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HALLUKS VALGUS CERRAHİ TEDAVİSİ SONRASI METATARS UZUNLUĞUNDAKİ DEĞİŞİMİN KLİNİK SONUCA ETKİLERİ

Year 2017, Volume: 18 Issue: 1, 19 - 23, 17.01.2017
https://doi.org/10.18229/kocatepetip.341658

Abstract

ÖZ

AMAÇ: Bu çalışmanın amacı halluks valgus tanısı ile proksimal metatarsal osteotomi ya da distal metatarsal osteotomi uygulanarak cerrahi yöntemle tedavi edil-miş hastalarda metatars uzunluğundaki değişimin kli-nik sonuca etkilerini araştırmaktır.

GEREÇ VE YÖNTEM: Toplam 62 hasta çalışmaya dahil edildi. Hastaların 9 tanesi erkek ve 53 tanesi kadındı. Çalışma grubunda ameliyat esnasında ortalama yaş 45.9 yıldı. Hastaların 30 tanesine kresentik proksimal osteotomi (KPO) ve 32 tanesine distal chevron osteotomisi (DCO) uygulandı. Ortalama ameliyat sonrası takip süresi 24.3 aydı. Ameliyat sonrası 4. haftada, 3, 6, 12.aylarda ve daha sonra yıllık takip muayenelerindeklinik ve radyolojik değerlendirme yapıldı. American Orthopedic Foot and Ankle Society (AOFAS) skoru, Visual Analogue Scale (VAS) skoru, metatarsal uzunluk, halluks valgus açısı (HVA) ve intermetatarsal açı (IMA) değerlendirme kriterleri olarak belirlendi.

BULGULAR: Hem distal chevron osteotomisi hem de kresentik proksimal osteotomi uygulanan hastalarda ortalama HVA ve ortalama IMA ameliyat öncesi döneme göre ameliyat sonrası takiplerde istatistiksel olarak anlamlı düzeyde gerilemiştir. Birinci metatars uzunluğundaki ortalama değişim distal chevron osteotomisi sonrası -2.8 mm iken kresentik proksimal osteotomi sonrası -1.2 mm ölçüldü. Halluks valgus açısının ortalama düzelme miktarı distal chevron grubunda 13.6 derece ve kresentik proksimal osteotomi grubunda 20.4 derece idi. 3 mm’den fazla metatars kısalması olan hastalarda anlamlı olarak daha kötü VAS skorları tespit edildi. Çalışmamızda hiçbir hastada kaynamama veya metatars başında avasküler nekroz gözlemlenmemiştir. Son kontrolde DCO grubundan 8 hasta ve KPO grubundan 5 hasta benzer şikayetleri olan başka hastalara ameliyatı tavsiye etmeyeceğini bildirmiştir.

SONUÇ: Distal chevron osteotomisi kresentik proksimal osteotomiye kıyasla birinci metatars uzunluğunda daha yüksek oranda kısalmaya ve bununla bağlantılı olarak daha yüksek oranda transfer metatarsaljiye yol açmaktadır.

