Üç Farklı Osteotomi İle Tedavi Edilen Halluks Valgus Hastalarında, Sesamoid Kemik Redüksiyonun Değerlendirilmesi

Yıl 2018, , 91 - 95, 02.07.2018

Çağrı Özcan , Raşit Ozcafer Hakan Bahar Sarper Gürsu

https://doi.org/10.30565/medalanya.399896

Cited By: 1

Öz

Amaç: Bu çalışmanın amacı halluks valgus cerrahisinde üç farklı osteotominin sesamoid rotasyonuna etkisini araştırmaktır. 

Yöntem: Mart 2012-Ocak 2015 arasında 108 hastanın 64'ü retrospektif olarak incelendi. Sırasıyla 26,18 ve 20 hastaya distal chevron osteotomisi, proksimal domeosteotomisi ve lapidus osteotomisi uygulandı. Hastaların yaş ortalaması 46,6 (26-62) ve takip süresi ortalama 17 ay (12- 26) idi. 

Bulgular: Son kontrollerinde ortalama Halluks valgus açısı 18.4º , intermetatarsal açısı 7.4 º, AOFAS skoru 86.1, sesamoid rotasyonu 13,5 idi. Preoperatif ve postoperatif sesamoid rotasyon farklılıkları sesamoid pozisyonlarının çoğunu kendi başlarına düzeltebilme kabiliyetleri açısından üç farklı osteotomi karşılaştırıldığında, Lapidus osteotomisi yapılan hastalarda hem proksimal dome yapılan hastalara göre (p:0.02) hem de distal chevron yapılan hastalara göre (p:0.000) sesamoid redüksiyonu başarısı açısından anlamlı bir fark bulunmuştur. Proksimal dome yapılan hastalarla distal chevron yapılan hastalar arasında sesamoid redüksiyon başarısı açısından anlamlı bir fark bulunmamıştır (p=0.242). 

Sonuç: Lapidus osteotomisi uygulanan hastalarda hem sesamoid rotasyon açılarının değişimi bakımından hem de sesamoid redüksiyonu açısından diğer iki osteotomi çeşidine göre daha iyi sonuçlar bulunmuştur. Çalışmamıza göre, Lapidus prosedürünün, sesamoid redüksiyonun nüks ile ilişkili olduğu düşünüldüğünde, orta ve şiddetli halluks valguslu hastalarda daha iyi sonuçlar vereceğini düşünüyoruz. 

Anahtar Kelimeler

Sesamoid reduction, Lapidus osteotomy, Sesamoid bone

Evaluation of Sesamoid Bone Reduction in Hallux Valgus Patients Treated With Three Different Osteotomy

Öz

Aim:The aim of this study is to investigate the effect of three different osteotomies on sesamoid rotation in hallux valgus surgery. 

Patients and Method: 64 out of 108 patients between March 2012-January 2015 were included retrospectively. Procedure of distal chevron, proximal dome and lapidus was applied to 26,18 and 20 patients respectively. Mean age of patients was 46,6 (26-62) and mean time of follow-up was 17 months. 

Results: At the last follow - up of patients, the mean hallux valgus angle was 18.4º, intermetatarsal angle was 7.4 º, AOFAS score was 86.1, sesamoid rotation was 13,5. When three different osteotomies were compared in terms of preop and postop sesamoid rotation differences in terms of their ability to correct most sesamoid position within themselves, a significant difference was found in patients treated with lapidus osteotomy in terms of success of sesamoid reduction compared to both patients treated with proximal dome osteotomy (p: 0.02) and patients treated with distal chevron osteotomy (p: 0.000). There was no significant difference in the success rate of sesamoid reduction between patients with proximal dome and patients with distal chevron. (P = 0.242) 

Discussion: Patients treated with lapidus osteotomy; both sesamoid rotation angle changes and sesamoid reduction were found to be better than the other two osteotomy types. According to the study, we think that the lapidus procedure will give better results in patients with moderate and severe hallux valgus when sesamoid reduction is considered to be related to recurrence. 

Anahtar Kelimeler

Sesamoid reduction, Lapidus osteotomy, Sesamoid bone

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