi k\u0131r\u0131lmas\u0131 yayg\u0131nd\u0131r.<\/p>\n

              Ayak bile\u011fi k\u0131r\u0131klar\u0131:<\/strong>\u00a0Ayak bile\u011fi burkulmaya m\u00fcsaittir. Ayak bile\u011fi v\u00fccudun t\u00fcm y\u00fck\u00fcn\u00fc ta\u015f\u0131mas\u0131 ve hareketli bir eklem olmas\u0131ndan dolay\u0131 ani hareketlerde, kayma, y\u00fcksekten atlama gibi durumlarda burkulur bazen ise k\u0131r\u0131l\u0131r.<\/p>\n

              En s\u0131k\u0131nt\u0131l\u0131 kemik k\u0131r\u0131\u011f\u0131?<\/strong><\/p>\n

              Skafoid k\u0131r\u0131\u011f\u0131:<\/strong>\u00a0El bile\u011fi en karma\u015f\u0131k ve hareket kabiliyeti en y\u00fcksek eklemimizdir. Temel el hareketlerimiz skafoid kemi\u011fi arac\u0131l\u0131\u011f\u0131yla yap\u0131l\u0131r. G\u00f6revleri ve bulundu\u011fu konum nedeniyle skafoid kemi\u011fi \u00e7ok \u00f6nemlidir ve do\u011fru kaynamaz ise elde ciddi fonksiyon kayb\u0131 meydana gelir.<\/p>\n

              Skafoid k\u0131r\u0131klar\u0131n\u0131n te\u015fhis ve tedavisi di\u011fer k\u0131r\u0131klara g\u00f6re biraz daha zordur.<\/p>\n

              Skofoid k\u0131r\u0131klar\u0131nda fiziki muayene ye ek olarak el ve bilek i\u00e7in \u00e7ekilen r\u00f6ntgen bazen k\u0131r\u0131k tespiti i\u00e7in yetersiz kalabilir bu gibi durumlarda BT (Bilgisayarl\u0131 Tomografi) ve MR (Manyetik Rezonans) \u00e7ekilerek de\u011ferlendirilmesinde yarar vard\u0131r. El bile\u011finde k\u0131r\u0131k \u015f\u00fcphesi var ise atel yard\u0131m\u0131yla 15 - 20 g\u00fcn el bile\u011fini sabitlemek ve m\u00fcmk\u00fcnse hi\u00e7 kullanmamak \u00f6nemlidir. Bu s\u00fcre\u00e7 bittikten sonra yeniden g\u00f6r\u00fcnt\u00fcleme teknikleri ile el bile\u011finin son durumu tespit edilip tedaviye devam edilir.<\/p>\n

              Skafoid en zor kaynayan k\u0131r\u0131klar\u0131n ba\u015f\u0131nda gelir nedenlerine k\u0131saca de\u011finirsek;<\/strong><\/p>\n

                \n
              1. Kemik k\u0131r\u0131klar\u0131n\u0131n kaynamas\u0131 i\u00e7in k\u0131r\u0131k kemi\u011fe yeterli derecede kan iletimi olmal\u0131d\u0131r. Skafoid kemi\u011fi anatomik yap\u0131s\u0131ndan dolay\u0131 kanlanmas\u0131 s\u0131n\u0131rl\u0131d\u0131r ve ge\u00e7 kaynar.<\/li>\n
              2. K\u0131r\u0131k b\u00f6lgesi el ekleminin i\u00e7inde kal\u0131r ve k\u0131r\u0131\u011f\u0131n iyile\u015fmesi i\u00e7in gereken reaksiyonlardan biri olan eklem s\u0131v\u0131 temas\u0131 daha zor olur.<\/li>\n
              3. El ekleminde olmas\u0131 nedeniyle hareketli bir eklem olmas\u0131 skafoid kemi\u011fini sabitlemeyi \u00e7ok zorla\u015ft\u0131r\u0131r. Her durumda sarg\u0131, atel ve al\u00e7\u0131ya ra\u011fmen skafoid bir miktar hareket eder bu da iyile\u015fme s\u00fcrecini uzat\u0131r.<\/li>\n
              4. Basit k\u0131r\u0131klarda genelde ciddi bir sorun olmasa da skafoid kemi\u011finde par\u00e7al\u0131 k\u0131r\u0131k olu\u015ftuysa tedavi \u00e7ok daha zor bir hal al\u0131r.<\/li>\n<\/ol>\n

