Halluks Valgus Cerrahisinde Distal Metatars Chevron Osteotomisinin Kilitli Plak ve İntramedüller Cihaz ile Tespitinin Geriye Dönük Olarak Karşılaştırılması.

Yıl 2019, Cilt: 21 Sayı: 3, 377 - 387, 31.12.2019

Ahmet Sinan Sarı Ubeydullah Sevgili Özgün Karakuş

https://doi.org/10.24938/kutfd.573524

Öz

Amaç: Yakın zamanda,
distal metatars chevron osteotomisinin tespitinde kullanılmak üzere yeni bir
intramedüller cihaz geliştirilmiştir. Çalışmamızın amacı halluks valgus
cerrahisinde yapılan distal metatars chevron osteotomisinde, kilitli plak tespiti
sonuçlarını intramedüller cihaz tespiti sonuçları ile karşılaştırmaktır.

Gereç ve Yöntemler: Geriye dönük
olarak, halluks valgus tedavisi için distal metatarsal chevron osteotomisi
yapılmış ve kilitli plak veya intramedüller cihaz ile tespit edilmiş 29
hastanın 29 ayağı incelenmiştir. Kilitli plak ile tespit 14 hastada (14 ayakta)
ve intramedüller cihaz tespit 15 hastada (15 ayakta) kullanılmıştır.

Bulgular: Ortalama takip
süresi 31 aydır (6–56). Kilitli plak ve intramedüller cihaz grupları arasında
hastanın yaşı, ameliyat edilen taraf, ameliyat süresi, hastanede kalış süresi,
takip süresi veya postop Amerikan Ortopedik Ayak ve Ayak Bileği Skoru (AOFAS)
açısından anlamlı bir fark saptanmamıştır (p>0.05). Ameliyat sonrası dönemde
halluks valgus açısı ve intermetatarsal açı ameliyat öncesi döneme göre her iki
grupta da anlamlı bir şekilde azalmıştır (p<0.01). Kilitli plak grubunda 2 (%14.3)
hastada ve intramedüller cihaz grubunda 5 (%33.3) hastada implant irritasyonu
sebebi ile implant çıkarma ameliyatı gerçekleştirilmiştir. Ancak implant
çıkarma oranları açısından gruplar arasında anlamlı fark bulunmamıştır (p>0.05).

Sonuç: Distal metatars chevron osteotomisinde hem
kilitli plak hem de intramedüller cihaz tespitinin orta dereceli halluks
valgusun cerrahi tedavisinde etkili olduğu bulunmuştur. Ancak hem kilitli plak
hem de intramedüller cihaz tespitinin nispeten yüksek implant çıkarma oranları
ile karakterize olduğu saptanmıştır.a

Anahtar Kelimeler

chevron osteotomisi, halluks valgus, implant çıkarma, intramedüller cihaz, kilitli plak, osteotomi plağı

Destekleyen Kurum

Mevcut değil.

LOCKING PLATE VERSUS INTRAMEDULLARY DEVICE FIXATION FOR THE DISTAL METATARSAL CHEVRON OSTEOTOMY IN HALLUX VALGUS: A RETROSPECTIVE STUDY

Öz

Objective: Recently,
an innovative intramedullary device was introduced for the fixation of the
capital fragment in the distal metatarsal chevron osteotomy. The aim of the
present study was to compare the outcomes of locking plate and intramedullary
device fixation in the distal metatarsal chevron osteotomy in the surgical
treatment of hallux valgus.

Material and Methods: We
reviewed 29 patients (29 feet) treated with distal metatarsal chevron
osteotomies fixated by locking plate or intramedullary device for hallux valgus.
Locking plate fixation were used for 14 patients (14 feet) and intramedullary
device fixation were used for 15 patients (15 feet).

Results: The
mean follow-up period was 31 (6–56) months. The locking plate and
intramedullary device groups did not differ significantly with respect to age,
affected side, surgical time, duration of hospital stay, follow – up period or
postoperative American Orthopedic Foot and Ankle Society scores (p>0.05).
The hallux valgus angle and the intermetatarsal angle decreased significantly
in both the locking plate and the intramedullary device groups (p<0.01). Two
patients (14.3%) in the locking plate group and 5 patients (33.3%) in the
intramedullary device group had implant removal surgery because of implant
irritation but the difference in implant removal rates were not statistically
significant.

Conclusion: We
found both locking plate and intramedullary device fixation methods were
effective in the fixation of distal metatarsal chevron osteotomy for correction
of moderate hallux valgus. However, both locking plate and intramedullary
device fixation methods were associated with a relatively high implant removal
rate.

Anahtar Kelimeler

Chevron osteotomy, hallux valgus, implant removal, intramedullary device, locking plate, osteotomy plate

Kaynakça

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