İleri Yaş, Ciddi Deformite ve Azalan Beklentiler: Yaşlılarda Halluks Valgus İçin Uygulanan Farklı Osteotomilerin Fonksiyonel ve Radyolojik Sonuçları

Yıl 2026, Cilt: 7 Sayı: 1, 162 - 170, 31.01.2026

Ufuk Arzu , Batuhan Gencer , Serdar Orhan , Yılmaz Kerem Akayoğlu , Deniz Gülabi

https://doi.org/10.47482/acmr.1672585

Öz

Arka plan: İleri yaş sıklıkla halluks valgusta (HV) kemik kalitesinin azalmasıyla ilişkilendirilse de, bunun cerrahi sonuçlar üzerindeki doğrudan etkisi belirsizliğini korumaktadır. Bu çalışmanın amacı, 65 yaş üstü ve 65 yaş altı hastalar arasında HV ameliyatlarının fonksiyonel ve radyolojik sonuçlarını karşılaştırmaktır.
Yöntemler: 2011-2024 yılları arasında HV ameliyatı geçiren 102 hasta üzerinde retrospektif bir analiz yapıldı. Cerrahi yöntemler arasında distal ve proksimal osteotomiler ve Lapidus artrodezi yer aldı. Fonksiyonel sonuçlar Görsel Analog Skalası (VAS) ve Amerikan Ortopedik Ayak ve Ayak Bileği Derneği (AOFAS) Halluks Metatarsofalangeal-İnterfalangeal Derecelendirme Sistemi skoru kullanılarak değerlendirildi. Radyografik sonuçlar ameliyat öncesi ve sonrası halluks valgus açısı (HVA) ve intermetatarsal açı (IMA) ölçümleri ile değerlendirildi.
Bulgular: 102 hastadan 87'si 65 yaşın altında (%85,3) 15'i 65 yaş üzerindeydi (%14,7). Yaş grupları arasında AOFAS skorlarında (p=0,916), VAS skorlarında (p=0,481) veya radyografik parametrelerde (p>0,05) anlamlı bir fark bulunmadı. Ancak cerrahi tekniğin sonuçları önemli ölçüde etkilediği gözlendi; artrodez, distal osteotomilere kıyasla daha fazla açısal düzeltme ve daha düşük VAS skorlarıyla sonuçlandı (p<0,05). Proksimal osteotomiler, distal prosedürlere göre daha iyi düzeltme gösterdi, ancak fonksiyonel skorlarda anlamlı bir fark yoktu (p>0,05).
Sonuçlar: HV cerrahisinde yaşın fonksiyonel ve radyolojik sonuçlar üzerindeki etkisi anlamlı bulunmadı. Cerrahi başarı olasılığı, hastanın yaşından ziyade kullanılan tekniğe bağlıdır. Deformitenin ciddiyetine göre uyarlanmış bireyselleştirilmiş tedavi planlarının kullanılmasının, hastanın yaşından bağımsız olarak daha üstün sonuçlar verdiği gösterilmiştir.

Anahtar Kelimeler

Halluks valgus , proksimal osteotomi , distal osteotomi , artrodez , yaşlı

Advanced Age, Severe Deformity and Diminished Expectations: Functional and Radiological Outcomes of Different Osteotomies for Hallux Valgus in The Elderly

Öz

Background: Although advanced age is often linked to reduced bone quality in hallux valgus (HV), its direct impact on surgical outcomes is unclear. This study aimed to compare the functional and radiological outcomes of HV surgeries between patients aged ≥65 and <65 years.
Methods: A retrospective analysis of 102 patients who underwent HV surgery between 2011 and 2024 was conducted. Surgical methods included distal and proximal osteotomies and Lapidus arthrodesis. Functional outcomes were assessed using the visual analog scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) Hallux Metatarsophalangeal- Interphalangeal Rating System score. Radiographic outcomes were evaluated using preoperative and postoperative measurements of the hallux valgus angle (HVA) and the intermetatarsal angle (IMA).
Results: Among the 102 patients, 87 were under 65 years of age (85.3%) and 15 were older (14.7%). No significant differences were found between the age groups in terms of AOFAS scores (p=0.916), VAS scores (p=0.481), or radiographic parameters (p>0.05). However, surgical technique significantly affected outcomes; arthrodesis resulted in greater angular correction and lower VAS scores than distal osteotomies (p<0.05). Proximal osteotomies showed better correction than distal procedures, but without significant differences in functional scores (p>0.05).
Conclusions: Age does not significantly affect functional and radiological outcomes in HV surgery. The likelihood of surgical success depends on the technique used rather than the patient’s age. The utilization of individualized treatment plans tailored to the severity of the deformity has been demonstrated to yield superior outcomes, irrespective of the patient's age.

Anahtar Kelimeler

Hallux valgus , proximal osteotomy , distal osteotomy , arthrodesis , elderly

Etik Beyan

This study was reviewed and approved by the Marmara University Faculty of Medicine, Non-Pharmaceuticals and Non-Medical Devices Research Ethics Committee (Protocol No: 09.2024.1588, Date: 24.12.2024). Informed consent was obtained from all individual participants included in the study.

Destekleyen Kurum

The authors declared that this study has received no financial support.

Teşekkür

The authors declare that they have no acknowledgements to report.

Kaynakça

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