Öz
Amaç: Aşil tendon rüptürü en sık görülen tendon rüptürüdür ve akut Aşil tendon rüptürleri için en iyi tedavi tartışmalıdır. Mini açık veya perkütan onarım teknikleri erken iyileşme ve günlük yaşama erken dönme sağlar. Ancak sural sinir hasarı ve yeniden rüptür gibi bazı dezavantajları vardır. Bu çalışmanın amacı, akut Aşil tendon rüptürünün perkütan onarımının sural siniri anatomik konumunda bulup koruyarak yapılmasının güvenliğini ve güvenilirliğini belirlemektir.
Gereç ve Yöntem: Kasım 2013-Şubat 2017 tarihleri arasında perkütan Aşil tendonu onarımı yapılan 24 hasta çalışmaya dâhil edildi. Hastalarda postoperatif erken dönemde ve son kontrollerinde yara iyileşme problemleri, komplikasyonları, ayak bileği hareket açıklıkları ve Amerikan Ayak ve Ayak Bileği Derneği skorları (AOFAS) değerlendirildi.
Bulgular: Ortalama takip süresi 23 aydı. Hastaların son kontrollerinde etkilenen ayak bileklerinde 47,9 ± 3,1° plantar fleksiyon ve 20,1 ± 2,6° dorsifleksiyon olduğu görüldü. Ölçümler istatistiksel olarak sağlam tarafla benzerdi. Ortalama AOFAS skoru 91 ± 9,6 idi.
Sonuç: Perkütan Aşil tendon onarımı, sural sinir anatomik konumunda tanımlandığında daha güvenli ve güvenilir bir yöntemdir.
Anahtar Kelimeler
Aşil tendon rüptürü cerrahi tedavi perkütan onarım sural sinir
Kaynakça
- Ozkaya U, Parmaksizoglu AS, Kabukcuoglu Y, Sokucu S, Basilgan S. Open minimally invasive Achilles tendon repair with early rehabilitation: functional results of 25 consecutive patients. Injury. 2009; 40 (6): 669-72.
- Assal M, Jung M, Stern R, Rippstein P, Delmi M, Hoffmeyer P. Limited open repair of Achilles tendon ruptures: a technique with a new instrument and findings of a prospective multicenter study. J Bone Joint Surg Am. 2002 Feb; 84-A (2):161-70.
- Mavrodontidis A, Lykissas M, Koulouvaris P, Pafilas D, Kontogeorgakos V, Zalavras C. Percutaneous repair of acute Achilles tendon rupture: a functional evaluation study with a minimum 10-year follow-up. Acta Orthop Traumatol Turc. 2015; 49 (6): 661-7.
- Henríquez H, Muñoz R, Carcuro G, Bastías C. Is percutaneous repair better than open repair in acute Achilles tendon rupture? Clin Orthop Relat Res. 2012; 470(4):998-1003.
- Suchak A, Bostick G, Reid D, Blitz S, Jomha N. The incidence of Achilles tendon ruptures in Edmonton, Canada. Foot Ankle Int. 2005; 26.932–6.
- Grassi A, Amendola A, Samuelsson K, Svantesson E, Romagnoli M, Bondi A, Mosca M, Zaffagnini S. Minimally Invasive Versus Open Repair for Acute Achilles Tendon Rupture: Meta-Analysis Showing Reduced Complications, with Similar Outcomes, After Minimally Invasive Surgery. J Bone Joint Surg Am. 2018 Nov 21; 100 (22): 1969-81.
- Webb JM, Bannister GC. Percutaneous repair of the ruptured tendo Achillis. J Bone Joint Surg Br. 1999 Sep; 81 (5): 877-80.
- Maes R, Copin G, Averous C. Is percutaneous repair of the Achilles tendon a safe technique? A study of 124 cases. Acta Orthop Belg. 2006 Apr; 72 (2):179-83.
- Bradley JP, Tibone JE. Percutaneous and open surgical repairs of Achilles tendon rupture. A comparative study. Am J Sports Med 1990; 18: 188-95.
- Haji A, Sahai A, Symes A, Vyas JK. Percutaneous versus open tendo Achillis repair. Foot Ankle Int 2004; 25: 215-8.
