Scarf osteotomisi ileri seviye halluks valguslarda Turan ve Distal chevron osteotomileri kadar etkili midir ?
Öz
Amaç: Orta ve ileri seviye halluks valgus hastalarında 2 farklı distal (Turan, Chevron) ve diafiz osteotomisi (Scarf)‘nin klinik ve radyolojik sonuçlarını karşılaştırmaktır.
Materyal ve metod:2013-2016 yılları arasında opere dilen 77 hastadan 38 hasta çalışmaya dahil edildi.17 hastaya Turan osteotomisi , 12 hastaya Distal Chevron osteotomisi 9 hastaya Scarf osteotomisi yapıldı. Hastalar preoperatif ve postoperatif klinik parametreler ve radyolojik parametreler ile değerlendirildi.
Bulgular: Her üç grubun postoperatif HVA (halluksvalgus açısı), İMA (intermetatarsal açı), DMAA (distalmetatarsalartikular açı), Metatars uzunluğu, AOFAS, VAS ve HMS (hasta memnuniyet skoru) , OneWay ANOVA yöntemi kullanılarak yapılan analizde anlamlı fark bulunmuştur. Bu değerler Turek testi incelenerek birbirleri arasında kıyaslandığında; HVA, İMA, DMAA Scarfosteotomisi yapılan hastalarda distal Chevron ve Turan osteotomisi yapılan hastalara göre anlamlı derecede daha yüksek kaldığı görülmüştür.AOFAS, VAS ve HMS ise ScarfOsteotomisi yapılan hastalarda distal Chevron ve Turan osteotomisi yapılan hastalara göre anlamlı derecede daha düşük olduğu görülmüştür.
Sonuç: Turan ve Chevron osteotomilerinin klinik ve radyolojik sonuçları arasında anlamlı fark bulunamamıştır. Çalışmamıza göre bu iki osteotomininScarfosteotomisine göre klinik ve radyolojik olarak üstün olduğu gösterilmiştir.
Anahtar Kelimeler
Halluks Valgus Halluks Valgus Scarf Osteotomisi Turan Osteotomisi
Kaynakça
- 1. Easley ME, Trnka HJ.Current concepts review: hallux valgus part 1: pathomechanics, clinical assessment, and nonoperative management. Foot Ankle Int. 2007;28(5):654-9PMID: 17559782
- 2. Easley ME, Trnka HJ.Current concepts review: hallux valgus part II: operative treatment.Foot Ankle Int. 2007;28(6):748-58PMID: 17592710
- 3. Parmaksızoğlu A. Özer K. Yazıcı N. Özkaya F. Halluks valgusda distal metatarsal oblik osteotomi ve yumuşak doku girişimi ile kombinasyonu. Acta orthop Traumatol Turc 1996; 30, 226-229
- 4. Özcan Ç, Ozcafer R, Bahar H, Gürsu S, Evaluation of Sesamoid Bone Reduction in Hallux Valgus Patients Treated With Three Different Osteotomy. Acta Med. Alanya 2018; 2018;2(2):91-95. DOI:10.30565/medalanya.399896
- 5. J. MR., Foot and Ankle pearls, Hanley & Belfus 1.Ed 2001; 110–121.
