Cerrahi Tedavi uygulanmış Ayak Bileği Kırıklarının Klinik, Radyolojik ve Fonksiyonel Sonuçlarının Değerlendirilmesi

Year 2022, , 556 - 562, 20.10.2022

Cemal Güler , Zekeriya Okan Karaduman , Şafak Orhan , Yalçın Turhan , Mehmet Arıcan , Ozan Turhal , Zafer Orhan

https://doi.org/10.18521/ktd.1113371

Abstract

Amaç: Ayak bileği vücudun yürüme fonksiyonunda önemli bir eklemdir. Deplase ve
stabil olmayan kırıkların ve eklem uyumunun konservatif yöntemlerle sağlanamadığı
durumlarda cerrahi tedavi gerekir. Cerrahi tedavinin temel amacı, normal bir
tibiotalar eklem ilişki için talusun ayak bileği içindeki anatomik pozisyonunu
sağlamaktır.
Gereç ve Yöntem: Ocak 2006-Ekim 2015 tarihleri arasında polikliniğimize
başvuran, ayak bileği kırığı tanısı alan ve cerrahi tedavi uygulanan 73 hasta
retrospektif olarak sağlam ayak bileği ile karşılaştırıldı.
Bulgular: Ameliyat olan hastalardan; 34'ünde bimalleol kırığı (%46.58), 8'inde
(%10.96) trimalleol kırığı, 14'ünde lateral malleol kırığı (%19.18), 13'ünde medial
malleol kırığı (%17.81), 1’inde posterior malleol kırığı ile birlikte ayak bileği çıkığı
(%1.37) ve 1’inde de medial malleol kırığı ile birlikte arka malleol kırığı vardı
(%1.37). Lauge Hansen sınıflamasına göre en sık SER (Supinasyon Eksternal
Rotasyon) kırık tipi (14 olgu) (%19.18), ardından ikinci en sık PER (Pronasyon
Eksternal Rotasyon) kırık tipi (14 olgu) (%19.18) görüldü. Danis - Weber
sınıflamasına göre en sık Tip C (21 vaka) (% 52.50) ve ikinci en sık Tip B (14 vaka)
(% 35,00) görüldü. Kaynama süresi kırık tipine göre incelendiğinde istatistiksel
olarak anlamlı farklılık gözlenmedi (p=0,064).
Sonuç: Ayak bileği kırıklarında cerrahi tedavi uygulanacaksa fibula uzunluğu
sağlanmalı, eklem yüzeyinin anatomik olarak redükte edilmesi amacıyla rijit iç tespit
yapılmalı ve ayak bileği hareketlerine erken başlanmalıdır.

Keywords

Yetişkin, Ayak Bileği Kırığı, Cerrahi Tedavi

Evaluation of Clinical, Radiological and Functional Outcomes of Surgically Treated Ankle Fractures

Abstract

Objective: The ankle is an important joint in the walking function of the body.
Surgical treatment is required in cases where displaced and unstable fractures and
joint compatibility cannot be achieved by conservative methods. The main goal of
surgical treatment is to restore the anatomical position of the talus within the ankle
for a normal tibiotalar joint relationship.
Methods: 73 patients who were admitted to our outpatient clinics between January
2006 and October 2015, who were diagnosed with ankle fracture and underwent
surgical treatment, were retrospectively evaluated and compared with the intact
ankle.
Results: Of the patients who had surgery; Bimalleol fracture in 34 (46.58%),
trimalleol fracture in 8 (10.96%), lateral malleolar fracture in 14 (19.18%), medial
malleolar fracture in 13 (17.81%), with posterior malleolar fracture in 1 ankle
dislocation (1.37%) and 1 had posterior malleolar fracture with medial malleolus
fracture (1.37%). According to the Lauge Hansen classification, the most common
type of SER (Supination External Rotation) fracture (14 cases) (19.18%), followed
by the second most common PER (Pronation External Rotation) fracture type (14
cases) (19.18%). According to the Danis - Weber classification, Type C (21 cases)
(52.50%) was the most common and Type B (14 cases) (35.00%) was the second
most common. When the union time was analyzed according to the fracture type, no
statistically significant difference was observed (p=0.064).
Conclusions: If surgical treatment is applied in ankle fractures the length of the
fibula should be ensured, rigid internal fixation should be made with the aim of
anatomical reduction of the joint surface, and ankle movements should be started
early.

Keywords

ankle fracture, Adult, surgical treatment

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