Öz
This study aimed to evaluate the clinical and radiological results of surgically treated Sanders type 2-3-4 fractures in the mid-term follow-up. 66 patients with calcaneus fractures treated in our clinic between June 2010 and June 2016 and who underwent surgical treatment were included in the study. Demographic characteristics, complications that developed during follow-up, and clinical follow-up notes were recorded in the patient files. 33 patients with displaced intra-articular calcaneus fractures and 37 calcaneus fractures were included in the study. 28 (84.8%) of the patients were male and 5 (15.2%) were female. The average age of the patients was 43 (19-75). According to the Sanders classification, 13 (35.1%) of the 37 calcaneus fractures in the study group were Type 2, 19 (51.3%) were Type 3, and 5 (13.5%) were Type 4. The shortest period between trauma and surgery was 4 days and the longest was 10 days, with a median of 7 days. Among the 33 operated patients, the shortest follow-up period was 12 months, the longest follow-up period was 72 months, and the median follow-up period was 48 months. Complications developed in 9 patients after surgery. Wound necrosis or dehiscence developed in 5 patients, deep infection in 1 patient, subtalar arthritis in 2 patients, and exostosis on the heel in 1 patient. Shoe changes occurred in 5 of the 33 patients included in the study. These patients use silicone insoles or soft-soled shoes. 3 patients had to change jobs. Although good results are achieved with surgical treatment of calcaneus fractures, complications may develop in the mid-term follow-up. Therefore, these patients should be closely monitored after surgery.
Kaynakça
- Andermahr, J., Helling, H. J., Rehm, K. E., & Koebke, Z. (1999). The vascularization of the os calcaneum and the clinical consequences. Clinical Orthopaedics and Related Research®, 363, 212-218.
- Clare, MP. (2008). Calcaneal fractures. In: Pinzur M.S (editor), Orthopedic Knowledge Update: Foot and Ankle 4, American Academy of Orthopaedic Surgeons, pp. 7594.
- Crosby, LA. & Fitzgibbons, T. (1993). İntraarticular calcaneal fractures Results of closed treatment. Clin Orthop, 290:47-54.
- Çırpar, M., &Ekşioğlu, MF., (2013). Kalkaneus Kırıkları. TOTBİD Dergisi, 12(2):168-176. DOI: 10.5606/totbid.dergisi.2013.19
- Ege, R. (2004). Ayak travmaları ve ayak arka bölge yaralanmaları, kalkaneus kırığı. Travmatoloji Ankara, 4437-4511.
- Gavlik, J. M., Rammelt, S., & Zwipp, H. (2002). The use of subtalar arthroscopy in open reduction and internal fixation of intra-articular calcaneal fractures. Injury, 33(1), 63-71. DOI: 10.1177/24730114231163822
- Juliano, P., & Nguyen, H. (2001). Fractures of the calcaneus Foot and ankle trauma, 32:3551.
- Lim EV., & Leung, JP., (2001). Complications of intraarticular calceneal fractures. Clin Orthop, 391:7-16. DOI: 10.1097/00003086-200110000-00003
- Martinus Richter, M., ve ark. (2015). Foot İnjuries. In:Browner B.D., Jesse B., Jupiter J.B., Krettek C., Paul AA.(eds) Skeletal Trauma:Basic Science. Management, and Reconstruction, (2-Volume set). Fifth Edition, Saunders, 22512387.e14.
- Murphy, GA., (2003). Fractures and dislocations of foot. In:Campbell’sOperativeOrthopaedics, Volume Four, 10th edition. Mosby, Philadelphia, 4231-4247.
- Sanders, R. (1992). Intra-articular fractures of the calcaneus: present state of the art. Journal of orthopaedic trauma, 6(2), 252-265.
- Sanders, R. (1999). Fractures and fracture-dislocations of the calcaneus. İn: Surgery of the foot and ankle, Coughlin M.J., Mann R.A. Editors seventh edition (vol-2) Mosby, 1422-1464.
- Sanders, R., Hansen, S. T., & McReynolds, I. S. (1991). Trauma to the calcaneus and it’s tendon. Fractures of the calcaneus. Disorders of the Foot and Ankle, 1, 2338-2339.
- Sanders, R., Fortin, P., DiPasquale, T., & Walling, A. (1993). Operative treatment in 120 displaced intraarticular calcaneal fractures results using a prognostic computed tomography scan classification. Clinical Orthopaedics and Related Research®, 290, 87-95.