- 6. S. M. Perera AM. Mason L. The pathogenesis of halluks valgus . Bone Jt. Surg Am 1997; 07, 93-94PMID: 21915581
- 7. W. S. Tadashı Kato, The Etiology of halluks valgus in Japan. J Vol. 157 – issue- 2007; 78-81.PMID: 7249466
- 8. Slullitel G, López V, Calvi JP. Effect of First Ray Insufficiency and Metatarsal Index on Metatarsalgia in Hallux Valgus. Foot Ankle Int. 2016;37(3):300-306. PMID: 26542161
- 9. Dereymaeker G. Scarf osteotomy for correction of hallux valgus. Surgical technique and results as compared to distal chevron osteotomy. Foot Ankle Clin 2000; 5: 513-524PMID: 11232395
- 10. Coetzee JC. Scarf osteotomy for hallux valgus repair: the dark side. Foot Ankle Int 2003;24:29-33. PMID: 12540078
- 11. Fakoor M. Sarafan N Mohammadhoseini P et al. Comparison of Clinical Outcomes of Scarfand Chevron Osteotomies and the Mc Bride Procedure İn theTreatment of Hallux Valgus Deformity. Arch Bone Jt Surg. 2014;2 (1):31-33. PMID: 25207310
- 12. Zollinger-Kies H. Kundert H. Mid-termresults of Scarfosteotomy in hallux valgus. Int Orthop. 2010; 34(7): 981–989
- 13. Perugia D, Basile A, Gensini A, et al. Scarf osteotomy for severe hallux valgus. İnt Orthop. 2003; 27:103-6. PMID: 20157812
- 14. Elshazly O. Abdel Rahman A. Fahmy H.Scarf versus long chevron osteotomies for the treatment of hallux valgus: A prospective randomized controlled study.Foot And Ankle Surgery 2012 ;51(4):437-44.
- 15. Uygur E. Özkan NK. Akan K. Çift H. comparasion of Chevron and Lindgren turan osteotomy techniques in hallux valgus surgery: a prospective randomized controlled study. Acta OrthopTraumatol turc 2016; 50(3):255-6. PMID: 27130379
- 16. Sofu H, Çamurcu Y, Koçkara N Konya MN. Aydın K. Halluks valgus cerrahi tedavisi sonrası metatars uzunluğundaki değişimin klinik sonuca etkileri. Kocatepe Tıp Dergisi 2017 Sayı 1; 19 – 23
- 17. Hammel E, Abi Chala ML, Wagner T. Complications of first ray osteotomies: a consecutive series of 475 feet with first metatarsal Scarf osteotomy and first phalanx osteotomy. Rev Chir Orthop Reparatrice Appar Mot. 2007;93(7):710-9. PMID: 18065882
- 18. Bozkurt M, Tigaran C, Dalstra M, Jensen NC, Linde F. Stability of a cannulated screw versus a Kirschner wire for t he proximal crescentic osteotomy of the first metatarsal: a biomechanical study. J Foot Ankle Surg 2004;43:138-43. PMID: 15181429
Öz
Aim :Clinical and radiologic comparison of diaphyseal osteotomy (Scarf) with two different distal osteotomies (Chevron and Turan) in moderate and advanced hallux valgus patients.
Material and method:In this retrospective study, 77 patients were evaluated between 2013-2016. The remaining 38 patients who met the inclusion criteria of 77 patients were included in the study. Turan osteotomies were performed on 17 patients. Chevron osteotomies were performed on 12 patients and Scarf osteotomies were performed on 9 patients.Patients were evaluated with preoperative and postoperative clinical parameters (AOFAS, VAS, PSS) and radiological parameters (HVA, IMA, DMAA, SP, 1.ML, 1.W.S.).
Results:All three groups, postoperative HVA, IMA, DMAA, Metatarsal length, AOFAS, VAS and PSS were found significantly different in the analysis using One Way ANOVA method. When these values were compared between each other by examining the Turek test; HVA, IMA, DMMA were significantly higher in Scarf osteotomy patients than patients treated with distal Chevron and Turan osteotomy.AOFAS, VAS and PSS were found to be significantly lower in patients with Scarf osteotomy compared to patients withDistal Chevron and Turan osteotomy.
Conclusion:There was no statistically significant difference between the clinical and radiological results of Turan and Chevron osteotomies.The clinical and radiological superiority of these two osteotomies to Scarf osteotomy was statistically determined.
