Mehmet AŞIK, Cengiz ŞEN, Fatih DİKİCİ, Ömer TAŞER

Kronik lateral ayak bileği instabilitelerinin tedavisinde Bröstrom-Gould ameliyatının yeri

Amaç: Kronik lateral ayak bileği instabilitesi olan 10 hastada uygulanan Bröstrom-Gould ameliyatı ve erken sonuçları değerlendirildi. Çalışma planı: Kronik lateral ayak bileği instabilitesi olan 10 hastanın (4 kadın, 6 erkek; yaş dağılımı 14-32) 11 ayak bileğine Bröstrom-Gould ameliyatı uygulandı. Altı hastada lezyon sağ, üçünde sol tarafta ve bir hastada bilateraldi. İlk yaralanma ile ameliyat arasında geçen süre ortalama 3 yıl 2 ay (dağılım 18 ay-5 yıl) idi. Hastaların tamamında kronik fonksiyonel instabilite, ağrı ve şişlik mevcuttu. Ayrıca yedi hastada boşalma şikayetleri bulunmaktaydı. Sonuçlar Sefton kriterlerine göre değerlendirildi. Ortalama takip süresi 19 ay (dağılım 6-27 ay) idi. Sonuçlar: Sefton kriterlerine göre altı ayak bileğinde (%55) çok iyi; üç ayak bileğinde (%27) iyi ve iki ayak bileğinde (%18) yetersiz sonuç alındı. Ameliyat sonrası hiçbir hastada enfeksiyon, geç yara iyileşmesi ve sinir lezyonu gibi komplikasyonlarla karşılaşılmadı. Çıkarımlar: Normal doku feda edilmeden stabilitenin sağlanması ve inversiyon ile subtalar hareket kısıtlılığı gibi önemli komplikasyonlar yaratmaması nedeniyle kronik lateral ayak bileği instabilitesi olan hastalarda anatomik tamir yöntemlerinden biri olan Bröstrom-Gould ameliyatı tercih edilmelidir.

Anahtar Kelimeler:

Ortopedik işlemler, Lateral ligament, ayak bileği, Stres, mekanik, Ligamentler, eklem, Kronik hastalık, Ayak bileği, Eklem instabilitesi, Ortopedi, Yaralar ve yaralanmalar, Ayak bileği yaralanmaları, Tedavi sonucu, Ayak bileği eklemi

Bröstrom-Gould procedure for the treatment of chronic lateral ankle instability

Objectives: We evaluated the results in 10 patients who underwent surgery using the Brostrom-Gould method for chronic lateral ankle instability. Methods: Brostrom-Gould procedure was performed in 11 ankles of 10 patients (4 females, 6 males; age range 14-32 years) with chronic lateral ankle instability. Ankle injury was localized to the right (n=6) and left (n=3) ankles. One patient had bilateral instability. The average period between the time of injury and that of operation was 38 months (range 18 months to 5 years). All the patients presented with chronic functional instability, pain, and edema, of which seven patients had giving-way, as well. The results were evaluated using the Sefton criteria. Mean follow-up was 19 months (range 6-27 months). Results: According to the Sefton criteria, excellent, good, and fair results were obtained in six (55%), three (27%), and two (18%) patients, respectively. No postoperative complications occurred including infections, delayed wound healing, and nerve injuries. Conclusion: Achievement of stability without sacrificing healthy tissues and avoidance of important complications such as limited subtalar and inversion motion make Brostrom-Gould procedure the treatment of choice in the anatomic reconstruction of patients with chronic lateral ankle instability.

Keywords:

Orthopedic Procedures, Lateral Ligament, Ankle, Stress, Mechanical, Ligaments, Articular, Chronic Disease, Ankle, Joint Instability, Orthopedics, Wounds and Injuries, Ankle Injuries, Treatment Outcome, Ankle Joint,

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