                Kemik k\u0131r\u0131klar\u0131 nas\u0131l tedavi edilir?<\/strong><\/p>\n

                K\u0131r\u0131klar\u0131n \u00e7ok b\u00fcy\u00fck bir k\u0131sm\u0131 sorunsuz kaynamaktad\u0131r. Enfeksiyon ve kaynamama durumu nadiren ya\u015fan\u0131r.<\/p>\n

                Kemik k\u0131r\u0131klar\u0131nda tedavi k\u0131r\u0131\u011f\u0131n olu\u015ftu\u011fu kemik ve k\u0131r\u0131lma \u015fekline belirlenir. A\u00e7\u0131k k\u0131r\u0131klar ve par\u00e7al\u0131 k\u0131r\u0131klar en hayati k\u0131r\u0131klard\u0131r hasta ciddi oranda kan kaybedebilir ve enfeksiyon kapabilir.<\/p>\n

                Tedavi k\u0131r\u0131\u011f\u0131n \u015fekli ve k\u0131r\u0131k b\u00f6lgesine g\u00f6re damarlar, kaslar di\u011fer yumu\u015fak doku hasarlar\u0131 da g\u00f6z \u00f6n\u00fcnde bulundurularak yap\u0131l\u0131r. T\u00fcm k\u0131r\u0131k tedavilerinde ilk \u00f6nce k\u0131r\u0131lan kemik eski do\u011fal konumuna getirilip k\u0131r\u0131k y\u00fczeyler birbirine temas ettirilir sabitlenerek ba\u015flan\u0131r. Do\u011fru ba\u015flamayan k\u0131r\u0131k tedavilerinde yanl\u0131\u015f kaynama, ge\u00e7 kaynama, kaynamama, k\u0131r\u0131k \u00e7evresindeki dokular\u0131n zarar g\u00f6rmesi gibi tedavi s\u00fcrecini uzatan bir\u00e7ok olumsuz durum olu\u015fabilir.<\/p>\n

                K\u0131r\u0131k tedavisi \u00f6ncesi k\u0131r\u0131k olan ya da oldu\u011fu d\u00fc\u015f\u00fcn\u00fclen b\u00f6lge i\u00e7in r\u00f6ntgen \u00e7ekilir ve kemiklerin k\u0131r\u0131k sonras\u0131 konumu belirlenip hastan\u0131n a\u011fr\u0131 e\u015fi\u011fi ve k\u0131r\u0131\u011f\u0131n durumuna g\u00f6re anestezi olmadan, lokal ve ya genel anestezi ile tedaviye ba\u015flan\u0131r. K\u0131r\u0131klarda en \u00f6nemli konu k\u0131r\u0131k b\u00f6lgesinin sabitlenmesi ve iyile\u015febilmesi i\u00e7in kemi\u011fe zaman verilmesidir. Bu sabitleme i\u015flemi k\u0131r\u0131\u011f\u0131n t\u00fcr\u00fcne yerine g\u00f6re sarg\u0131, atel, al\u00e7\u0131 ve platinler arac\u0131l\u0131\u011f\u0131yla yap\u0131l\u0131r.<\/p>\n