References

  • Klugarova J, Hood V, Bath-Hextall F et al. The effectiveness of surgery for adults with hallux valgus deformity: a systematic review protocol. The JBI Database of Systematic Reviews and Implementation Reports 12(7):3-11, 2014.
  • Wen J, Ding Q, Yu Z et al. Adaptive changes of foot pressure in hallux valgus patients. Gait Posture. 36(3):344-349, 2012.
  • Nix S, Smith M, Vicenzino B. Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. J Foot Ankle Res. 3(1):21, 2010.
  • Kristen KH, Berger C, Stelzig S et al. The SCARF osteotomy for the correction of hallux valgus deformities. Foot Ankle Int. 23:221–229, 2002.
  • Menz HB, Lord SR. Gait instability in older people with hallux valgus. Foot Ankle Int. 26:483-489, 2005.
  • Menz HB, Lord SR. The contribution of foot problems to mobility impairment and falls in community-dwelling older people. J Am Geriatr Soc. 49:1651-1656, 2001.
  • Robinson AHN, Limbers JP. Modern concepts in the treatment of hallux valgus. J Bone Joint Surg Br. 87(8):1038-1045, 2005.
  • Schuh R, Trnka HJ. Hallux Valgus-Distal Osteotomies. European Surgical Orthopaedics and Traumatology: The EFORT Textbook. 3417-3432, 2014.
  • Gallentine JW, Deorio JK, Deorio MJ. Bunion surgery using locking-plate fixation of proximal metatarsal chevron osteotomies. Foot Ankle Int. 28:361–368, 2007.
  • Buciuto, R. Prospective Randomized Study of Chevron Osteotomy Versus Mitchell’s Osteotomy in Hallux Valgus. Foot Ankle Int. 35(12):1268-1276, 2014.
  • Glazebrook M, Copithorne P, Boyd G et al. Proximal opening wedge osteotomy with wedge-plate fixation compared with proximal chevron osteotomy for the treatment of hallux valgus: a prospective, randomized study. J Bone Joint Surg Am. 96(19):1585-1592, 2014.
  • Smith SE, Landorf KB, Butterworth PA, Menz HB. Scarf versus chevron osteotomy for the correction of 1–2 intermetatarsal angle in hallux valgus: a systematic review and meta-analysis. J Foot Ankle Surg. 51(4):437-444, 2012.
  • Lee KM, Ahn S, Chung CY et al. Reliability and relationship of radiographic measurements in hallux valgus. Clin Orthop Relat Res. 470(9):2613-2621, 2012.
  • Pentikainen I, Ojala R, Ohtonen P et al. Preoperative Radiological Factors Correlated to Long-Term Recurrence of Hallux Valgus Following Distal Chevron Osteotomy. Foot Ankle Int. 35(12):1262-1267, 2014.
  • Schuh R, Willegger M, Holinka J et al. Angular correction and complications of proximal first metatarsal osteotomies for hallux valgus deformity. Int Orthop. 37(9):1771-1780, 2013.
  • Coughlin MJ, Jones CP. Hallux valgus and first ray mobility: A prospective study. J Bone Joint Surg Am. 89(9):1887-1898, 2007.
  • Bettazzoni, F, Leardini A, Parenti-Castelli V, Giannini S. Mathematical model for pre-operative planning of linear and closing-wedge metatarsal osteotomies for the correction of hallux valgus. Med Biol Eng Comput. 42(2):209-215, 2004.
  • Brodsky JW, Beischer AD, Robinson AH et al. Surgery for hallux valgus with proximal crescentic osteotomy causes variable postoperative pressure patterns. Clin Orthop Relat Res. 443:280-286, 2006.
  • Goldberg A, Singh D. Treatment of Shortening Following Hallux Valgus Surgery. Foot Ankle Clin. 19(2):309-316, 2014.
  • Maceira E, Monteagudo M. Transfer Metatarsalgia Post Hallux Valgus Surgery. Foot Ankle Clin. 19(2):285-307, 2014.
  • Rose B, Bowman N, Edwards H et al. Lengthening scarf osteotomy for recurrent hallux valgus. Foot Ankle Surg. 20(1):20-25, 2014.
  • Park CH, Jang JH, Lee SH, Lee WC. A comparison of proximal and distal chevron osteotomy for the correction of moderate hallux valgus deformity. Bone Joint J. 95(5):649-656, 2013.
  • Thordarson D, Ebramzadeh E, Moorthy M et al. Correlation of hallux valgus surgical outcome with AOFAS forefoot score and radiological parameters. Foot Ankle Int. 26(2):122-127, 2005.
  • Green MA, Dorris MF, Baessler TP et al. Avascular necrosis following distal Chevron osteotomy of the first metatarsal. Foot Ankle Surg. 32(6):617-622, 1992.
  • Meier PJ, Kenzor, JE. The risks and benefits of distal first metatarsal osteotomies. Foot Ankle Int. 6(1):7-17, 1985
Year 2017, Volume: 18 Issue: 1, 19 - 23, 17.01.2017
https://doi.org/10.18229/kocatepetip.341658

