İleri Evre Halluks Rijidusta Tek Başsız Kompresyon Vidası ve Patik Şeklinde yapılan Alçı ile Uygulanan Artrodez Sonuçlarının Retrospektif Değerlendirilmesi

Bu çalışmada, halluks rijidus tanılı hastalarda bir adet başsız kompresyon vidası ve patik şeklinde yapılan alçılama ile artrodez uygulamasının sonuçları değerlendirildi. Halluks rijidus tanısı ile Aralık 2017-Temmuz 2019 tarihleri arasında opere edilen; 12 hastanın 13 ayağına artrodez işlemi gerçekleştirildi. Ameliyat sırasında proksimal falanksın ve 1. metatarsın eklem yüzlerine kıkırdak dokular çıkarılacak şekilde rezeksiyon uygulandı. Başsız kanüllü kompresyon vidası ile artrodez uygulandı, patik şeklinde alçı yapılarak takip edildi. Ameliyat öncesi ve sonrası radyografik değerlendirmelerde halluks valgus ve birinci parmak dorsifleksiyon açıları ölçüldü. Hastalar American Orthopaedic Foot and Ankle Society (AOFAS) halluks metatarsofalangeal-interfalangeal skalası ile klinik olarak değerlendirildi. Hastalar ortalama 11.6 ay takip edildi. AOFAS skoruna göre, son takipte sekiz ayak mükemmel, üç ayak iyi, iki ayak orta sonuç olarak bulundu. Cerrahi öncesine göre AOFAS skorunda ortalama 39.8 puanlık artış elde edildi (p=0.001). Radyolojik değerlendirmede halluks valgus açısında ortalama yaklaşık 13° azalma saptanırken dorsofleksiyon açısında 2° artış saptandı. Komplikasyon olarak iki ayakta kaynamama gelişti. Hiçbir hastada yara yerinde enfeksiyon ve ciltte nekroz gelişmedi. Halluks rijidus cerrahisinde bir adet başsız kompresyon vidası ve patik şeklinde yapılan alçılama ile uygulanan artrodez işlemi ileri evre artrozu olan hastalar için uygun bir tedavi yöntemidir.

Anahtar Kelimeler:

Artrodez, Başsız Kompresyon Vidası, Halluks Rijidus, Metatarsofalangeal Eklem

Retrospective Evaluation of the Results of Arthrodesis Applied with a Single Headless Compression Screw and a Plaster in the Shape of a Bootie in Advanced Hallux Rigidus

In this study, the results of arthrodesis application with a single headless compression screw and a plaster in the shape of a bootie patients with hallux rigidus were evaluated. Operated with the diagnosis of hallux rigidus between December 2017 and July 2019; Arthrodesis was performed on 13 feet of 12 patients. During the operation, resection was performed to remove the cartilage tissues of the proximal phalanx and the first metatarsal joint surfaces. Arthrodesis was applied with a headless cannulated compression screw, followed by plaster in the form of a bootie. Hallux valgus and first finger dorsiflexion angles were measured by radiographic evaluations before and after surgery. The patients were clinically evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale. The patients were followed up for an average of 11.6 months. According to the AOFAS score, eight feet were excellent, three feet were good, and two feet were moderate in the last follow-up. An average of 39.8-point increase in AOFAS score was obtained compared to preoperative (p=0.001). In radiological evaluation, an average of 13° decrease was observed in the angle of hallux valgus, while a 2° increase was observed in the angle of dorsiflexion. As a complication, nonunion developed in two feet. None of the patients developed infection at the wound site and necrosis of the skin. Arthrodesis applied with a headless compression screw and a plaster cast in hallux rigidus surgery is a suitable treatment method for patients with advanced stage arthrosis.

Keywords:

Arthrodesis, Hallux Rigidus, Headless Compression Screw, Metatarsophalangeal Joint,

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