- Zhou K, Song L, Zhang P, Wang C, Wang W. Surgical Versus Non-Surgical Methods for Acute Achilles Tendon Rupture: A Meta-Analysis of Randomized Controlled Trials. J Foot Ankle Surg. 2018 Nov - Dec; 57 (6): 1191-9.
- Rowley DI, Scotland TR. Rupture of the Achilles tendon treated by a simple operative procedure. Injury 1982; 14.252-4.
- Klein W, Lang DM, Saleh M. The use of the Ma-Griffith technique for percutaneous repair of fresh ruptured Tendo Achillis. Chir Organi Mov 1991; 76: 223-8.
- Ma GWC, Griffith TG. Percutaneous repair of acute closed ruptured Achilles tendon: a new technique. Clin Orthop 1977; 128: 247-55.
- Olsson N, Silbernagel KG, Eriksson BI, Sansone M, Brorsson A, Nilsson-Helander K, Karlsson J. Stable surgical repair with accelerated rehabilitation versus nonsurgical treatment for acute Achilles tendon ruptures: a randomized controlled study. Am J Sports Med. 2013 Dec; 41 (12): 2867-76.
- Wilkins R, Bisson LJ. Operative versus nonoperative management of acute Achilles tendon ruptures: a quantitative systematic review of randomized controlled trials. Am J Sports Med. 2012 Sep; 40 (9): 2154-60.
- Maffuli N. Rupture of the Achilles tendon. J Bone Joint Surg 1999; 81-A: 1019-36.
- Rahm S, Spross C, Gerber F, Farshad M, Buck FM, Espinosa N. Operative treatment of chronic irreparable Achilles tendon ruptures with large flexor hallucis longus tendon transfers. Foot Ankle Int. 2013 Aug; 34 (8):1100-10.
- Wegrzyn J, Luciani J-F, Philippot R, Brunet-Guedj E, Moyen B, Besse J-L. Chronic Achilles tendon rupture reconstruction using a modified flexor hallucis longus transfer. Int Orthop. 2009; 34 (8): 1187-92.
- Hockenbury RT, Johns JC. A biomechanical in vitro comparison of open versus percutaneous repair of tendon achilles. Foot Ankle 1990; 11: 67-72.
Öz
Aim: Achilles tendon rupture is the most common tendon rupture and the best treatment for acute Achilles tendon ruptures remains controversial. Mini open or percutaneous repair techniques offer early recovery and return to daily life, but have some disadvantages such as sural nerve injury and re-rupture. The aim of this study is to determine the safety and reliability of percutaneous repair of Achilles tendon rupture with identifying and retracting the sural nerve on its anatomical location.
Materials and Methods: Twenty-four patients who had undergone percutaneous Achilles tendon repair between November 2013 and February 2017 were included in this study. Wound healing problems, complications, ankle range of motions, and American Foot and Ankle Society score in early postoperative period and at the last follow-up were assessed.
Results: The average follow up period was 23 months. At last follow up injured ankles had 47.9±3.1° plantar flexion and 20.1±2.6° dorsiflexion statistically similar to the uninjured side. The average AOFAS score was 91±9.6.
Conclusion: Percutaneous Achilles tendon repair is safer and more reliable method when the sural nerve was identified at its anatomical location.
Anahtar Kelimeler
Achilles tendon rupture surgical treatment percutaneous repair sural nerve
Kaynakça
- Ozkaya U, Parmaksizoglu AS, Kabukcuoglu Y, Sokucu S, Basilgan S. Open minimally invasive Achilles tendon repair with early rehabilitation: functional results of 25 consecutive patients. Injury. 2009; 40 (6): 669-72.
- Assal M, Jung M, Stern R, Rippstein P, Delmi M, Hoffmeyer P. Limited open repair of Achilles tendon ruptures: a technique with a new instrument and findings of a prospective multicenter study. J Bone Joint Surg Am. 2002 Feb; 84-A (2):161-70.
