Kalkaneus Kırıklarında İki Farklı Cerrahinin Ayak Fonksiyonu, Ağrı, Denge ve Yürüyüş Özelliklerine Etkisi
Yıl 2023,
, 256 - 262, 23.06.2023
Şulenur Yıldız
,
Elif Kırdı
,
Utku Gürhan
,
Fatih İnci
,
Semra Topuz
,
Nilgün Bek
,
Erman Ceyhan
Öz
Amaç: Çalışmamızın amacı, kalkaneus intra-artiküler kırıklarında cerrahi tedavi yöntemlerinden olan açık redüksiyon-internal fiksasyon ve kapalı redüksiyon-internal fiksasyon yöntemlerini ayak fonksiyonu, ağrı, denge ve yürüyüş özellikleri açısından karşılaştırmaktı. Materyal ve metod: Çalışma kapsamında intra-artiküler kalkaneus kırığı sonrasında cerrahi tedavi yapılan 20 hasta değerlendirildi. Bireyler geçirdikleri cerrahi tipine göre açık redüksiyon-internal fiksasyon (n=9) ve kapalı redüksiyon-internal fiksasyon (n=11) gruplarına ayrıldı. Ayak bileği aktif ve pasif dorsifleksiyon eklem hareket açıklıkları, plantar fleksör ve hamstring kas kısalıkları ölçüldü. Ağrı değerlendirmesinde Görsel Analog Skalası Ayak-Ayak Bileği (VAS-FA) formu kullanıldı. Ayak fonksiyonu, Amerikan Ortopedik Ayak-Ayak Bileği Derneği (AOFAS) Ayak Bileği-Arka Ayak Skalası ile değerlendirildi. Denge değerlendirmesinde postüral salınım, stabilite skor ve sınırları değerlendirilirken, yürüyüşün zaman mesafe karakteristikleri incelendi. Bulgular: Gruplar, demografik ve antropometrik parametreler açısından birbirine benzer özellikler göstermekteydi (p> 0,05). Aktif ve pasif dorsifleksiyon eklem hareket açıklıkları, plantar fleksör ve hamstring kas kısalıkları, VAS-FA ve AOFAS Ayak Bileği-Arka Ayak Skalası parametreleri açısından fark yoktu (p> 0,05). Postüral salınım, stabilite sınırı ve skorları ile yürüyüşün zaman ve mesafe karakteristikleri arasında anlamlı fark bulunmadı (p> 0,05). Sonuç: Kalkaneus intra-artiküler kırıklarının cerrahi tedavilerinden açık redüksiyon-internal fiksasyon ve kapalı redüksiyon-internal fiksasyon arasında ayak fonksiyonu, ağrı, denge ve yürüyüş parametreleri açısından fark olmaması nedeniyle komplikasyon riski daha az olan kapalı redüksiyonun tercih edilmesi önerilmektedir.
Kaynakça
- Ballardini, G., Florio, V., Canessa, A., Carlini, G., Morasso, P., & Casadio, M. (2020). Vibrotactile Feedback for Improving Standing Balance. Front Bioeng Biotechnol, 8, 94. https://doi.org/10.3389/fbioe.2020.00094
- Besch, L., Radke, B., Mueller, M., Daniels-Wredenhagen, M., Varoga, D., Hilgert, R. E., Mathiak, G., Oehlert, K., & Seekamp, A. (2008). Dynamic and functional gait analysis of severely displaced intra-articular calcaneus fractures treated with a hinged external fixator or internal stabilization. J Foot Ankle Surg, 47(1), 19-25. https://doi.org/10.1053/j.jfas.2007.10.013
- Çolak, İ., Çolak, T., Polat, M. G., Timurtaş, E., Bulut, G., & Gülabi, D. (2018). The Results of Physical, Radiologic, Pedabarographic, and Quality-of-Life Assessments in Patients with Surgically Treated Intraarticular Calcaneus Fractures. J Foot Ankle Surg, 57(6), 1172-1180. https://doi.org/10.1053/j.jfas.2018.06.009
- de Kruijff, L. G. M., Prins, M., van der Krans, A., Hoencamp, R., & van der Wurff, P. (2018). Combat-related foot injuries: impact on gait and functional outcome. J R Army Med Corps, 164(5), 322-327. https://doi.org/10.1136/jramc-2017-000870
- DeWall, M., Henderson, C. E., McKinley, T. O., Phelps, T., Dolan, L., & Marsh, J. L. (2010). Percutaneous reduction and fixation of displaced intra-articular calcaneus fractures. J Orthop Trauma, 24(8), 466-472. https://doi.org/10.1097/BOT.0b013e3181defd74
- Epstein, N., Chandran, S., & Chou, L. (2012). Current concepts review: intra-articular fractures of the calcaneus. Foot Ankle Int, 33(1), 79-86. https://doi.org/10.3113/fai.2012.0079
- Gur, G., Turgut, E., Dilek, B., Baltaci, G., Bek, N., & Yakut, Y. (2017). Validity and reliability of visual analog scale foot and ankle: the Turkish version. The Journal of Foot and Ankle Surgery, 56(6), 1213-1217.
