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Vojnosanitetski pregled
2019, vol. 76, br. 4, str. 404-411
jezik rada: engleski
vrsta rada: originalan članak
objavljeno: 12/05/2019
doi: 10.2298/VSP161230105M
Creative Commons License 4.0
Mičelova i Goldenova metatarzalna osteotomija u lečenju umerenih deformiteta čukljeva: uporedna analiza
aKliničko-bolnički centar Zvezdara, Beograd
bUniversity Clinic for Orthopaedic Surgery, Skoplje, Republic of North Macedonia
cUniverzitet u Beogradu, Medicinski fakultet, Institut za ortopedsko-hirurške bolesti 'Banjica'
dKlinički centar Univerziteta Sarajevo, Federacija BiH
eUniverzitet u Beogradu, Medicinski fakultet, Institut za medicinsku statistiku i informatiku

e-adresa: nadanmikic@gmail.com

Sažetak

Uvod/Cilj. Mada se operativno lečenje čuklja primenjuje duže od 100 godina, još uvek nije ustanovljena tehnika koja bi se mogla smatrati takozvanim zlatnim standardom. Cilj rada bio je poređenje postoperativnih rezultata postupaka po Mitchell-u i Golden-u u lečenju umerenih deformiteta hallux valgus-a. Metode. U opservacionoj studiji kontrole slučajeva (case control) učestvovalo je 49 pacijenata (81 stopalo) operisanih distalnom osteotomijom I metatarzalne kosti po Mitchell-u i 49 pacijenata (77 stopala) operisanih proksimalnom osteotomijom I metatarzalne kosti po Golden-u. Za procenu rezultata lečenja korišćene su: Klasifikacija po Boney i McNab-u modifikovana po Hellal-u i Hallux Meta-tarsophalangeal Interphalangeal Score (HMIS). Rezultati su statistički obrađeni, a vrednosti p < 0,05 uzete su kao statistički značajne. Rezultati. Oba hirurška postupka su pokazala uspešne statistički visoko značajno bolje postoperativne rezultate u odnosu na preoperativne (p < 0,001). Poređenjem rezultata Mitchell-ovog i Golden-ovog postupka prema klasifikaciji po Bonney i McNab-u modifikovanoj po Hellal-u pokazano je da postoji visoko statistički značajna razlika u korist postupka po Mitchell-u (p < 0,001), a poređenjem na osnovu HMIS-a da nema statistički značajne razlike (p = 0,123). Analiza procene rezultata oba postupka na osnovu vrednosti hallus-valgus ugla, intermetatarzalnog ugla, pozicije sezamoida, dužine imobilizacije, trajanja lečenja i komplikacija pokazala je da postoji visoko statistički značajna razlika u korist postupka po Mitchell-u (p < 0,001), dok je procena vrednosti skraćenja prve metatarzalne kosti pokazala da je skraćenje izraženije kod postupka po Mitchell-u (p < 0,001), što ide u prilog Golden-ovoj metodi. U pogledu pokreta palca operisanih stopala nije postojala statistički značajna razlika (p = 0,723) između dva postupka. Zaključak. Oba postupka su pokazala dobre postoperativne rezultate. Poređenjem rezultata oba postupka došlo se do zaključka da su rezultati Mitchell-ovog postupka bolji u odnosu na Golden-ov postupak.

Ključne reči

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