Öz
Amaç:
Distal fibula kırıklarının tedavisinde sindesmotik vida fiksasyonuna (SSF) deltoid ligament tamirinin (DLR) eklenmesinin fonksiyonel ve radyografik sonuçlar ve yaşam kalitesi üzerindeki orta-uzun vadeli etkisini değerlendirmektir.
Yöntem:
Maltepe Üniversite Hastanesi Ortopedi ve Travmatoloji Anabilim Dalı’nda distal fibula kırığı tanısı ile SSF veya SSF+DLR yapılan 78 hasta geriye dönük olarak çalışmaya dahil edildi.
Bulgular:
Olguların %71,8’i erkekti. Ortalama yaş 39,24±11,95 yıldı. SSF grubu ile karşılaştırıldığında SSF+DLR grubunda radyografik, fonksiyonel sonuçlar ve yaşam kalitesi daha iyiydi. Ek olarak, SSF+DLR grubunda operasyon süresi daha uzundu.
Sonuç:
Distal fibula kırıklarında uygun olgularda DLR yapılması orta-uzun vadede daha iyi klinik sonuçlara katkıda bulunabilir.
Anahtar Kelimeler: Ayak bileği, deltoid ligament tamiri, distal fibula kırıkları, sindesmoz
Kaynakça
Andersen MR, Diep LM, Frihagen F, Hellund JC, Madsen JE, Figved W. Importance of syndesmotic reduction on clinical outcome after syndesmosis injuries. J Orthop Trauma 2019;33(8):397-403.
Mak MF, Stern R, Assal M. Repair of syndesmosis injury in ankle fractures: Current state of the art. EFORT Open Rev 2018;3(1):24-29.
Jeong MS, Choi YS, Kim YJ, Kim JS, Young KW, Jung YY. Deltoid ligament in acute ankle injury: MR imaging analysis. Skeletal Radiol 2014;43(5):655-663.
Dabash S, Elabd A, Potter E, Fernandez I, Gerzina C, Thabet AM, et al. Adding deltoid ligament repair in ankle fracture treatment: is it necessary? A systematic review. Foot Ankle Surg 2019;25(6):714-720.
Gu G, Yu J, Huo Y, Xu G, Yin Z, Yu J, et al. Efficacy of deltoid ligament reconstruction on the curative effect, complication and long-term prognosis in ankle fracture-dislocation with deltoid ligament injury. Int J Clin Exp Med 2017;10(9):13778-13783.
Diab HS. Suture anchor repair for ruptured deltoid ligament in pronation ankle fractures. Curr Orthop Pract 2017;28(5):459-464.
Yu GR, Zhang MZ, Aiyer A, Tang X, Xie M, Zeng LR, et al. Repair of the acute deltoid ligament complex rupture associated with ankle fractures: a multicenter clinical study. J Foot Ankle Surg 2015;54(2):198-202.
Wu K, Lin J, Huang J, Wang Q. Evaluation of transsyndesmotic fixation and primary deltoid ligament repair in ankle fractures with suspected combined deltoid ligament injury. J Foot Ankle Surg 2018;57(4):694-700.
Zhao HM, Lu J, Zhang F, Wen XD, Li Y, Hao DJ, et al. Surgical treatment of ankle fracture with or without deltoid ligament repair: a comparative study. BMC Musculoskelet Disord 2017;18(1):1-7.
Woo SH, Bae SY, Chung HJ. Short-term results of a ruptured deltoid ligament repair during an acute ankle fracture fixation. Foot Ankle Int 2018;39(1):35-45.
Li T, Sun X, Li Y, Yang M, Li S, Jiang X, et al. Clinical Study of Ankle Fracture Combined With Deltoid Ligament Injury: Repair or Not? A Retrospective, Comparative Study. J Foot Ankle Surg 2020;59(4):648-652.
Jones CR, Nunley JA. Deltoid ligament repair versus syndesmotic fixation in bimalleolar equivalent ankle fractures. J Orthop Trauma 2015;29(5):245-249.
Rosa I, Rodeia J, Fernandes PX, Teixeira R, Ribeiro H, Consciência JG. Comparison of deltoid ligament repair and syndesmotic fixation in malleolar fractures. Sci J Foot Ankle Surg 2019;13(3):205-211.
Lee TH, Jang KS, Choi GW, Jeong CD, Hong SJ, Yoon MA, et al. The contribution of anterior deltoid ligament to ankle stability in isolated lateral malleolar fractures. Injury 2016;47(7):1581-1585.
Sun X, Li T, Sun Z, Li Y, Yang M, Li S, et al. Does routinely repairing deltoid ligament injuries in type B ankle joint fractures influence long term outcomes? Injury 2018;49(12):2312-2317.
Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 1994;15:349-353.
Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 1992;30(6):473-483.
Murphy JM, Kadakia AR, Irwin TA. Variability in radiographic medial clear space measurement of the normal weight-bearing ankle. Foot Ankle Int 2012;33(11):956-963.
Kraus VB, Kilfoil TM, Hash Ii T, Mcdaniel G, Renner JB, Carrino JA, et al. Atlas of radiographic features of osteoarthritis of the ankle and hindfoot. Osteoarthritis Cartilage 2015;23(12):2059-2085.
Choi S, Choi Y, Baek E, Jo S. Does repair of deltoid ligament contribute to restoring a mortise in SER type IV ankle fracture with syndesmotic diastasis? Arch Orthop Trauma Surg 2020 Oct 29. doi: 10.1007/s00402-020-03645-7. Epub ahead of print.
