Abdülkadir BİLİR, Emre ATAY, Ayşe ERTEKİN

Acil Servise Başvuran Hastalardaki Sesamoid Kemiklerin ve Aksesuar Kemikçiklerin Ayak ve Ayak Bileğindeki Görülme Sıklığının Belirlenmesi

Aksesuar kemikçikler ve sesamoid kemikler, ayakta çeşitli hastalıklara neden olan ve kırıkları taklit eden kemikleşmesini tamamlamış kemik yapılardır. Radyografilerde tesadüfen keşfedilirler ve çoğu zaman gözden kaçırılarak yanlış teşhislere yol açarlar. Bu nedenle, acil servise ayak ve ayak bileği şikâyeti ile başvuran hastaların radyografi görüntülerinde aksesuar kemikçik ve sesamoid kemiklerin görülme sıklığının belirlenmesi amaçlandı. Acil Servisi başvuran hastalara ait anteroposterior, oblik ve lateral ayak grafileri (506) retrospektif olarak değerlendirildi. Aksesuar kemikçiklerin ve sesamoid kemiklerin varlığı, prevalansı, bir arada bulunuşu ve dağılımı cinsiyete ve ekstremite tarafına göre detaylı olarak analiz edildi. 506 ayak grafisinde, %18.4 oranında aksesuar kemikçik, % 86.4 oranında sesamoid kemik tespit edildi. En yaygın aksesuar kemikçikler; os naviculare accessorium (%11.5), os peroneum (%3.6), os trigonum (% 1.8), os supranaviculare (%0.4), os vesalianum (%0.2), os supratalare (%0.2), os subfibulare (% 0.6) ve os calcaneus secundarius (%0.2)’tur. Radyografilerin %86.4'ünde halluks sesamoid gözlemlendi. Halluks’un interfalangeal sesamoid kemiği, radyografilerin %2'sinde görüldü. Metatarsofalangeal sesamoid kemik insidansı MTP II’de % 2, MTP IV’te % 0.4 ve MTP V’te % 6.7 olarak bulundu. Çalışmanın sonuçları literatürde belirtilen aralıklarda olmasına rağmen, çalışma grubunun farklı populasyon ve yaş gruplarından oluşması ve sadece acil servise başvuran hastaların dahil edilmesi nedeni ile diğer literatür raporlardan önemli ölçüde farklı göstermektedir.

Anahtar Kelimeler:

Aksesuar kemikçikler, Anatomi, Acil servis, Sesamoid kemikler

Determination of Frequency of Sesamoid Bones and Accessory Ossicles in Foot and Ankle in Patients Admitted to Emergency Service

Accessory ossicles and sesamoid bones are bone structures that have completed ossification that mimic fractures and cause various diseases in the foot. They are discovered by chance on radiographs and are often overlooked, and lead to misdiagnosis. For this reason, it was aimed to determine the frequency of the accessory ossicles and sesamoid bones in the radiographic images of the patients who were admitted to the emergency department with foot and ankle complaints. Anteroposterior, oblique and lateral foot radiographs of patients (506) admitted to the Emergency Service were evaluated retrospectively. The presence, prevalence, coexistence and distribution of accessory ossicles and sesamoid bones were analyzed in detail according to gender and extremity sides. In 506 foot radiographs, accessory ossicles were detected in 18.4% and sesamoid bones in 86.4%. The most common accessory ossicles were accessory navicular (11.5%), os peroneum (3.6%), os trigonum (1.8%), os supranaviculare (0.4%), os vesalianum (0.2%), os supratalare (0.2%), os subfibulare (%0.6) ve os calcaneus secundarius (%0.2). We observed hallux sesamoid in 86.4% of radiographs. Interphalangeal sesamoid bone of the hallux was seen in 2% of radiographs. Incidences of MTP I were found as 2% in the MTP II, 0.4% MTP IV and 6.7% MTP V. In conclusion, although the results of the study are within the ranges stated in the literature, they differ significantly from other literature reports because the study group consisted of different population and age groups and only patients who applied to the emergency department were included.

Keywords:

Accessory ossicles; Anatomy; Emergency service; Sesamoid bones,

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