- Mavrodontidis A, Lykissas M, Koulouvaris P, Pafilas D, Kontogeorgakos V, Zalavras C. Percutaneous repair of acute Achilles tendon rupture: a functional evaluation study with a minimum 10-year follow-up. Acta Orthop Traumatol Turc. 2015; 49 (6): 661-7.
- Henríquez H, Muñoz R, Carcuro G, Bastías C. Is percutaneous repair better than open repair in acute Achilles tendon rupture? Clin Orthop Relat Res. 2012; 470(4):998-1003.
- Suchak A, Bostick G, Reid D, Blitz S, Jomha N. The incidence of Achilles tendon ruptures in Edmonton, Canada. Foot Ankle Int. 2005; 26.932–6.
- Grassi A, Amendola A, Samuelsson K, Svantesson E, Romagnoli M, Bondi A, Mosca M, Zaffagnini S. Minimally Invasive Versus Open Repair for Acute Achilles Tendon Rupture: Meta-Analysis Showing Reduced Complications, with Similar Outcomes, After Minimally Invasive Surgery. J Bone Joint Surg Am. 2018 Nov 21; 100 (22): 1969-81.
- Webb JM, Bannister GC. Percutaneous repair of the ruptured tendo Achillis. J Bone Joint Surg Br. 1999 Sep; 81 (5): 877-80.
- Maes R, Copin G, Averous C. Is percutaneous repair of the Achilles tendon a safe technique? A study of 124 cases. Acta Orthop Belg. 2006 Apr; 72 (2):179-83.
- Bradley JP, Tibone JE. Percutaneous and open surgical repairs of Achilles tendon rupture. A comparative study. Am J Sports Med 1990; 18: 188-95.
- Haji A, Sahai A, Symes A, Vyas JK. Percutaneous versus open tendo Achillis repair. Foot Ankle Int 2004; 25: 215-8.
- Zhou K, Song L, Zhang P, Wang C, Wang W. Surgical Versus Non-Surgical Methods for Acute Achilles Tendon Rupture: A Meta-Analysis of Randomized Controlled Trials. J Foot Ankle Surg. 2018 Nov - Dec; 57 (6): 1191-9.
- Rowley DI, Scotland TR. Rupture of the Achilles tendon treated by a simple operative procedure. Injury 1982; 14.252-4.
- Klein W, Lang DM, Saleh M. The use of the Ma-Griffith technique for percutaneous repair of fresh ruptured Tendo Achillis. Chir Organi Mov 1991; 76: 223-8.
- Ma GWC, Griffith TG. Percutaneous repair of acute closed ruptured Achilles tendon: a new technique. Clin Orthop 1977; 128: 247-55.
- Olsson N, Silbernagel KG, Eriksson BI, Sansone M, Brorsson A, Nilsson-Helander K, Karlsson J. Stable surgical repair with accelerated rehabilitation versus nonsurgical treatment for acute Achilles tendon ruptures: a randomized controlled study. Am J Sports Med. 2013 Dec; 41 (12): 2867-76.
- Wilkins R, Bisson LJ. Operative versus nonoperative management of acute Achilles tendon ruptures: a quantitative systematic review of randomized controlled trials. Am J Sports Med. 2012 Sep; 40 (9): 2154-60.
- Maffuli N. Rupture of the Achilles tendon. J Bone Joint Surg 1999; 81-A: 1019-36.
- Rahm S, Spross C, Gerber F, Farshad M, Buck FM, Espinosa N. Operative treatment of chronic irreparable Achilles tendon ruptures with large flexor hallucis longus tendon transfers. Foot Ankle Int. 2013 Aug; 34 (8):1100-10.
- Wegrzyn J, Luciani J-F, Philippot R, Brunet-Guedj E, Moyen B, Besse J-L. Chronic Achilles tendon rupture reconstruction using a modified flexor hallucis longus transfer. Int Orthop. 2009; 34 (8): 1187-92.
- Hockenbury RT, Johns JC. A biomechanical in vitro comparison of open versus percutaneous repair of tendon achilles. Foot Ankle 1990; 11: 67-72.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2020 |
| Gönderilme Tarihi | 23 Ağustos 2019 |
| Yayımlandığı Sayı | Yıl 2020Cilt: 59 Sayı: 3 |
