Lisfrank Kırıklı Çıkıklarında Anatomik Redüksiyon ve Tespit Sonuçlarımız

Yıl 2013, Cilt: 13 Sayı: 2, 62 - 65, 11.03.2014

Ahmet Fırat Ali Öçgüder Osman Tecimel Kemal Altunlu Çetin Işık Mahmut Aytekin Mustafa Akkaya Murat Bozkurt

Öz

Amaç: Çalışmamızda stabil olmayan lisfrank kırıklarındaanatomik redüksiyon ve fiksasyonun kısa dönem sonuçlarınıdeğerlendirmeyi amaçladık.

Gereç ve yöntemler: 2009-2012 yılları arasında stabilolmayan lisfrank eklemi kırığı ile kliniğimizde anatomikredüksiyon ve fiksasyon ile tedavi edilmiş 15 hastaretrospektif olarak değerlendirildi. Klinik değerlendirmeler AOFAS skoru ve Maryland ayak skoru, radyolojikdeğerlendirme standart ön-arka, yan ve oblik grafilerdekaynamama, redüksiyon kalitesi ve postravmatik artrozaraştırılarak yapıldı.

Bulgular: Ortalama takip süresi 23 ay (12-46) ve 42 (20-64) idi. Ortalama AOFAS skoru 81,7±7,3 puan ve Maryland ayak skoru 82,6 ±7,5 idi. Üç hastada (%20) postravmatikosteoartrit gelişti.

Sonuç: Lisfrank eklemi kırıklarında anatomik redüksiyon vestabil bir fiksasyon ile kısa dönemde iyi klinik ve radyolojiksonuç elde edilebileceğini düşünüyoruz.

Anahtar Kelimeler

Lisfrank eklemi, kırık, anatomik redüksiyon

Results Of Lisfranc Fractures Treated With Anatomical Reduction And Fixation

Öz

Introduction: We aimed to investigate the early results of anatomic reduction and fixation of unstable lisfranc fractures.Materials and methods: The results of fifteen patients who have been diagnosed to have unstable lisfranc fracture and have been treated with with anatomical reduction and fixation in our clinic between years 2009 and 2012 were evaluated retrospectively. AOFAS and Maryland foot scores were used for clinical evaluation. Radiological assesment was conducted using standardized anteroposterior lateral and oblique radiographs for non-union, quality of reduction and posttraumatic arthrosis.Results: The mean follow-up time was 23 months (12-46) and median age was 42 (20-64). The mean AOFAS was 81,7±7,3 and Maryland foot score was 82,6 ±7,5.Postttraumatic osteoarthritis was determined in three (20%) patients.Conclusion: We think that better clinical and radiological results can be achieved with anatomical reduction and stable fixation in lisfranc joint fractures in the earlier periods.

Anahtar Kelimeler

Lisfranc joint, fracture, anatomical reduction

Kaynakça

• Görgeç M, Esenkaya İ, Nalbantoğlulu U, Türkmen M. Lisfranc eklem yaralanmaları ve tedavisi. Acta Orthop Traumatol Turc 1994;28: 240-4.
• Murphy AG: Ayağın Kırık ve Çıkıları, Campbell’s Operative Orthopaedics, 11th Edition. Canale & Beaty,2011; 487148
• Buzzard, BM , Briggs, PJ. Surgical management of acute tarsometatarsal fracture dislocation in the adult. Clin Orthop 1998;353:125-133.
• Hardcastle PH, Reschauer R, Kutscha-Lissberg E, Schoffmann W. Injuries to the tarsometatarsal joint. Incidence, classification and treatment. J. Bone and Joint Surg 1982;64-B(3):349-356.
• Myerson MS, Fisher RT, Burgess AR, Kenzora JE. Fracture dislocations of the tarsometatarsal joints: end results correlated with pathology and treatment. Foot Ankle 1986;6(5):225-242.
• Teng A, Pinzur M, Lomasney L, Mahoney L, Havey R. Functional outcome following anatomic restoration of tarsal-metatarsal fracture dislocation. Foot Ankle Int 2002; 23(10):922-926.
• Trevino SG, Kodros S. Controversies in tarsometatarsal injuries. Orthop Clin North Am. 1995;26(2):229-38.
• Sanders R, Fortin P, DiPasquale T, Walling A. Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification. Clin Orthop Relat Res. 1993; 290:87-95.
• Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the anklehindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15(7):349-53.
• Stein RE. Radiological aspects of the tarsometatarsal joints. Foot Ankle 1983;3(5):286-9.
• Rosenberg GA, and Patterson BM. Tarsometatarsal (Lisfranc’s) fracture-dislocation. Am J Orthop 1995;7-16.
• Quénu E and Küss E: Étude sur les luxations du métatarse. (Luxations métatarso-tarsiennes). Du diastasis entre le 1er et le 2e métatarsien. Rev. chir 1909.
• Kuo RS, Tejwani NC, DiGiovanni CW, Holt SK, Benirschke SK, Hansen ST et al. Outcome after open reduction and internal fixation of lisfranc joint injuries. J Bone Joint Surg Am. 2000;82:1609-18.
• Arntz CT, Veith RG, Hansen ST Jr. Fractures and fracturedislocations of the tarsometatarsal joint. J Bone and Joint Surg 1988;70-A:173-181.
• Curtis MJ, Myerson MS, Szura B. Tarsometatarsal joint injuries in the athlete. Am. J. Sports Med 1993;21: 497-502. Myerson M. The diagnosis and treatment of injuries to the Lisfranc joint complex. Orthop Clin North America 1989;20: 655-664.
• Blanco RP, Merchán CR, Sevillano RC, Martínez LM. Tarsometatarsal fractures and dislocations. J Orthop Trauma 1988;2:188-194.
• Sangeorzan Goossens M, De Stoop N. Lisfranc’s fracturedislocations: etiology, radiology, and results of treatment. A review of 20 cases. Clin Orthop 1983;176:154-162.
• Sangeorzan BJ, Veith RG, Hansen ST Jr. Salvage of Lisfranc’s tarsometatarsal joint by arthrodesis. Foot and Ankle 1990;10:193-200.