- Holtmann, J. A., Südkamp, N. P., Schmal, H., & Mehlhorn, A. T. (2017). Gastrocnemius Recession Leads to Increased Ankle Motion and Improved Patient Satisfaction After 2 Years of Follow-Up. J Foot Ankle Surg, 56(3), 589-593. https://doi.org/10.1053/j.jfas.2017.01.037
- Işıklar, Z. U., & FE, B. (2006). Kalkaneus kırıkları. TOTBID (Türk Ortopedi ve Travmatoloji Birliği Derneği) Dergisi, 5(1-2), 44-52.
- Kitaoka, H. B., Alexander, I. J., Adelaar, R. S., J, A. N., Myerson, M. S., Sanders, M., & Lutter, L. D. (1997). Clinical Rating Systems for the Ankle-Hindfoot, Midfoot, Hallux, and Lesser Toes. Foot Ankle Int, 18(3), 187-188. https://doi.org/10.1177/107110079701800315
- Lentz, T. A., Sutton, Z., Greenberg, S., & Bishop, M. D. (2010). Pain-related fear contributes to self-reported disability in patients with foot and ankle pathology. Arch Phys Med Rehabil, 91(4), 557-561. https://doi.org/10.1016/j.apmr.2009.12.010
- Mitchell, M. J., McKinley, J. C., & Robinson, C. M. (2009). The epidemiology of calcaneal fractures. Foot (Edinb), 19(4), 197-200. https://doi.org/10.1016/j.foot.2009.05.001
- Nakale, N. T., Strydom, A., Saragas, N. P., & Ferrao, P. N. F. (2018). Association Between Plantar Fasciitis and Isolated Gastrocnemius Tightness. Foot Ankle Int, 39(3), 271-277. https://doi.org/10.1177/1071100717744175
- Otman, A. S., Demirel, H., & Sade, A. (2014). Tedavi hareketlerinde temel değerlendirme prensipleri. Pelikan yayıncılık.
- Šarabon, N. (2011). Development of software for comprehensive analyses of force plate measurements. Kinesiology, 43(2.), 204-212.
- Schepers, T., & Patka, P. (2009). Treatment of displaced intra-articular calcaneal fractures by ligamentotaxis: current concepts' review. Arch Orthop Trauma Surg, 129(12), 1677-1683. https://doi.org/10.1007/s00402-009-0915-8
- Seat, A., & Seat, C. (2020). Lateral Extensile Approach Versus Minimal Incision Approach for Open Reduction and Internal Fixation of Displaced Intra-articular Calcaneal Fractures: A Meta-analysis. J Foot Ankle Surg, 59(2), 356-366. https://doi.org/10.1053/j.jfas.2019.08.007
- Serrador, J. M., Lipsitz, L. A., Gopalakrishnan, G. S., Black, F. O., & Wood, S. J. (2009). Loss of otolith function with age is associated with increased postural sway measures. Neurosci Lett, 465(1), 10-15. https://doi.org/10.1016/j.neulet.2009.08.057
- Stagni, R., Leardini, A., O'Connor, J. J., & Giannini, S. (2003). Role of passive structures in the mobility and stability of the human subtalar joint: a literature review. Foot Ankle Int, 24(5), 402-409. https://doi.org/10.1177/107110070302400505
- Tomesen, T., Biert, J., & Frölke, J. P. (2011). Treatment of displaced intra-articular calcaneal fractures with closed reduction and percutaneous screw fixation. J Bone Joint Surg Am, 93(10), 920-928. https://doi.org/10.2106/jbjs.H.01834
- Walde, T. A., Sauer, B., Degreif, J., & Walde, H. J. (2008). Closed reduction and percutaneous Kirschner wire fixation for the treatment of dislocated calcaneal fractures: surgical technique, complications, clinical and radiological results after 2-10 years. Arch Orthop Trauma Surg, 128(6), 585-591. https://doi.org/10.1007/s00402-008-0590-1
- Wallin, K. J., Cozzetto, D., Russell, L., Hallare, D. A., & Lee, D. K. (2014). Evidence-based rationale for percutaneous fixation technique of displaced intra-articular calcaneal fractures: a systematic review of clinical outcomes. J Foot Ankle Surg, 53(6), 740-743. https://doi.org/10.1053/j.jfas.2014.03.018
- Webster, K. E., Wittwer, J. E., & Feller, J. A. (2005). Validity of the GAITRite walkway system for the measurement of averaged and individual step parameters of gait. Gait Posture, 22(4), 317-321. https://doi.org/10.1016/j.gaitpost.2004.10.005
The Effect of Two Different Surgery on Foot Function, Pain, Balance and Gait Characteristics in Calcaneus Fractures
