South Clin Ist Euras. 2015; 26(3): 243-247 | DOI: 10.5505/jkartaltr.2015.35467

Akut Aþil Tendon Rüptürü Tedavisinde Perkütan ve Açýk Tekniklerin Karþýlaþtýrýlmasý

Evren Akpýnar¹, Hasan Hüseyin Ceylan², Gökhan Polat³, Ömer Naci Ergin³, Mehmet Erdil⁴, Ýbrahim Tuncay^5
1Metin Sabancý Baltalimaný Kemik Hastalýklarý Eðitim Ve Araþtýrma Hastanesi
²Sultançiftliði Lütfiye Nuri Burat Devlet Hastanesi
³Ýstanbul Üniversitesi Ýstanbul Týp Fakültesi Ortopedi Ve Travmatoloji Ad,
⁴Ýstanbul Medipol Üniversitesi Týp Fakültesi Ortopedi Ve Tavmatoloji Ad,
⁵Bezmialem Vakýf Üniversitesi Ortopedi Ve Travmatoloji Ad.

GÝRÝÞ ve AMAÇ: Aþil tendon rüptürü sýk rastlanan bir yaralanma türü olmasýna raðmen tedavisi halen tartýþmalýdýr. Çalýþmamýzda Aþil tendon tamirinde kullanýlan perkütan ve açýk cerrahi tekniklerin fonksiyonel durumunu karþýlaþtýrmak amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmamýzda 33’ü perkütan (ortalama takip süresi 39 [16–49] ay), 57’si açýk (ortalama takip süresi 44,16 [16–95] ay) teknikle tedavi edilmiþ 90 hastanýn sonuçlarý geriye dönük olarak karþýlaþtýrýldý. Hastalar AOFAS skoru, ayakbileði eklem hareket açýklýðý, dorsifleksiyon ve plantar fleksiyon gücü, iþe ve spora yeniden baþlama zamanlarý açýsýndan deðerlendirildi.
BULGULAR: Her iki grubun demografik özellikleri benzer olarak deðerlendirildi ve yaþ, cinsiyet, ortalama takip süreleri açýsýndan fark yoktu. Fonksiyonel deðerlendirmede AOFAS skorlarýnda (p=0.266), plantar fleksiyonda (p=0.106), dorsifleksiyonda (p=0.104), dorsifleksiyon (p=0.531) ve plantar fleksiyon (p=0.413) güçlerinde iki grup arasýnda istatistiksel olarak anlamlý fark yoktu. Gruplarýn komplikasyon oranlarýnda anlamlý fark yoktu.
TARTIÞMA ve SONUÇ: Aþil tendon rüptüründe perkütan ve açýk tekniklerin fonksiyonel sonuçlarý baþarýlýdýr ve perkütan tekniðin erken iyileþme ve iþe dönme açýsýndan üstünlüðü gösterilememiþtir.

Anahtar Kelimeler: Açýk cerrahi teknik, Aþil tendon rüptürü, peruktan cerrahi teknik.

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Comparison of Percutaneous and Open Techniques in Treatment of Acute Achilles Tendon Rupture

Evren Akpýnar¹, Hasan Hüseyin Ceylan², Gökhan Polat³, Ömer Naci Ergin³, Mehmet Erdil⁴, Ýbrahim Tuncay^5
1Metin Sabancý Baltalimaný Bone Diseases Training And Research Hospital
²Sultançiftliði Lütfiye Nuri Burat Hospital
³Ýstanbul University Ýstanbul Medical Faculty Orthopedics And Traumatology
⁴Ýstanbul Medipol University Medical Faculty Orthopedics And Traumatology
⁵Bezmialem University Medical Faculty Orthopedics And Traumatology

INTRODUCTION: Acute Achilles tendon rupture is a common injury for which recommended treatment is still controversial. The aim of the present study was to compare functional results of percutaneous and open surgical techniques of Achilles tendon repair.
METHODS: Ninety patients (33 percutaneous repairs with a mean follow-up of 39 [16–49] months, and 57 open repairs with a mean follow-up of 44.16 [16–95] months) were included in this retrospective, comparative study. Patients were evaluated for American Orthopaedic Foot and Ankle Society (AOFAS) scores, ankle range of motion (ROM), dorsiflexion and plantar flexion strength, and time of return to work and sports at last follow-up.
RESULTS: Both groups had similar demographic characteristics, and there were no differences in terms of age, gender, and mean follow-up. In functional assessment, there were no statistical differences in AOFAS scores (p=0.266), plantar flexion (p=0.106), dorsiflexion (p=0.104), plantar flexion (p=0.413), and dorsiflexion strength (p=0.531) between the 2 groups. Regarding complications, there were no statistical differences between the groups.
DISCUSSION AND CONCLUSION: Percutaneous and open Achilles repair can be performed with successful functional rates, and percutaneous technique did not show any superiority in terms of early recovery and return to work.

Keywords: Open surgical technique, Achilles tendon rupture, percutaneous surgical technique.

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