Anahtar Kelimeler
Kaynakça
- 1. Easley ME, Trnka HJ.Current concepts review: hallux valgus part 1: pathomechanics, clinical assessment, and nonoperative management. Foot Ankle Int. 2007;28(5):654-9PMID: 17559782
- 2. Easley ME, Trnka HJ.Current concepts review: hallux valgus part II: operative treatment.Foot Ankle Int. 2007;28(6):748-58PMID: 17592710
- 3. Parmaksızoğlu A. Özer K. Yazıcı N. Özkaya F. Halluks valgusda distal metatarsal oblik osteotomi ve yumuşak doku girişimi ile kombinasyonu. Acta orthop Traumatol Turc 1996; 30, 226-229
- 4. Özcan Ç, Ozcafer R, Bahar H, Gürsu S, Evaluation of Sesamoid Bone Reduction in Hallux Valgus Patients Treated With Three Different Osteotomy. Acta Med. Alanya 2018; 2018;2(2):91-95. DOI:10.30565/medalanya.399896
- 5. J. MR., Foot and Ankle pearls, Hanley & Belfus 1.Ed 2001; 110–121.
- 6. S. M. Perera AM. Mason L. The pathogenesis of halluks valgus . Bone Jt. Surg Am 1997; 07, 93-94PMID: 21915581
- 7. W. S. Tadashı Kato, The Etiology of halluks valgus in Japan. J Vol. 157 – issue- 2007; 78-81.PMID: 7249466
- 8. Slullitel G, López V, Calvi JP. Effect of First Ray Insufficiency and Metatarsal Index on Metatarsalgia in Hallux Valgus. Foot Ankle Int. 2016;37(3):300-306. PMID: 26542161
- 9. Dereymaeker G. Scarf osteotomy for correction of hallux valgus. Surgical technique and results as compared to distal chevron osteotomy. Foot Ankle Clin 2000; 5: 513-524PMID: 11232395
- 10. Coetzee JC. Scarf osteotomy for hallux valgus repair: the dark side. Foot Ankle Int 2003;24:29-33. PMID: 12540078
- 11. Fakoor M. Sarafan N Mohammadhoseini P et al. Comparison of Clinical Outcomes of Scarfand Chevron Osteotomies and the Mc Bride Procedure İn theTreatment of Hallux Valgus Deformity. Arch Bone Jt Surg. 2014;2 (1):31-33. PMID: 25207310
- 12. Zollinger-Kies H. Kundert H. Mid-termresults of Scarfosteotomy in hallux valgus. Int Orthop. 2010; 34(7): 981–989
- 13. Perugia D, Basile A, Gensini A, et al. Scarf osteotomy for severe hallux valgus. İnt Orthop. 2003; 27:103-6. PMID: 20157812
- 14. Elshazly O. Abdel Rahman A. Fahmy H.Scarf versus long chevron osteotomies for the treatment of hallux valgus: A prospective randomized controlled study.Foot And Ankle Surgery 2012 ;51(4):437-44.
- 15. Uygur E. Özkan NK. Akan K. Çift H. comparasion of Chevron and Lindgren turan osteotomy techniques in hallux valgus surgery: a prospective randomized controlled study. Acta OrthopTraumatol turc 2016; 50(3):255-6. PMID: 27130379
- 16. Sofu H, Çamurcu Y, Koçkara N Konya MN. Aydın K. Halluks valgus cerrahi tedavisi sonrası metatars uzunluğundaki değişimin klinik sonuca etkileri. Kocatepe Tıp Dergisi 2017 Sayı 1; 19 – 23
- 17. Hammel E, Abi Chala ML, Wagner T. Complications of first ray osteotomies: a consecutive series of 475 feet with first metatarsal Scarf osteotomy and first phalanx osteotomy. Rev Chir Orthop Reparatrice Appar Mot. 2007;93(7):710-9. PMID: 18065882
- 18. Bozkurt M, Tigaran C, Dalstra M, Jensen NC, Linde F. Stability of a cannulated screw versus a Kirschner wire for t he proximal crescentic osteotomy of the first metatarsal: a biomechanical study. J Foot Ankle Surg 2004;43:138-43. PMID: 15181429
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Cerrahi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 23 Ağustos 2019 |
| Gönderilme Tarihi | 21 Kasım 2018 |
| Kabul Tarihi | 31 Mart 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 3 Sayı: 2 |
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