                Cerrahi D\u0131\u015f\u0131 K\u0131r\u0131k Tedavileri:\u00a0<\/strong>K\u0131r\u0131k tedavilerinde temel prensip k\u0131r\u0131k kemik u\u00e7lar\u0131n\u0131 bir araya getirilip sabitlemektir. Bu sabitleme en kolay nas\u0131l sa\u011flanabilecekse k\u0131r\u0131k tedavisinde en uygun y\u00f6ntem odur. K\u0131r\u0131k tedavilerinde ba\u015fvurulan y\u00f6ntemlere bakal\u0131m.<\/p>\n

                Bandaj \/Sarg\u0131 :\u00a0<\/strong>Kemikte tam k\u0131r\u0131lma olmad\u0131\u011f\u0131 k\u0131smi k\u0131r\u0131k, \u00e7atlak oldu\u011fu durumlarda uygulanan y\u00f6ntemdir. Genellikle \u00e7abuk kaynar ve kullan\u0131m\u0131 kolayd\u0131r.<\/p>\n

                Atel:\u00a0<\/strong>K\u0131r\u0131klarda hastaya ilk yard\u0131m olarak al\u00e7\u0131 ya da cerrahi tedavi uygulanana kadar k\u0131r\u0131k kemik stabilizasyonunu sa\u011flamak i\u00e7in uygulan\u0131r.<\/p>\n

                Al\u00e7\u0131 Tedavisi:\u00a0<\/strong>Kap\u0131l\u0131 ve basit k\u0131r\u0131klarda yani kemi\u011fin k\u0131smi ya da tam k\u0131r\u0131ld\u0131\u011f\u0131 kemik u\u00e7lar\u0131n\u0131n birbirine temas ettirilebildi\u011fi k\u0131r\u0131klarda k\u0131r\u0131k b\u00f6lgesini sabitlemek i\u00e7in uygulan\u0131r genellikle 40 \u2013 70 g\u00fcn s\u00fcreyle kaynama s\u00fcresinde k\u0131r\u0131k kemi\u011fin hareketini engellemek ve d\u0131\u015fardan gelebilecek darbe ve bask\u0131lara kar\u015f\u0131 k\u0131r\u0131k b\u00f6lgesini korumak i\u00e7in uygulan\u0131r.<\/p>\n

                Cerrahi k\u0131r\u0131k Tedavileri:\u00a0<\/strong>A\u00e7\u0131k ve par\u00e7al\u0131 k\u0131r\u0131klarda ba\u015fvurulan y\u00f6ntemlerdir.\u00a0 Temel ama\u00e7 m\u00fcmk\u00fcn olan en k\u00fc\u00e7\u00fck kesilerle \u00e7evre yumu\u015fak dokulara en az hasar\u0131 verecek \u015fekilde k\u0131r\u0131k hatt\u0131n\u0131 do\u011fal konumuna getirip gerekiyorsa d\u0131\u015f ve i\u00e7 metal sabitleme \u00fcr\u00fcnleriyle k\u0131r\u0131klar\u0131n cerrahi tedavisi yap\u0131l\u0131r.<\/p>\n

                Cerrahi tedaviler \u00e7e\u015fitlilik g\u00f6sterir d\u0131\u015fardan ve i\u00e7eriden olmak \u00fczere iki farkl\u0131 tespit yap\u0131l\u0131r.\u00a0 \u0130\u00e7eriden tespitlerde kemik plaklar\u0131, kemik kanal\u0131na \u00e7iviler yerle\u015ftirilir. D\u0131\u015far\u0131dan tespitlerde ise eksternal fiksat\u00f6rler kullan\u0131l\u0131r baz\u0131 k\u0131r\u0131klarda hem i\u00e7eriden hem de d\u0131\u015far\u0131dan tespitler gerekir. Kemik kanal\u0131na \u00e7ivi uygulamalar\u0131 genellikle bacak b\u00f6lgesindeki uzun kemiklere uygundur. Kol kemiklerindeki k\u0131r\u0131klarda daha s\u0131n\u0131rl\u0131 olarak kullan\u0131l\u0131r. D\u0131\u015fardan tak\u0131lan \u00e7ivi ve eksternal fiksat\u00f6rler metal halkalara sabitlenir. Eksternal fiksat\u00f6rlerde k\u0131r\u0131k hatt\u0131n\u0131n kesi yap\u0131larak a\u00e7\u0131lmas\u0131na gerek kalmaz.<\/p>\n