Abstract

References

  • Klugarova J, Hood V, Bath-Hextall F et al. The effectiveness of surgery for adults with hallux valgus deformity: a systematic review protocol. The JBI Database of Systematic Reviews and Implementation Reports 12(7):3-11, 2014.
  • Wen J, Ding Q, Yu Z et al. Adaptive changes of foot pressure in hallux valgus patients. Gait Posture. 36(3):344-349, 2012.
  • Nix S, Smith M, Vicenzino B. Prevalence of hallux valgus in the general population: a systematic review and meta-analysis. J Foot Ankle Res. 3(1):21, 2010.
  • Kristen KH, Berger C, Stelzig S et al. The SCARF osteotomy for the correction of hallux valgus deformities. Foot Ankle Int. 23:221–229, 2002.
  • Menz HB, Lord SR. Gait instability in older people with hallux valgus. Foot Ankle Int. 26:483-489, 2005.
  • Menz HB, Lord SR. The contribution of foot problems to mobility impairment and falls in community-dwelling older people. J Am Geriatr Soc. 49:1651-1656, 2001.
  • Robinson AHN, Limbers JP. Modern concepts in the treatment of hallux valgus. J Bone Joint Surg Br. 87(8):1038-1045, 2005.
  • Schuh R, Trnka HJ. Hallux Valgus-Distal Osteotomies. European Surgical Orthopaedics and Traumatology: The EFORT Textbook. 3417-3432, 2014.
  • Gallentine JW, Deorio JK, Deorio MJ. Bunion surgery using locking-plate fixation of proximal metatarsal chevron osteotomies. Foot Ankle Int. 28:361–368, 2007.
  • Buciuto, R. Prospective Randomized Study of Chevron Osteotomy Versus Mitchell’s Osteotomy in Hallux Valgus. Foot Ankle Int. 35(12):1268-1276, 2014.
  • Glazebrook M, Copithorne P, Boyd G et al. Proximal opening wedge osteotomy with wedge-plate fixation compared with proximal chevron osteotomy for the treatment of hallux valgus: a prospective, randomized study. J Bone Joint Surg Am. 96(19):1585-1592, 2014.
  • Smith SE, Landorf KB, Butterworth PA, Menz HB. Scarf versus chevron osteotomy for the correction of 1–2 intermetatarsal angle in hallux valgus: a systematic review and meta-analysis. J Foot Ankle Surg. 51(4):437-444, 2012.
  • Lee KM, Ahn S, Chung CY et al. Reliability and relationship of radiographic measurements in hallux valgus. Clin Orthop Relat Res. 470(9):2613-2621, 2012.
  • Pentikainen I, Ojala R, Ohtonen P et al. Preoperative Radiological Factors Correlated to Long-Term Recurrence of Hallux Valgus Following Distal Chevron Osteotomy. Foot Ankle Int. 35(12):1262-1267, 2014.
  • Schuh R, Willegger M, Holinka J et al. Angular correction and complications of proximal first metatarsal osteotomies for hallux valgus deformity. Int Orthop. 37(9):1771-1780, 2013.
  • Coughlin MJ, Jones CP. Hallux valgus and first ray mobility: A prospective study. J Bone Joint Surg Am. 89(9):1887-1898, 2007.
  • Bettazzoni, F, Leardini A, Parenti-Castelli V, Giannini S. Mathematical model for pre-operative planning of linear and closing-wedge metatarsal osteotomies for the correction of hallux valgus. Med Biol Eng Comput. 42(2):209-215, 2004.
  • Brodsky JW, Beischer AD, Robinson AH et al. Surgery for hallux valgus with proximal crescentic osteotomy causes variable postoperative pressure patterns. Clin Orthop Relat Res. 443:280-286, 2006.
  • Goldberg A, Singh D. Treatment of Shortening Following Hallux Valgus Surgery. Foot Ankle Clin. 19(2):309-316, 2014.
  • Maceira E, Monteagudo M. Transfer Metatarsalgia Post Hallux Valgus Surgery. Foot Ankle Clin. 19(2):285-307, 2014.
  • Rose B, Bowman N, Edwards H et al. Lengthening scarf osteotomy for recurrent hallux valgus. Foot Ankle Surg. 20(1):20-25, 2014.
  • Park CH, Jang JH, Lee SH, Lee WC. A comparison of proximal and distal chevron osteotomy for the correction of moderate hallux valgus deformity. Bone Joint J. 95(5):649-656, 2013.
  • Thordarson D, Ebramzadeh E, Moorthy M et al. Correlation of hallux valgus surgical outcome with AOFAS forefoot score and radiological parameters. Foot Ankle Int. 26(2):122-127, 2005.
  • Green MA, Dorris MF, Baessler TP et al. Avascular necrosis following distal Chevron osteotomy of the first metatarsal. Foot Ankle Surg. 32(6):617-622, 1992.
  • Meier PJ, Kenzor, JE. The risks and benefits of distal first metatarsal osteotomies. Foot Ankle Int. 6(1):7-17, 1985
There are 25 citations in total.

