Kemal ŞAHAN, Abdulkadir POLAT, Feyzi KILIÇ, Cengiz KAZDAL, Fırat FİDAN, Ufuk ÖZKAYA

Deplase eklem içi kalkaneus kırıklarının cerrahi tedavisinde genişletilmiş lateral ve sinüs tarsi yaklaşımlarının klinik ve radyolojik sonuçlarının karşılaştırılması

Amaç: Bu çalışmanın amacı eklem içi kalkaneus kırıklarının açık redüksiyon internal fiksasyonunda Sinüs tarsi(ST) ve Lateral extansil(LE) yaklaşımları arası klinik ve radyolojik sonuçların karşılaştırılmasıdır. Gereç ve Yöntem: Kliniğimizde 2012-2017 yıllarında cerrahi yöntemle tedavi edilen 48 hastanın 51 kalkaneus kırığı retrospektif olarak incelendi. Hastalar iki grup olarak ayrıldı, preoperatif BT, erken postroperatif ve postoperatif 1. yıl grafileri ve The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score skorları değerlendirildi. Bulgular: Sanders sınıflamasına göre LE grubunda 9 hasta tip 2(%36), 16 hasta tip 3(%64), ST grubunda 8 hasta tip 2(%34,8), 13 hasta (%56,5) tip 3, 2 hasta(%8,7) tip 4 idi. Takip süresi ST’ de 16 ay (12-52), LE’ de 37 ay(16-70) idi. AOFAS-Hindfoot skoru 1. yılda ST grubunda 85(63-100), LE grubunda 83(52-93) bulundu. Cerrahi öncesi beklemesi süresi ST’ de ortalama 2(1-4) gün, LE’ de 6(3-12) gün olmak üzere daha kısa bulundu (χ2:5.22). Sonuç: Sinüs tarsi yaklaşımının, eklem içi kalkaneus kırıkları cerrahisinde preoperatif bekleme süresinin kısalttığı, anatomik restorasyon için yeterli görüş sağladığı ve cilt komplikasyonlarından kaçınmak adına etkilidir.

Anahtar Kelimeler:

Kalkaneus, sinüs tarsi, minimal invaziv cerrahi, lateral ekstensil yaklaşım

Comparison of clinical and radiological outcomes between extended lateral and sinus tarsi approach in the surgical treatment of displaced intraarticular calcaneal fractures surgery

Purpose: The aim of this stud was to compare the clinical and radiological results between Sinus-tarsi (ST) and Extended-Lateral (EL) approaches in open reduction internal fixation of intra-articular calcaneal fractures. Materials and Methods: 51 calcaneal fractures of 48 patients surgically treated between 2012 and 2017 were retrospectively analyzed. The patients were divided into two groups. Preoperative CT, early postoperative and postoperative 1st-year radiographs, and The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score scores were evaluated. Results: According to the Sanders classification, nine patients in the EL group were type 2(36%), 16 patients type 3 (64%), 8 patients in ST group type 234.8%), 13 patients (56.5%) type 3, 2 patients (8.7%) type 4. The mean AOFAS-Hindfoot score was 85(63-100) in the ST group and 83(52-93) in the LE group at one year. Mean preoperative waiting time was shorter, with an average of 2(1-4) days in ST and 6(3-12) days in LE. Conclusion: ST approach shortens the preoperative waiting time in intra-articular calcaneal fracture surgery, provides a sufficient vision for anatomical restoration, and effectively avoids complications.

Keywords:

Calcaneus, sinus tarsi, minimally invasive surgery, extended lateral approach,

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