Pes ekinovarus hastalarına uygulanan cerrahi tedavilerin erken klinik ve radyolojik sonuçları

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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