Akademik Veri Yönetim Sistemi
Joint diseases and related surgery, cilt.36, sa.2, ss.373-382, 2025 (SCI-Expanded, Scopus, TRDizin)
Objectives: This study aims to evaluate whether changes in ankle radiological parameters following fibular head resection due to tumors lead to ankle instability and/or ankle arthritis and to assess the impact of resection on clinical outcomes using pedobarographic analysis and pain and function scales.
Patients and methods: Between January 2005 and January 2023, a total of 30 patients (10 males, 20 females; mean age: 33.9±13.8
years; range, 10 to 67 years) who underwent proximal fibula resection were retrospectively analyzed. We assessed fibular rotation using axial ankle magnetic resonance imaging (MRI), fibular length, talar tilt angle, and talotibial angle changes using X-ray, foot load distribution changes through pedobarographic measurements, and clinical outcomes using the Visual Analog Scale (VAS) and Musculoskeletal Tumor Society (MSTS) scores.
Results: Fibular length and rotation were significantly reduced, while talar tilt and talocrural angle were higher on the operated side. Additionally, load balance and maximum pressure in the second to fifth toes (T2-5 regions) were significantly lower on the operated side. The mean VAS score was 1.5±1.4 and the mean MSTS score was 26.8±2.9. The MSTS scores showed weak negative correlations with differences in fibular length, fibular rotation, talar tilt, and talocrural angle, none of which were statistically significant (r=–0.35, –0.3, –0.1, –0.1, p=0.06, 0.1, 0.62, 0.61). In contrast, the VAS score showed a significant positive
correlation with fibular length difference (r=0.45, p=0.01), while
correlations with other parameters were not significant. A positive
correlation was observed between the percentage of resected
fibula and differences in fibular rotation (r=0.67, p<0.001), fibular
length (r=0.73, p<0.001), talocrural angle (r=0.49, p=0.003),
and talar tilt angle (r=0.66, p<0.001); this correlation was more
pronounced in patients with more than 30% resection.
Conclusion: Proximal fibula resection for tumors involving the
fibular head leads to significant changes in ankle radiological
measurements and load distribution. Despite these changes,
clinical outcomes, as reflected by low VAS scores and high MSTS
scores, indicate generally favorable patient-reported outcomes.
Keywords: Ankle, foot, pedobarography, proximal fibula resection,
proximal fibula tumors