Yıl 2023,
, 256 - 262, 23.06.2023
Şulenur Yıldız
,
Elif Kırdı
,
Utku Gürhan
,
Fatih İnci
,
Semra Topuz
,
Nilgün Bek
,
Erman Ceyhan
Öz
Objective: The aim of our study was to compare the surgical techniques which are open reduction-internal fixation and closed reduction-internal fixation in intra-articular calcaneus fractures in aspects of foot function, balance and gait. Materials and methods: In the study, 20 patients underwent surgical treatment after intra- in intra-articular calcaneus fracture were evaluated.Individuals were divided into open reduction-internal fixation (n=9) and closed reduction-internal fixation (n=11) groups according to the type of surgery they underwent. Active and passive ankle dorsiflexion range of motion, plantar flexor and hamstring muscles tightness were measured. Visual Analogue Scale Foot-Ankle (VAS-FA) form was used for pain assessment. Foot function was assessed using the American Orthopaedic Foot& Ankle Society (AOFAS) Ankle-Hindfoot Scale. In the evaluation of balance, postural sway, stability score and limits were evaluated, while the time-distance characteristics of gait were examined. Results: The groups showed similar characteristics in terms of demographic and anthropometric parameters (p> 0.05). There was no difference in terms of active and passive dorsiflexion joint ranges of motion, plantar flexor and hamstring muscle shortness, VAS-FA and AOFAS Ankle-Hindfoot Scale parameters (p > 0.05). There was no significant difference between postural sway, stability limit and scores, and time and distance characteristics of gait (p> 0.05). Conclusions: Since there is no difference between open reduction-internal fixation and closed reduction-internal fixation, among the surgical treatments of calcaneus intra-articular fractures, in terms of foot function, pain, balance and gait parameters, it is recommended to prefer closed reduction with less complication risk.
Kaynakça
- Ballardini, G., Florio, V., Canessa, A., Carlini, G., Morasso, P., & Casadio, M. (2020). Vibrotactile Feedback for Improving Standing Balance. Front Bioeng Biotechnol, 8, 94. https://doi.org/10.3389/fbioe.2020.00094
- Besch, L., Radke, B., Mueller, M., Daniels-Wredenhagen, M., Varoga, D., Hilgert, R. E., Mathiak, G., Oehlert, K., & Seekamp, A. (2008). Dynamic and functional gait analysis of severely displaced intra-articular calcaneus fractures treated with a hinged external fixator or internal stabilization. J Foot Ankle Surg, 47(1), 19-25. https://doi.org/10.1053/j.jfas.2007.10.013
- Çolak, İ., Çolak, T., Polat, M. G., Timurtaş, E., Bulut, G., & Gülabi, D. (2018). The Results of Physical, Radiologic, Pedabarographic, and Quality-of-Life Assessments in Patients with Surgically Treated Intraarticular Calcaneus Fractures. J Foot Ankle Surg, 57(6), 1172-1180. https://doi.org/10.1053/j.jfas.2018.06.009
- de Kruijff, L. G. M., Prins, M., van der Krans, A., Hoencamp, R., & van der Wurff, P. (2018). Combat-related foot injuries: impact on gait and functional outcome. J R Army Med Corps, 164(5), 322-327. https://doi.org/10.1136/jramc-2017-000870
- DeWall, M., Henderson, C. E., McKinley, T. O., Phelps, T., Dolan, L., & Marsh, J. L. (2010). Percutaneous reduction and fixation of displaced intra-articular calcaneus fractures. J Orthop Trauma, 24(8), 466-472. https://doi.org/10.1097/BOT.0b013e3181defd74
- Epstein, N., Chandran, S., & Chou, L. (2012). Current concepts review: intra-articular fractures of the calcaneus. Foot Ankle Int, 33(1), 79-86. https://doi.org/10.3113/fai.2012.0079
- Gur, G., Turgut, E., Dilek, B., Baltaci, G., Bek, N., & Yakut, Y. (2017). Validity and reliability of visual analog scale foot and ankle: the Turkish version. The Journal of Foot and Ankle Surgery, 56(6), 1213-1217.
