Mesut ULUÖZ, Kemal YÜCE, Vahid Erdal BATTAL, Osman ÇİLOĞLU

Tüm Pes Planus Tanılarımız Doğru Mu?

Amaç: Pes planusun tanısı için birçok radyolojik kriter tanımlanmıştır. Bu çalışmada radyolojik kriterlerin birbiriyle ilişkisini araştırmayı amaçladık. Gereç ve Yöntem: Araştırmada, askeri personel alım başvurusunda kullanılmak adına sağlık raporu almak için hastanemize gelen adaylardan planus tanısından dolayı elenen 126 aday geriye dönük değerlendirildi. Ayakta basarak çekilmiş yan grafiler ve muayene bulguları değerlendirildi. Kalkaneal zemin açısı (KZA), talo-kalkaneal açı (TKA), talus-1.metatars açısı (TMA), talo-horizantal açı (THA) ölçüldü. KZA kendi içinde 0-10, 10-15, 15-20 olarak 3 gruba ayrıldı ve bu gruplar diğer üç açıyla kıyaslandı. Bulgular: Muayene bulgusu değerlendirildiğinde 1. Grupta sağ ve sol ayakların tamamının planus olduğu görülürken; 2. Grupta sağ %21,7, sol %7,7 3. Grupta sağ %77,9 sol %87,6 oranında ayakların sağlam olduğu görülmüştür. TKA her üç grupta da normal çıkmıştır. TZA ve TMA değerlerinde ise Grup 1’den Grup 3’e gidildikçe ayakların sağlam çıkma oranı artmaktadır. Talusu ve 1. metatarsı baz alan açılar, klinik muayene bulgularıyla korelasyon göstermektedir. KZA’ya göre elenen 126 aday eğer diğer açılara göre değerlendirilseydi; TZA’dan 51 kişi, TMA’dan 48 kişi, TKA’dan 5 kişi elenmiş olacaktı. Sonuç: Klinik muayene bulgular ile en uyumlu açı meary açısıydı. Özellikle askeri personel alımında CP açısının ana kriter olarak alınması normal ayaklı adayları eleyecektir. Pes planus tanısında meary açısına öncelik verilmeli ve klinik muayene ile desteklenmelidir.

Are All Our Pes Planus Diagnoses Correct?

Objectives: Many radiological criteria have been defined for the diagnosis of pes planus. In this study, we aimed to investigate the relationship between radiological criteria. Materials and Methods: One hundred and twenty-six candidates who came to us to get a health report to be used in military personnel recruitment applications, who were eliminated due to planus diagnosis, were evaluated retrospectively. Lateral radiographs taken by standing up and examination findings were evaluated. Calcaneal picth angle (CP), talo-calcaneal angle (TC), talus-1. metatarsal angle (TM) (meary), talo-horizontal angle (TH) were measured. CP was divided into 3 groups as 0-10, 10-15, 15-20, and these groups were compared with the other three angles. Results: When the examination were evaluated, While it was observed that all feet were planus in Group 1; in the 2nd Group, the right feet were 21.7%, the left 7.7%, in the 3rd Group the right 77.9% and the left 87.6% feet were healthy. TKA was normal in all three groups. On the other hand, in TZA and TMA values, as you go from Group 1 to Group 3, the rate of foot recovery increases. Angles based on the talus and 1st metatarsal correlate with clinical examination findings. If 126 candidates were evaluated according to other angles; 51 people from TZA, 48 people from TMA, and 5 people from TKA would have been eliminated. Conclusion: The angle most compatible with clinical examination findings was the meary angle. Especially in the recruitment of military personnel, considering the CP angle as the main criterion will eliminate candidates with normal feet. When diagnosing pes planus, the angle of meary should be prioritized and it should be supported by clinical examination.

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