- Thermann, H., Krettek, C., Hüfner, T., Schratt, H. E., Albrecht, K., & Tscherne, H. (1998). Management of calcaneal fractures in adults. Conservative versus operative treatment. Clinical orthopaedics and related research, (353), 107–124. DOI: 10.1097/00003086-199808000-00013
- Zwipp, H., Rammelt, S., & Barthel, S. (2004). Calcaneal fractures--open reduction and internal fixation (ORIF). Injury, 35 Suppl 2, SB46–SB54. https://doi.org/10.1016/j.injury.2004.07.011
Öz
Bu çalışmada cerrahi tedavi edilen Sanders tip 2-3-4 kırıklarının orta dönem izlemlerinde klinik ve radyolojik sonuçları değerlendirilmesi amaçlandı. Haziran 2010-Haziran 2016 yılları arasında kliniğimizde tedavi edilen 66 kalkaneus kırığı olan ve cerrahi tedavi uygulanan hastalar çalışmaya alındı. Hasta dosyalarında demografik özelikleri, izlemlerinde gelişen komplikasyonları ve klinik izlem notları kaydedildi. Deplase intraartikular kalkaneus kırığı olan 33 hasta 37 kalkaneus kırığı çalışmaya alındı. Hastaların 28’i (%84,8) erkek 5’i (%15,2) kadındı. Hastaların ortalama yaşları 43 (19-75) idi. Sanders sınıflamasına göre çalışma grubunu oluşturan 37 kalkaneus kırığından 13’ü (%35,1) Tip2, 19’u (%51,3) Tip 3, 5’i (%13,5) Tip4’den oluşmaktadır. Hastaların travma ile cerrahi arasında geçen süreleri en kısa 4 ve en uzun 10 gün, ortanca değer 7 gün olarak tespit edildi. Opere edilen 33 hasta içerisinde en kısa takip süresi 12 en uzun takip süresi 72 ay, ortanca takip süresi 48 ay olarak saptandı. Cerrahi sonrası 9 hastada komplikasyon gelişti. 5 hastada yara yeri nekrozu ya da açılması, 1 hastada derin enfeksiyon, 2 hastada subtalar artrit, 1 hastada topukta eksoztoz gelişti. Çalışmaya alınan 33 hastanın 5’inde ayakkabı değişikliği meydana geldi. Bu hastalar silikon tabanlık veya yumuşak tabanlı ayakkabı kullanmaktadır. 3 hasta iş değiştirmek zorunda kalmıştır. Kalkaneus kırıklarında cerrahi tedavi ile her ne kadar iyi sonuçlar elde edilse de orta dönem izlemde komplikasyonlar gelişebilmektedir. Bu nedenle bu hastalar cerrahi sonrası yakın izleme alınmalıdır.
Kaynakça
- Andermahr, J., Helling, H. J., Rehm, K. E., & Koebke, Z. (1999). The vascularization of the os calcaneum and the clinical consequences. Clinical Orthopaedics and Related Research®, 363, 212-218.
- Clare, MP. (2008). Calcaneal fractures. In: Pinzur M.S (editor), Orthopedic Knowledge Update: Foot and Ankle 4, American Academy of Orthopaedic Surgeons, pp. 7594.
- Crosby, LA. & Fitzgibbons, T. (1993). İntraarticular calcaneal fractures Results of closed treatment. Clin Orthop, 290:47-54.
- Çırpar, M., &Ekşioğlu, MF., (2013). Kalkaneus Kırıkları. TOTBİD Dergisi, 12(2):168-176. DOI: 10.5606/totbid.dergisi.2013.19
- Ege, R. (2004). Ayak travmaları ve ayak arka bölge yaralanmaları, kalkaneus kırığı. Travmatoloji Ankara, 4437-4511.
- Gavlik, J. M., Rammelt, S., & Zwipp, H. (2002). The use of subtalar arthroscopy in open reduction and internal fixation of intra-articular calcaneal fractures. Injury, 33(1), 63-71. DOI: 10.1177/24730114231163822
- Juliano, P., & Nguyen, H. (2001). Fractures of the calcaneus Foot and ankle trauma, 32:3551.
- Lim EV., & Leung, JP., (2001). Complications of intraarticular calceneal fractures. Clin Orthop, 391:7-16. DOI: 10.1097/00003086-200110000-00003
- Martinus Richter, M., ve ark. (2015). Foot İnjuries. In:Browner B.D., Jesse B., Jupiter J.B., Krettek C., Paul AA.(eds) Skeletal Trauma:Basic Science. Management, and Reconstruction, (2-Volume set). Fifth Edition, Saunders, 22512387.e14.
- Murphy, GA., (2003). Fractures and dislocations of foot. In:Campbell’sOperativeOrthopaedics, Volume Four, 10th edition. Mosby, Philadelphia, 4231-4247.
- Sanders, R. (1992). Intra-articular fractures of the calcaneus: present state of the art. Journal of orthopaedic trauma, 6(2), 252-265.
- Sanders, R. (1999). Fractures and fracture-dislocations of the calcaneus. İn: Surgery of the foot and ankle, Coughlin M.J., Mann R.A. Editors seventh edition (vol-2) Mosby, 1422-1464.
- Sanders, R., Hansen, S. T., & McReynolds, I. S. (1991). Trauma to the calcaneus and it’s tendon. Fractures of the calcaneus. Disorders of the Foot and Ankle, 1, 2338-2339.
- Sanders, R., Fortin, P., DiPasquale, T., & Walling, A. (1993). Operative treatment in 120 displaced intraarticular calcaneal fractures results using a prognostic computed tomography scan classification. Clinical Orthopaedics and Related Research®, 290, 87-95.
- Thermann, H., Krettek, C., Hüfner, T., Schratt, H. E., Albrecht, K., & Tscherne, H. (1998). Management of calcaneal fractures in adults. Conservative versus operative treatment. Clinical orthopaedics and related research, (353), 107–124. DOI: 10.1097/00003086-199808000-00013
- Zwipp, H., Rammelt, S., & Barthel, S. (2004). Calcaneal fractures--open reduction and internal fixation (ORIF). Injury, 35 Suppl 2, SB46–SB54. https://doi.org/10.1016/j.injury.2004.07.011
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Ortopedi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Erken Görünüm Tarihi | 28 Ağustos 2024 |
| Yayımlanma Tarihi | 31 Ağustos 2024 |
| Gönderilme Tarihi | 1 Temmuz 2024 |
| Kabul Tarihi | 15 Ağustos 2024 |
| Yayımlandığı Sayı | Yıl 2024Cilt: 9 Sayı: 2 |