                Par\u00e7al\u0131 k\u0131r\u0131klarda a\u00e7\u0131k cerrahi maalesef mecburidir. Bu k\u0131r\u0131klarda k\u0131r\u0131k b\u00f6lgesi kesi yap\u0131larak a\u00e7\u0131l\u0131r t\u00fcm kemikler do\u011fal konumuna hizalan\u0131r platin ve plaklarla kemik par\u00e7alar\u0131 birbirine sabitlenir \u00e7evre yumu\u015fak doku hasarlar\u0131 onar\u0131ld\u0131ktan sonra kesi alan\u0131 kapat\u0131l\u0131r. Kullan\u0131lan plaklar\u0131n \u00e7o\u011fu k\u0131r\u0131k kaynamas\u0131ndan sonra istenirse \u00e7\u0131kar\u0131labilir ama baz\u0131 spesifik k\u0131r\u0131klarda plaklar \u00e7\u0131kar\u0131lmamak \u00fczere tak\u0131l\u0131r.<\/p>\n

                Kemik k\u0131r\u0131klar\u0131n\u0131n ortalama kaynama s\u00fcreleri ne kadard\u0131r?<\/strong><\/p>\n

                Kemik k\u0131r\u0131klar\u0131n\u0131n kaynamas\u0131n\u0131n net bir zaman\u0131 yoktur. Kaynama s\u00fcresi k\u0131r\u0131\u011f\u0131n olu\u015ftu\u011fu kemi\u011fe, ki\u015finin ya\u015f\u0131na g\u00f6re, k\u0131r\u0131\u011f\u0131n t\u00fcr\u00fcne g\u00f6re de\u011fi\u015fmektedir. \u00d6rnek olarak bir kol k\u0131r\u0131\u011f\u0131 bacak k\u0131r\u0131\u011f\u0131na g\u00f6re daha h\u0131zl\u0131 kaynamaktad\u0131r. Kemik k\u0131r\u0131klar\u0131n\u0131n kaynamas\u0131n\u0131 h\u0131zland\u0131ran ve ya yava\u015flatan bir\u00e7ok fakt\u00f6r bulunur.
                Kemik k\u0131r\u0131\u011f\u0131n\u0131n ortalama kaynama s\u00fcresi k\u0131r\u0131\u011f\u0131n yeri ve \u00e7e\u015fidine g\u00f6re 40 \u2013 70 g\u00fcn aras\u0131nda de\u011fi\u015fir.<\/p>\n

                B\u00fcy\u00fck kemik k\u0131r\u0131klar\u0131nda bu s\u00fcre 100 g\u00fcne kadar uzayabilir.<\/p>\n

                Kemik k\u0131r\u0131klar\u0131n\u0131n kaynama s\u00fcreleri neden gecikir?<\/strong><\/p>\n

                Kemik k\u0131r\u0131klar\u0131n\u0131n kaynama s\u00fcresini uzatan bir\u00e7ok fakt\u00f6r vard\u0131r. \u00d6zellikle kanlanmas\u0131 sorunlu olan k\u0131r\u0131klar\u0131n kayna s\u00fcresi uzar. El bile\u011findeki skafoid kemi\u011fi, bacak alt ve \u00fcst b\u00f6l\u00fcm\u00fcndeki uzun kemiklerin orta k\u0131s\u0131mlar\u0131nda olan k\u0131r\u0131klar daha ge\u00e7 kaynamaktad\u0131r.<\/p>\n

