Hafif Orta Evre Halluks Valgus Tedavisinde Intramedullar Plak Uygulamasının Etkinliği: Erken Dönem Sonuçlar

Abstract

Amaç: Halluks valgus, birinci metetarsal kemiğin varus deformitesi, başparmağın valgus deformitesi, sesamoid kemikler ve ekstensör tendonların laterale yer değiştirmesi ile karakterize, birinci metatarso-falangial eklemin kompleks deformitesidir. Bu deformitenin düzetilmesi için çeşitli cerrahi yöntemler tarif edilmiştir. Distal metatarsal osteotomi hafif orta evre halluks valgus cerrahisinde en sık kullanılan yöntemlerden biridir. Metatars osteotomi hattının fiksasyon materyali olarak çeşitli implantlar kullanılmaktadır. Bu çalışmanın amacı halluks valgus cerrahisinde intrameduller plak uygulamasının kısa dönem klinik ve radyolojik sonuçlarını ortaya koymaktır.

Gereç ve Yöntemler: 2012-2014 yılları arasında distal metatarsal osteotomi sonrası osteotomi hattı intramedüller kilitli plak kullanılarak tespit edilen halluks valgus hastalarının operasyon sonrası 6. ay verileri retrospektif olarak değerlendirildi. Cerrahi yaklaşım olarak Mitchell distal metatarsal osteotomi tekniği uygulandı. Hastaların klinik ve radyolojik özellikleri incelendi.

Bulgular: Çalışmaya yaş ortalaması 51,00±12,96 yıl olan toplam 36 (29 kadın, 7 erkek) hasta dahil edildi. Sekiz hastaya her iki ayağından cerrahi uygulandı. Ameliyat sonrası 6. ayda yapılan değerlendirmelerde halluks valgus açısı, distal metatarsal eklem açıları ve Amerikan Ortopedik Ayak ve Ayak Bileği Birliği halluks valgus skorlarında istatistiksel olarak anlamlı düzelme izlendi (her üç p değeri <0,001). İntermetetatarsal açı değerlendirildiğinde preoperatif ve ameliyat sonrası 6. ay arasında anlamlı bir değişiklik saptanmadı (p=0,058).

Sonuç: Hafif orta evre halluks valgus cerrahisinde ostetomi hattının tespitinde intramedüller kilitli plak uygulaması, güçlü bir tespit sağlaması, hızlı iyileşme ve hastaların günlük yaşam aktivitelerine hızlı dönüş imkanı sağlaması açısından efektif bir metottur.

Keywords

• Halluks valgus,intramedullar kilitli plak,distal metatarsal osteotomi

Efficacy of Intramedullar Locking Plate in Mild to Moderate Hallux Valgus Deformity: Early Outcomes

Abstract

Aim: Hallux valgus is a complex deformity of the first metatarsophalangeal joint characterized by varus deformity of the first metatarsal bone, valgus deformity of the big toe, and lateral deviation of the extensor tendons and sesamoid bones. Several surgical methods have been described for correction of the deformity. Distal metatarsal osteotomy is a commonly used procedure in mild-to moderate hallux valgus. Different materials have been used for the fixation of osteotomy. The aim of this study was to evaluate radiological and clinical efficacy of intramedullar locking plate in hallux valgus surgery.

Material and Methods: Postoperative 6th month data of patients with mild-to moderate hallux valgus deformity who underwent distal metatarsal osteotomy using an intramedullary locking plate between 2012 and 2014 were evaluated retrospectively. The surgical procedure was applied by Mitchell technique. Clinical and radiological features of the patients were analyzed.

Results: Thirty-six (29 female, 7 male) patients whit a mean age of 51.00±12.96 years were enrolled the study. Eight patients underwent bilateral surgery. There were statistically significant improvement in hallux valgus angle, distal metatarsal articular angles, and American Orthopaedic Foot and Ankle Society hallux valgus scores in the postoperative 6th month (all p values <0.001). No statistically significant difference were found between the preoperative and postoperative 6th month inter-metatarsal angle values (p=0.058).

Conclusion: The intramedullar locking plate usage in surgery of mild-to moderate hallux valgus deformity is an effective method providing strong fixation and quick recovery that led patients to gain an early improvement in the daily life activities.

Keywords

• Hallux valgus,intramedullar locking plate,distal metatarsal osteotomy

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