Details

Subjects Health Care Administration
Journal Section Articles
Authors

Hakan Sofu

Yalkın Çamurcu

Nizamettin Kockara

Mehmet Nuri Konya

Bahattin Kerem Aydın

Publication Date January 17, 2017
Acceptance Date May 24, 2016
Published in Issue Year 2017 Volume: 18 Issue: 1

Cite

APA Sofu, H., Çamurcu, Y., Kockara, N., Konya, M. N., et al. (2017). HALLUKS VALGUS CERRAHİ TEDAVİSİ SONRASI METATARS UZUNLUĞUNDAKİ DEĞİŞİMİN KLİNİK SONUCA ETKİLERİ. Kocatepe Tıp Dergisi, 18(1), 19-23. https://doi.org/10.18229/kocatepetip.341658
AMA Sofu H, Çamurcu Y, Kockara N, Konya MN, Aydın BK. HALLUKS VALGUS CERRAHİ TEDAVİSİ SONRASI METATARS UZUNLUĞUNDAKİ DEĞİŞİMİN KLİNİK SONUCA ETKİLERİ. KTD. January 2017;18(1):19-23. doi:10.18229/kocatepetip.341658
Chicago Sofu, Hakan, Yalkın Çamurcu, Nizamettin Kockara, Mehmet Nuri Konya, and Bahattin Kerem Aydın. “HALLUKS VALGUS CERRAHİ TEDAVİSİ SONRASI METATARS UZUNLUĞUNDAKİ DEĞİŞİMİN KLİNİK SONUCA ETKİLERİ”. Kocatepe Tıp Dergisi 18, no. 1 (January 2017): 19-23. https://doi.org/10.18229/kocatepetip.341658.
EndNote Sofu H, Çamurcu Y, Kockara N, Konya MN, Aydın BK (January 1, 2017) HALLUKS VALGUS CERRAHİ TEDAVİSİ SONRASI METATARS UZUNLUĞUNDAKİ DEĞİŞİMİN KLİNİK SONUCA ETKİLERİ. Kocatepe Tıp Dergisi 18 1 19–23.
IEEE H. Sofu, Y. Çamurcu, N. Kockara, M. N. Konya, and B. K. Aydın, “HALLUKS VALGUS CERRAHİ TEDAVİSİ SONRASI METATARS UZUNLUĞUNDAKİ DEĞİŞİMİN KLİNİK SONUCA ETKİLERİ”, KTD, vol. 18, no. 1, pp. 19–23, 2017, doi: 10.18229/kocatepetip.341658.
ISNAD Sofu, Hakan et al. “HALLUKS VALGUS CERRAHİ TEDAVİSİ SONRASI METATARS UZUNLUĞUNDAKİ DEĞİŞİMİN KLİNİK SONUCA ETKİLERİ”. Kocatepe Tıp Dergisi 18/1 (January 2017), 19-23. https://doi.org/10.18229/kocatepetip.341658.
JAMA Sofu H, Çamurcu Y, Kockara N, Konya MN, Aydın BK. HALLUKS VALGUS CERRAHİ TEDAVİSİ SONRASI METATARS UZUNLUĞUNDAKİ DEĞİŞİMİN KLİNİK SONUCA ETKİLERİ. KTD. 2017;18:19–23.
MLA Sofu, Hakan et al. “HALLUKS VALGUS CERRAHİ TEDAVİSİ SONRASI METATARS UZUNLUĞUNDAKİ DEĞİŞİMİN KLİNİK SONUCA ETKİLERİ”. Kocatepe Tıp Dergisi, vol. 18, no. 1, 2017, pp. 19-23, doi:10.18229/kocatepetip.341658.
Vancouver Sofu H, Çamurcu Y, Kockara N, Konya MN, Aydın BK. HALLUKS VALGUS CERRAHİ TEDAVİSİ SONRASI METATARS UZUNLUĞUNDAKİ DEĞİŞİMİN KLİNİK SONUCA ETKİLERİ. KTD. 2017;18(1):19-23.

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