Pes ekinovarus hastalarına uygulanan cerrahi tedavilerin erken klinik ve radyolojik sonuçları

Yıl 2019, Cilt: 16 Sayı: 1, 77 - 81, 22.03.2019

Baki Volkan Çetin Mehmet Akif Altay Serkan Sipahioğlu Uğur Erdem Işıkan Celal Bozkurt Baran Sarıkaya Cemil Ertürk

Öz

Amaç:
Dirençli ve ihmal edilmiş idyopatik pes ekinovarus hastalarında uygulanan
yumuşak doku cerrahilerindeki erken dönem klinik ve radyolojik sonuçlarını
değerlendirmek.

Metod:
Bu çalışmada, Haziran 2014 -Ağustos 2018 tarihleri arasında doğuştan çarpık
ayak nedeniyle başvuran ve yaş aralığı 9-87 ay (33 erkek, 10 kız; ort:
operasyon yaşı: 31,5 ay) olan 43 hastanın 56 ayağında uygulanan yumuşak doku
cerrahileri, geri dönük olarak incelendi. Takip süresi 12-36 aydı. (ort; 20,2
ay). Hastaların fizik muayene bulguları ve radyolojik incelemelerine göre operasyon
öncesi Pirani skorları ve radyolojik ölçümleri operasyon sonrası 3. aydan
sonraki son ziyaretleriyle karşılaştırıldı.

Bulgular:
Operasyon öncesi Pirani skorlarında görünüş, son kontrolde yapılan ölçümlerle
karşılaştırıldığında 4’den
fazla azalma olan hastalar çok iyi (11 ayak, %19,6), 3-4 arası azalma
iyi-tatminkar (27 ayak, %48,2), 3’ün
altında azalma kötü (18 ayak, %32,2) olarak bulundu. Operasyon öncesine göre
klinik değerlendirmede (Pirani skoru) anlamlı düzelme tespit edildi (p˂0,001).
Radyolojik incelemelerde operasyon öncesine göre anlamlı düzelme tespit edildi
(p˂0,001). 16 hastada (%28,5) çeşitli derecelerde yara yeri açılması ve cilt
nekrozu gelişti. 7 metatarsus adduktus, 3 hastada ekin varus deformitesi ve 2
hastada ön ayak supinasyonu, 1 tel çıkması gözlendi.

Sonuç:
Dirençli ve ihmal edilmiş İPEV
olgularda yumuşak doku cerrahileri erken dönemde, klinik ve radyolojik olarak tatminkâr
bulunmuştur.

Anahtar Kelimeler

Pes ekinovarus, çarpık ayak, Yumuşak doku gevşetme

Early clinical and radiological results of surgical treatments for pes equinovarus patients

Öz

Background:
To evaluate the early clinical and radiological results of soft tissue
surgeries in patients with resistant and neglected idiopathic pes equinovarus.

Methods: In this study,
between June 2014 and August 2018, who presented with congenital club foot aged
between 9-87 months (33 males, 10 females; mean age: 31.5 months) were
performed soft tissue surgeries in 56 feet of 43 patients viewed
retrospectively. Follow-up was 12-36 months. (mean; 20,2 months). According to
the physical examination findings and radiological examinations of the
patients, Pirani scores and radiological measurements were compared with the
last visits after the 3rd month after the operation.

Results: Compared to
preoperative measurements with Pirani scores after 3 months, patients with more
than 4 decreases were very good (11 feet, 19,6%), and the reduction of 3-4 was
good (27 feet, 48,2%). Less than 3 decrease was poor (18 foot, 32,2%). Significant
improvement was detected in the clinical evaluation (Pirani score) (p˂0,001). Significant improvement was detected
in radiological examinations (p˂0,001).
16 patients (28,5%) developed various types of wound healing problems and skin
necrosis. 7 metatarsus adductus, 3 patients with equinus varus deformity and 2
patients with forefoot supination and 1 wire out were observed.

Conclusion:  The soft tissue surgeries performed in the
resistant and neglected IPEV patients were found satisfactory in terms of early
clinical and radiological results.

 

Anahtar Kelimeler

Pes equinovarus, Club foot, Soft tissue release

Kaynakça

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