Clinical analysis of transverse process fractures: A comprehensive study on patient characteristics, management, and outcomes in trauma care Transvers uzantı kırıklarının klinik analizi: Travma bakımında hasta özellikleri, yönetimi ve sonuçları üzerine kapsamlı bir çalışma
Ulusal Travma ve Acil Cerrahi Dergisi, cilt.30, sa.5, ss.353-360, 2024 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 30 Sayı: 5
- Basım Tarihi: 2024
- Doi Numarası: 10.14744/tjtes.2024.91387
- Dergi Adı: Ulusal Travma ve Acil Cerrahi Dergisi
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.353-360
- Anahtar Kelimeler: Clinical outcomes, conservative management, pain management, transverse process fractures, thoracolumbar injury.
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
BACKGROUND: Transverse process fractures (TPFs) are commonly encountered in trauma patients and are often associated with polytrauma. While traditionally considered stable injuries, recent research suggests their significance in spinal trauma may be underestimated. This study aims to provide insights into the management and outcomes of TPFs, evaluating their predictive potential for identifying clinically significant spinal fractures and associated injuries. METHODS: A retrospective review of trauma registry data from a Level I trauma center was conducted, encompassing patients with TPFs from September 2022 to September 2023. Inclusion criteria involved patients aged 18 or older with confirmed TPFs via computed tomography (CT) and magnetic resonance imaging (MRI), managed nonoperatively. Data on demographics, injury mechanisms, associated injuries, pain management, and treatment outcomes were analyzed. Pain severity and functionality were assessed using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI). RESULTS: A total of 190 patients, predominantly male (129 patients, 67.9%), with a mean age of 45.7 years, were included in the study. Motor vehicle accidents (MVA) were the leading cause of admission (44.7%). Thoracic injuries were the most common associated pathology. Of the study cohort, 88 patients (46.3%) presented with single-level TPFs, while 102 patients (53.7%) had multilevel fractures. Analysis revealed distinct differences between these groups, with multilevel TPF patients exhibiting a higher frequency of associated injuries and a notable proportion requiring hospitalization or surgical intervention. Multilevel TPF patients exhibited higher initial pain and disability scores compared to single-level TPF patients. Both groups showed significant reductions in VAS and ODI scores at the 3-month follow-up. CONCLUSION: TPFs, previously considered minor injuries, demonstrate significant pain and functional limitations. They often accompany systemic pathologies, particularly in multilevel fractures, necessitating a multidisciplinary approach to management. The "Protection, Rest, Ice, Compression, Elevation" (PRICE) approach, including Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and muscle relaxants, along with collar or brace support when necessary, proves effective in pain management and functional improvement. These findings emphasize the importance of recognizing TPFs as complex injuries requiring tailored management strategies. Further research and collaboration among healthcare providers are warranted to refine treatment approaches and optimize outcomes for patients with TPFs.