Pes Equinovarus Tedavisindeki İki Cerrahi Tekniğinin Uzun Dönem Sonuçlarının Karşılaştırılması

Amaç: Konservatif tedaviye cevap vermeyen hastalarda pes equinovarus (PEV) cerrahisialternatif bir tedavi yöntemidir. Bu çalışmamızda Posteriomedial gevşetme (PMR) ve Kompletsubtalar gevşetme (CSTR) tekniklerinin uzun dönem fonksiyonel ve radyolojik sonuçlarınınkarşılaştırılması amaçlanmıştır.Yöntem: Pes ekinovarus olgularında kliniğimizde yapılan cerrahi tedavi (Posteromedialgevşetme ve komplet subtalar gevşetme) sonuçlarının karşılaştırılması amacıyla 59 hastanın 84ayağı değerlendirildi. Hastaların 45’i erkek 14’ü kız çocuklarıydı.Takip süresi ortalama 94,7aydı(7.83 yıl).Postoperatif olarak hastaların fonksiyonel değerlendirilmeleri Laaveg-Ponsetifonksiyon değerlendirme skoruna gore yapıldı. Hastaların radyolojik değerlendirilmeleri iseanteroposterior ve yan talokalkaneal açılar, talus 1.metatars açısı ile yapıldı. Ayak bimalleolaraçıları ölçüldü.Her iki teknikteTurco insizyonu uygulanmıştır.İstatistik değerlendirmede PearsonKi karekullanılmıştır. Bu çalışma Atatürk Üniversitesi etik kurulunun B.30,2ATA.0.01.00/87sayılı izni ile yapılmıştır.Bulgular: CSTR yapılan ayakların % 62,6’sı mükemmel, % 2,3’ü iyi, %22,3’ü orta ve %2,8’ikötü olarak değerlendirildi. PMR yapılan ayakların %44,8’I mükemmel, %33,8’i iyi ve %21,4’üorta olarak değerlendirildi. PMR yapılan hiç bir hastada kötü sonuç alınmadı.Sonuç olarak CSTRve PMR teknikleri arasında fonksiyonel ve komplikasyon sıklığı yönünden İstatistiksel olarakanlamlı fark bulundu (p

Anahtar Kelimeler:

PEV, cerrahi tedavi, uzun dönem sonuçlar.

Comparison of Long Term Results of Two Surgical Techniques In Pes Equinovarus Treatment

Objective: Surgical treatment of pes equinovarus (PEV) is sometimes a necessity for patientsthat do not respond to conservative treatment. This study aimed to compare the long termfunctional and radiographic results of Posteriomedial release (PMR) and Complete subtalarrelease (CSTR) techniques.Materials and Methods: We evaluated 84 feet of 59 (45 boy and 14 girls) patients whounderwent surgical treatment ( Posteromedial release and subtalar release) for PEV. The meanfollow-up period was 94.7 months ( 7.83 years). The functionel assessment was made accordingtoLaaveg-Ponseti functional scoring system and the radiographic evaluation was made by usingthe anteroposterior talocalocaneal angle , lateral talocalocaneal angle and talus-first metatarsalangle. Bimalleolar angles were measured.Turco incision was used for both techniques. PearsonChi Square was used for statistical analysis. This study was made by the B.30,2ATA.0.01.00/87numbered permission of ethical committee of Atatürk University.Results: Functional results were excellent in 62.6% of feet, good in 2.3% of feet, fair in 22.3%of feet, and poor in 2.8% of feet that underwent CSTR. Functional results were excellent in44.8% of feet, good in 33.8% of feet and fair in 21.4% of feet that underwent PMR. None ofthe patients were assessed as poor that underwent PMR.There were statistical significantdifferences between the two surgical procedures with respect to functional scores andcomplications (p

Keywords:

PEV, surgical treatment, long term results,

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