- Holtmann, J. A., Südkamp, N. P., Schmal, H., & Mehlhorn, A. T. (2017). Gastrocnemius Recession Leads to Increased Ankle Motion and Improved Patient Satisfaction After 2 Years of Follow-Up. J Foot Ankle Surg, 56(3), 589-593. https://doi.org/10.1053/j.jfas.2017.01.037
- Işıklar, Z. U., & FE, B. (2006). Kalkaneus kırıkları. TOTBID (Türk Ortopedi ve Travmatoloji Birliği Derneği) Dergisi, 5(1-2), 44-52.
- Kitaoka, H. B., Alexander, I. J., Adelaar, R. S., J, A. N., Myerson, M. S., Sanders, M., & Lutter, L. D. (1997). Clinical Rating Systems for the Ankle-Hindfoot, Midfoot, Hallux, and Lesser Toes. Foot Ankle Int, 18(3), 187-188. https://doi.org/10.1177/107110079701800315
- Lentz, T. A., Sutton, Z., Greenberg, S., & Bishop, M. D. (2010). Pain-related fear contributes to self-reported disability in patients with foot and ankle pathology. Arch Phys Med Rehabil, 91(4), 557-561. https://doi.org/10.1016/j.apmr.2009.12.010
- Mitchell, M. J., McKinley, J. C., & Robinson, C. M. (2009). The epidemiology of calcaneal fractures. Foot (Edinb), 19(4), 197-200. https://doi.org/10.1016/j.foot.2009.05.001
- Nakale, N. T., Strydom, A., Saragas, N. P., & Ferrao, P. N. F. (2018). Association Between Plantar Fasciitis and Isolated Gastrocnemius Tightness. Foot Ankle Int, 39(3), 271-277. https://doi.org/10.1177/1071100717744175
- Otman, A. S., Demirel, H., & Sade, A. (2014). Tedavi hareketlerinde temel değerlendirme prensipleri. Pelikan yayıncılık.
- Šarabon, N. (2011). Development of software for comprehensive analyses of force plate measurements. Kinesiology, 43(2.), 204-212.
- Schepers, T., & Patka, P. (2009). Treatment of displaced intra-articular calcaneal fractures by ligamentotaxis: current concepts' review. Arch Orthop Trauma Surg, 129(12), 1677-1683. https://doi.org/10.1007/s00402-009-0915-8
- Seat, A., & Seat, C. (2020). Lateral Extensile Approach Versus Minimal Incision Approach for Open Reduction and Internal Fixation of Displaced Intra-articular Calcaneal Fractures: A Meta-analysis. J Foot Ankle Surg, 59(2), 356-366. https://doi.org/10.1053/j.jfas.2019.08.007
- Serrador, J. M., Lipsitz, L. A., Gopalakrishnan, G. S., Black, F. O., & Wood, S. J. (2009). Loss of otolith function with age is associated with increased postural sway measures. Neurosci Lett, 465(1), 10-15. https://doi.org/10.1016/j.neulet.2009.08.057
- Stagni, R., Leardini, A., O'Connor, J. J., & Giannini, S. (2003). Role of passive structures in the mobility and stability of the human subtalar joint: a literature review. Foot Ankle Int, 24(5), 402-409. https://doi.org/10.1177/107110070302400505
- Tomesen, T., Biert, J., & Frölke, J. P. (2011). Treatment of displaced intra-articular calcaneal fractures with closed reduction and percutaneous screw fixation. J Bone Joint Surg Am, 93(10), 920-928. https://doi.org/10.2106/jbjs.H.01834
- Walde, T. A., Sauer, B., Degreif, J., & Walde, H. J. (2008). Closed reduction and percutaneous Kirschner wire fixation for the treatment of dislocated calcaneal fractures: surgical technique, complications, clinical and radiological results after 2-10 years. Arch Orthop Trauma Surg, 128(6), 585-591. https://doi.org/10.1007/s00402-008-0590-1
- Wallin, K. J., Cozzetto, D., Russell, L., Hallare, D. A., & Lee, D. K. (2014). Evidence-based rationale for percutaneous fixation technique of displaced intra-articular calcaneal fractures: a systematic review of clinical outcomes. J Foot Ankle Surg, 53(6), 740-743. https://doi.org/10.1053/j.jfas.2014.03.018
- Webster, K. E., Wittwer, J. E., & Feller, J. A. (2005). Validity of the GAITRite walkway system for the measurement of averaged and individual step parameters of gait. Gait Posture, 22(4), 317-321. https://doi.org/10.1016/j.gaitpost.2004.10.005