Diz çevresi deformiteleri tedavisinde Taylor spatial frame’in etkinliği

Abstract

Amaç: Bu çalışmanın amacı Taylor spatial frame (TSF) ile diz çevresi deformitelerinin tamamen düzeltilip düzeltilemeyeceğini ve diz çevresi deformitelerinde TSF uygulamasının kolay ve güvenli bir tedavi şekli olup olmadığını belirlemekti. Çalışma planı: Diz eklemi çevresinde deformitesi olan ve TSF ile tedavi edilen 37 hastanın (ortalama yaş: 23, dağılım: 10-58) 50 alt ekstremitesi geriye dönük olarak değerlendirildi. Bu ekstremitelerin 33 tanesinde tibial, 17’sinde femoral deformiteler mevcuttu. Tüm hastalara operasyon öncesi standart ön-arka, lateral grafiler çekildi ve ayakta çekilen boy grafilerinde ölçümleri yapıldı. Ayakta çekilen boy grafilerinde mekanik aks sapması, bacak boyu eşitsizliği, lateral femoral distal açı (LFDA) ve medial proksimal tibial açı (MPTA) ölçümleri yapıldı. Tüm ölçümler eksternal fiksatör çıkarıldıktan sonra tekrarlandı. Bulgular: TSF ile geçirilen ortalama süre 20.3 (dağılım: 4-36) hafta idi. Eksternal fiksatörün çıkarılmasından sonraki ortalama takip süresi 32 (dağılım: 15-54) ay olarak bulundu. Tüm deformiteler TSF ile tam olarak tedavi edildi İki vaka dışndaki tüm olgularda konsolidasyon sağlandı; bu 2 olguda kemik greftine ihtiyaç duyuldu. Çıkarımlar: Sonuç olarak, diz çevresindeki translasyon ve rotasyon ile komplike olmuş büyük deformitelerde TSF’nin güvenli ve etkin bir tedavi yöntemi olduğunu düşünmekteyiz.

Keywords

• Deformite; diz; Taylor spatial frame; tedavi.

Efficacy of the Taylor spatial frame in the treatment of deformities around the knee

Abstract

Objective: The aim of this study was to determine whether the Taylor spatial frame (TSF) can precisely correct deformities around the knee and whether application of TSF is easy and safe for treatment of the deformities around the knee.
Methods: This study included 50 retrospectively reviewed limbs of 37 patients (mean age: 23 years, range: 10 to 58 years) with deformity around the knee joint treated using the TSF. Thirty-three limbs had tibial and 17 femoral deformities. Preoperative standard anteroposterior, lateral radiographs and standing orthoroentgenographic measurements were taken for each patient. Mechanical axis deviation (MAD), leg-length discrepancy (LLD) and lateral femoral distal angle (LDFA) and medial proximal tibial angle (MPTA) were measured from standing orthoroentgenographics. All measurements were repeated after external fixator removal.
Results: The frame was applied for an average of 20.3 (range: 4 to 36) weeks. Mean follow-up time following removal of external fixator was 32 (range: 15 to 54) months. An effective and accurate correction was achieved in all cases. Solid bone consolidation was obtained in all but two cases which underwent bone grafting.
Conclusion: Taylor spatial frame appears to be a safe and effective method for the gradual correction of the complex translational and rotational deformities around the knee.

Keywords

• Deformity
• knee
• Taylor spatial frame
• treatment

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