TOPUK AĞRISININ NADİR BİR NEDENİ, KALKANEUS YERLEŞİMLİ İNTRAOSSEÖZ LİPOM: 9 OLGUNUN RETROSPEKTİF ANALİZİ ve LİTERATÜR DERLEMESİ

Yıl 2017, Cilt: 80 Sayı: 1, 20 - 25, 30.03.2017

Ahmet Salduz Mehmet Demirel Murat Altan Serkan Bayram

https://doi.org/10.18017/iuitfd.307458

Öz

Amaç: İntrakalkaneal lipom nadir görülür ve
sıklıkla asemptomatiktir. Semptomatik olan vakalarda ise çoğunlukla ilk ve en
sık şikâyet basit topuk ağrısıdır. Bu çalışmanın amacı, topuk ağrısı sebebiyle
başvurdukları kliniklerde çeşitli ön tanılar alarak cerrahi dışı yöntemler ile
tedavi edilmeye çalışılan ve kliniğimizde cerrahi olarak başarıyla tedavi
edilmiş 9 olgunun retrospektif analizini ve literatür derlemesini sunmaktır.

Gereç ve Yöntem: Kliniğimizde 2008 ve 2015 yılları arasında
intrakalkaneal lipom tanısı ile ameliyat edilen 9 hasta (4 kadın, 5 erkek)
çalışmaya dahi edildi. Ortalama yaş 40,6 (19-70) yıl idi. Ortalama takip süresi
50,4 (12-114) ay idi. Başlangıçtaki yanlış tanı ile gerçek tanı arasındaki süre
20,8 (12-48) ay idi. Hastalar kliniğimize başvurmadan önce, Achilles tendiniti, epin kalkanei,
retrokalkaneal bursit ve plantar fasiit tanıları almış ve tedavi edilmeye
çalışılmıştır.

Bulgular: Yedi hasta küretaj & kemik grefti ve 2
hasta küretaj & kemik sementi ile tedavi edildi. Tüm hastalar ortalama 5
(3-11) ayda tamamen ağrısız iyileşti. Kemik greftlerinin tam olarak konsolidasyonu
ortalama 6 (5-9) ayda görüldü. Ortalama AOFAS skoru ameliyat öncesi 80,4 ten
birinci yılda 95,3’e yükseldi.

Sonuç: Topuk ağrısı olan hastalarda
intrakalkaneal lipom ayırıcı tanıda düşünülmelidir. Küretaj ve kemik grefti ile
grefonaj ağrılı ve kritik boyutta intrakalkaneal lipomlar için iyi bir cerrahi
tedavi seçeneği olabilir.

Anahtar kelimeler: Topuk ağrısı; kemik
içi lipomlar; kalkaneus.

Anahtar Kelimeler

Topuk ağrısı, kemik içi lipomlar, kalkaneus

A RARE CAUSE OF THE HEEL PAIN: INTRAOSSEOUS LIPOMA OF THE CALCANEUS: A REVIEW OF LITERATURE AND RETROSPECTIVE ANALYSIS OF 9 CASES

Öz

Objective: Intracalcaneal lipoma is a rare disease and
frequently asymptomatic. Usually the first and the most common complaint is
simple heel pain in symptomatic cases. The purpose of this study is to present
a literature review and retrospective analysis of 9 cases with intracalcaneal
lipoma whose various preliminary diagnosis varied in other clinics due to heel
pain.

Material and Methods: Between 2008 and 2015, 9 patients (4 females and 5
males) with intracalcaneal lipoma were operated in our institution. The mean
age of the patients was 40.6 (19-70) years. The mean follow-up was 50,4
(12-114) months. The time between initial misdiagnosis and confirmed diagnosis
was 20.8 (12-48) months. The patients were treated as misdiagnosed with Achilles
tendinitis, epin calcanei, retrocalcaneal bursitis and plantar fasciitis before
admission to our clinic.

Results: Seven patients were treated with curratage & bone
grafting and 2 patients with curettage & bone cementing. All patients
recovered without heel pain in the mean 5 (3-11) months. Complete consolidation
of the bone graft was seen at the mean 6 (5-9) month. The mean AOFAS score was
increased from 80.4 preoperatively to 95.3 at the first year.

Conclusion: Intracalcaneal lipoma should be considered in the differential
diagnosis of the patients with  heel
pain. Curettage and bone grafting can be a good surgical option for the treatment
of painful and critically sized intracalcaneal lipomas.

Keywords: Heel pain; intraosseous
lipoma; calcaneus.

Anahtar Kelimeler

Heel pain, intraosseous lipoma, calcaneus

Kaynakça

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