Necip GÜVEN, Sezai ÖZKAN, Fatih GÜZEL, Tülin TÜRKÖZÜ, Şehmuz KAYA, Abbas TOKYAY

Eklem İçi Kalkaneus Kırıklarında Sinus Tarsi ve Ekstensil Lateral Yaklaşımın Karşılaştırılması

Amaç: Bu çalışmada kalkaneus kırığı cerrahisinde ekstansil lateral (EL) yaklaşım ile sinüs tarsi (ST) yaklaşımının klinik ve radyolojik sonuçlarını karşılaştırmayı amaçladık. Gereç ve yöntem: Bu retrospektif çalışmaya, EL grupta 22 hasta ve sinüs tarsi grubunda 18 hasta olmak üzere Sanders II-III kalkaneus kırığı olan toplam 40 hasta dahil edildi. Radyolojik değerlendirmede, preoperative ve postoperative dönemde Bohler ve Gissane açısı, kalkaneusun uzunluğu, genişliği ve yüksekliğindeki değişiklikler ölçüldü. Klinik olarak ise Amerikan Ortopedik Ayak ve Ayak Bileği Derneği (AOFAS) ve görsel analog skalası (VAS) değerlendirildi. Ayrıca postoperative komplikasyonlar da değerlendirildi. Bulgular: Demografik veriler açısından her iki grubun sonuçları benzerdi. ST grubundaki hastaların lateral ekstensil grubuna göre ameliyata alınma ve hastane kalış süresi açısından istatistiksel olarak anlamlı bir şekilde daha kısaydı ( p=0.019, p=0.02, sırasıyla). Gruplar arasında radyolojik, klinik AOFAS ve VAS skorları açısından anlamlı fark bulunmadı. Ekstensile lateral grubunda %13,6 yüzeyel enfeksiyon görüldü ve sinüs tarsi grubunda herhangi bir yara sorununa rastlanmadı (p=0,102). Sural sinir yaralanması extensil lateral grupta 36.4% oranında, sinüs tarsi grubunda ise 5.6% oranında görüldü (p=0.003). Sonuç: Her iki yaklaşımın klinik ve radyolojik sonuçları benzerdi. Ancak hastanede kısa yatış süresi, yara yeri enfeksiyon problemlerinin ve sural sinir yaralanmasının az olması ST yaklaşımının avantajıydı.

Anahtar Kelimeler:

Kalkaneus kırığı, ekstensil lateral, sinus tarsi

Comparison of Sinus Tarsi and Extensile Lateral Approach in Intra-articular Calcaneus Fractures

Objective: In this study, we aimed to compare the clinical and radiological results of the extensile lateral (EL) approach and sinus tarsi (ST) approach in calcaneal fracture surgery. Materyal-Metod: A total of 40 patients with Sanders II-III calcaneal fractures, including 22 patients in the EL group and 18 patients in the ST group, were included in this retrospective study. In the radiological evaluation, changes in the calcaneus Bohler and Gissane angle, length, width, and height were measured during the preoperative and postoperative period. Clinically, American Orthopedic Foot and Ankle Society (AOFAS) and the visual analog scale (VAS) were evaluated. In addition, postoperative complications were also evaluated. Results: In terms of demographic data, the results of both groups were similar. Both the length of hospital stay and the time to surgery were shorter in the ST group (p=0.019, p=0.02, respectively). There was no significant difference between the groups regarding radiological, clinical AOFAS and VAS scores. 13.6% superficial infection was seen in the EL group, and no wound problems were encountered in the ST group (p=0.102). The rate of sural nerve injury was 36.4% in the EL group and 5.6% in the ST group (p =0.003). Conclusion: Both approaches clinical and radiological outcomes were similar. However, the advantages of the ST approach were shorter hospital stays, lower rate wound infections, and sural nerve injury problems.

Keywords:

Calcaneus fracture extensile lateral, sinus tarsi, minimally invasive,

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