                K\u0131r\u0131k b\u00f6lgesinde olu\u015fan yumu\u015fak doku ve kan damarlar\u0131ndaki hasar\u0131n boyutu da k\u0131r\u0131k b\u00f6lgesine yeterince kan ula\u015famamas\u0131na sebep olaca\u011f\u0131 i\u00e7in k\u0131r\u0131\u011f\u0131n kaynama s\u00fcresini uzatabilir.<\/p>\n

                A\u00e7\u0131k k\u0131r\u0131klarda yumu\u015fak doku onar\u0131m\u0131 \u00e7ok \u00f6nemlidir.<\/p>\n

                K\u0131r\u0131k hangi y\u00f6ntemle tedavi edilirse edilsin t\u00fcm tedavilerde iyi sabitleme gerekir yeterince iyi sabitlenemeyen k\u0131r\u0131klar\u0131n kaynama s\u00fcresi uzayacakt\u0131r hatta kaynamama sorunu bile olu\u015fabilir.<\/p>\n

                Kemi\u011fin k\u0131r\u0131k u\u00e7lar\u0131 birbirine temas ettirilip \u00f6zellikle sabitlenmelidir aksi takdirde kemi\u011fin k\u0131r\u0131k ucalar\u0131nda kemik \u00f6l\u00fcm\u00fc olu\u015fabilir.<\/p>\n

                Yanl\u0131\u015f ve eksik beslenme v\u00fccudun hasar onar\u0131m s\u00fcresini uzat\u0131r.<\/p>\n

                Sigara, alkol gibi al\u0131\u015fkanl\u0131klar k\u0131r\u0131k kaynama s\u00fcresini olumsuz y\u00f6nde etkilerler. K\u0131r\u0131k kaynamas\u0131 tamamlanana kadar bu gibi al\u0131\u015fkanl\u0131klardan hastan\u0131n vazge\u00e7mesi \u00e7ok \u00f6nemlidir.<\/p>\n

                Ayr\u0131ca kans\u0131zl\u0131k, \u015feker hastal\u0131\u011f\u0131 gibi rahats\u0131zl\u0131klarda da kaynama gecikir bu kans\u0131zl\u0131k tedavisi g\u00f6rmeleri, \u015fekerlerinin de kontrol alt\u0131nda tutulmas\u0131 \u00f6nemlidir.<\/p>\n

                Kemik k\u0131r\u0131klar\u0131n\u0131n iyile\u015fmesinde beslenmenin \u00f6nemi nedir?<\/strong><\/p>\n

                K\u0131r\u0131lan kemiklerin kaynama s\u00fcrelerini h\u0131zland\u0131rmak i\u00e7in beslenme b\u00fcy\u00fck \u00f6nem ta\u015f\u0131r. Kemik k\u0131r\u0131\u011f\u0131 olan bir hastan\u0131n k\u0131r\u0131k \u00f6ncesi hayat\u0131na g\u00f6re kalori ihtiyac\u0131 artar normal d\u00f6nemden daha fazla kalori almal\u0131d\u0131r \u00f6rnek verecek olursak yeti\u015fkin bir birey i\u00e7in g\u00fcnl\u00fck kalori ihtiyac\u0131 ortalama 2500 kalori iken k\u0131r\u0131k tedavisi g\u00f6rd\u00fc\u011f\u00fc s\u00fcre\u00e7te 5000 \u2013 6000 kaloriye ihtiya\u00e7 duyulur. G\u00fcnl\u00fck protein al\u0131m\u0131 20 gr kadar art\u0131r\u0131lmal\u0131d\u0131r.<\/p>\n

                Bu g\u0131dalar \u00f6zellikle protein ve kalsiyum a\u00e7\u0131s\u0131ndan zengin kelle pa\u00e7a \u00e7orbas\u0131, yo\u011furt, s\u00fct, peynir gibi g\u0131dalar\u0131n extra t\u00fcketilmesi, D vitamini al\u0131nmas\u0131 kaynama s\u00fcrecine olumlu y\u00f6nde etki eder.<\/p>\n

