Akromiyoklaviküler çıkıklarda Ethibond sütür ve semitendinozus otogretfi ilerekonstrüksiyon sonuçlarının karşılaştırması

Year 2013, Volume: 47 Issue: 5, 307 - 310, 29.10.2013

Mohsen Mardani-kivi Ahmadreza Mirbolook Mostafa Salariyeh Keyvan Hashemi-motlagh Khashayar Saheb-ekhtiari

Abstract

Amaç: Akromiyoklaviküler (AC) eklem çıkıklarında 5 numara Ethibond sütür ve semitendinozus otogretfi kullanılarak yapılan cerrahi rekonstrüksiyonların sonuçlarının karşılaştırması amaçlandı.
Çalışma planı: Bu analitik kesitsel çalışmada AC eklem çıkığı nedeniyle cerrahi tedavi uygulanmış olan 39 hastanın (35 erkek, 4 kadın; ortalama yaş: 32.6±11.8) kayıtları retrospektif olarak tarandı. Yirmi bir hastaya 5 numara Ethibond sütür (Grup A), 18 hastaya ise semtendinozus otogrefti (Grup B) kullanılarak rekonstrüksiyon uygulandı. Veritabanı taramasında ortalama 25.7 aylık bir takip dönemindeki radyografik bulgular, Constant ve VAS skorları ve enfeksiyon kayıtları değerlendirildi.
Bulgular: A ve B gruplarının ortalama Constant skoru sırasıyla 91±1 ve 92±2.1 olarak bulundu. Zanca grafisinde A grubunda 15, B grubunda ise 12 hastada AC eklemin redükte edilmiş olduğu görüldü. A grubunda 6, B grubunda ise 5 hastada AC eklemde %25’in altında subluksasyon saptandı. Redüksiyon başarısı, hasta tatmini ve ağrı açısından gruplar arasında anlamlı fark saptanmadı (p>0.05). Hiçbir hastada derin enfeksiyon görülmedi.
Çıkarımlar: Her iki teknik de başarılı sonuç verdiğinden semitendinozus otogreftindeki greft alma morbiditesinden kaçınmak için 5 numara Ethibond sütür kullanılması tercih edilebilir.

Keywords

Akromiyoklaviler eklem çıkığı; Constant skoru; Ethibond, Görsel Ağrı Skalası; semitendinozus otogrefti.

The comparison of Ethibond sutures and semitendinosus autograft in the surgical treatment of acromioclavicular dislocation

Abstract

Objective: The aim of this study was to compare the results of the surgical reconstruction of the acromioclavicular joint (ACJ) dislocations using No. 5 Ethibond suture or semitendinosus autograft.
Methods: This analytical cross-sectional study was conducted on the medical records of 39 patients (35 males and 4 females; mean age: 32.6±11.8 years), with complete ACJ joint dislocation (Type 3 to 6). Twenty one patients underwent reconstruction using No. 5 Ethibond suture (Group A) and 18 patients using semitendinosus tendon autograft (Group B). The patients’ database records were queried for the information regarding the evaluations during follow-up period (mean: 25.7 months) such as radiographic evaluations, Constant score, VAS score and infection.
Results: The mean Constant score was 91±1 and 92±2.1 in Groups A and B, respectively. There was a reduction of ACJ based on Zanca view in 15 patients in Group A and 12 patients in Group B. There was subluxation of ACJ by less than 25% in six patients in Group A and five in Group B, in that, the difference was not significant. Patients expressed acceptable satisfaction and equal pain severity in rest and daily activity in both groups. No deep infection has been observed.
Conclusion: Since both surgical techniques led to satisfactory results, reduction of ACJ, excellent functional score and acceptable patient satisfaction, No. 5 Ethibond suture technique could be recommended as the treatment of choice due to the absence of morbidity in removing semitendinosus autograft tendon.  

Keywords

Acromioclavicular joint dislocation, Constant score, Ethibond suture, semitendinosus autograft, Visual analogue score

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