                Kemik k\u0131r\u0131\u011f\u0131 yanl\u0131\u015f kaynarsa ne olur?<\/strong><\/p>\n

                Kemik k\u0131r\u0131klar\u0131n\u0131n yanl\u0131\u015f kaynamas\u0131 tedaviyi uygulayan hekimin hatas\u0131ndan kaynaklanabilece\u011fi gibi hastan\u0131n tedavi s\u00fcrecinde yapt\u0131\u011f\u0131 yanl\u0131\u015flardan da kaynaklanabilir. Yanl\u0131\u015f kaynama hastaya k\u0131r\u0131\u011f\u0131n yerine g\u00f6re k\u0131smi ya da ciddi bir fonksiyon kayb\u0131, a\u011fr\u0131 ve estetik g\u00f6r\u00fcn\u00fcm bozuklu\u011fu olu\u015fturabilece\u011fi gibi ciddi hareket k\u0131s\u0131tl\u0131klar\u0131na da yol a\u00e7abilir.<\/p>\n

                Yanl\u0131\u015f kaynamalarda cerrahi y\u00f6ntemlerle d\u00fczeltme tedavileri gerekebilir.<\/p>\n

                Kemik k\u0131r\u0131klar\u0131nda k\u00f6k h\u00fccre tedavisi<\/strong><\/p>\n

                K\u0131r\u0131lan kemi\u011fin kaynamas\u0131 i\u00e7in k\u0131r\u0131k hatt\u0131 kanlanmal\u0131d\u0131r \u00e7o\u011fu k\u0131r\u0131k\u2019ta bu s\u00fcre\u00e7 sorunsuz ger\u00e7ekle\u015fse de baz\u0131 kemiklerin kanlanmas\u0131 sorunlu olabiliyor. Bu gibi k\u0131r\u0131klarda kemik ili\u011fi ya da ya\u011f kaynakl\u0131 k\u00f6k h\u00fccrelerden destek al\u0131yoruz.<\/p>\n

                Ya\u011f k\u00f6k h\u00fccreleri kar\u0131n b\u00f6lgesinden mini liposuction ile temin ederken, kemik ili\u011fi k\u00f6k h\u00fccrelerini pelvis kemi\u011finden aspirasyon yaparak k\u0131sa bir anestezi i\u015flemi e\u015fli\u011finde al\u0131p ameliyathanede steril ko\u015fullarda haz\u0131rl\u0131yoruz.<\/p>\n

                Kemik k\u0131r\u0131klar\u0131nda h\u0131zl\u0131 kaynama sa\u011flamak i\u00e7in \u00f6zellikle kemik ili\u011fi kaynakl\u0131 k\u00f6k h\u00fccrelerle k\u0131r\u0131k hatt\u0131 beslendi\u011finde k\u0131r\u0131k b\u00f6lgesi hem daha fazla kanlan\u0131r hem de kemik onar\u0131m\u0131 i\u00e7in gerekli kemik ili\u011fi k\u00f6k h\u00fccreleri a\u00e7\u0131s\u0131ndan zengin bir tedavi alan\u0131 olu\u015fturulmu\u015f olur.<\/p>\n

                Kemik k\u0131r\u0131klar\u0131nda k\u00f6k h\u00fccre tedavisi kaynamas\u0131, kanlanmas\u0131 sorunlu olan kemik k\u0131r\u0131klar\u0131nda ilk tedavi s\u0131ras\u0131nda tercih edilebilece\u011fi gibi kaynamas\u0131 geciken ya da kaynamayan kemik k\u0131r\u0131klar\u0131 i\u00e7inde destek tedavisi olarak tercih edilmesinde b\u00fcy\u00fck fayda sa\u011flar.<\/p>\n

                \"\"<\/p>\n<\/div>\n<\/div><\/div><\/div>

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