Biyolojik açık cerrahi yöntem ile Aşil tendonu onarımının fonksiyonel sonuçları

Öz

Amaç: Çalışmanın amacı biyolojik açık cerrahi yöntem ile Aşil tendon onarımı ve erken postoperatif mobilizasyon uygulanan hastaların orta dönem fonksiyonel sonuçlarını değerlendirmekti.

Çalışma planı: Biyolojik açık cerrahi yöntemle Aşil tendon onarımı yapılan 22 erkek hasta retrospektif olarak değerlendirildi. Hastaların her iki ayak bilekleri Amerikan Ayak ve Ayak Bileği Derneği’nin (AOFAS) art ayak skoru, izokinetik kas kuvveti ve dayanıklılığı, 15° dorsifleksiyon ve 20° plantarfleksiyonda aktif açı reprodüksiyon testleri ile ölçülerek karşılaştırıldı.

Bulgular: Hastaların ortalama yaşı 38.6 yıl, ortalama takip süreleri 33.7 ay olarak saptandı. Bir hastada künt travma nedeniyle postoperatif 1. aydaki rerüptür dışında ek bir komplikasyon izlenmedi. Hastaların ortalama AOFAS art ayak skoru 97.9 idi. Her iki ayak bileğinin 30°/sn’deki zirve tork (izokinetik kas kuvveti) ve 120°/sn’deki toplam iş (izokinetik kas dayanıklılığı) değerleri karşılaştırıldığında bilekler arasında anlamlı fark görülmedi. 15° dorsifleksiyon ve 20° plantarfleksiyon açılarında aktif açı reprodüksiyon testi ile yapılan propriosepsiyon değerlendirmesinde her iki tarafın da benzer olduğu saptandı.

Çıkarımlar: Biyolojik açık Aşil tendon onarımı ve sonrasında uygulanan erken mobilizasyon programının aktif genç hastalarda oluşan akut Aşil tendon yırtıkları için uygun bir girişim olduğu düşüncesindeyiz. Tedavi ile düşük komplikasyon oranları elde edilmiş, ayak bileği kas gücü ve dayanıklılığının yanı sıra pozisyon hissi de geri kazanılmıştır.

Anahtar Kelimeler

• Biyolojik açık Aşil tendon onarımı; izokinetik kas gücü ve dayanıklılığı; pozisyon hissi ölçümü

Functional outcomes of repair of Achilles tendon using a biological open surgical method

Öz

Objective: The aim of this study was to evaluate the mid-term functional outcomes of ankles following biological open Achilles tendon repair and early postoperative mobilization.

Methods: The study retrospectively evaluated 22 male patients who underwent one-sided biological open Achilles tendon repair. The American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, isokinetic muscle strength and endurance tests and active angle reproduction test at 15° of dorsiflexion and 20° of plantarflexion of the injured and uninjured sides were measured and compared.

Results: Mean age was 38.6 years and mean follow-up was 33.7 months. One patient had rerupture following a blunt trauma 1 month after operation. No other complication was seen. Mean AOFAS hindfoot score was 97.9 (range: 90 to 100). Peak isokinetic torque at 30°/sec (isokinetic muscle strength) and total work at 120°/sec (isokinetic muscle endurance) did not significantly differ between the operated and uninjured ankles. Proprioceptive evaluation with active angle reproduction test at 15°of dorsiflexion and 20° of plantarflexion was similar between the two sides.

Conclusion: Biological open Achilles tendon repair with early postoperative mobilization appears to be a convenient intervention for acute Achilles tendon rupture in active young patients. Treatment results in low complication rates and restores ankle strength, endurance and position sense.

Anahtar Kelimeler

• Biological open Achilles tendon repair
• isokinetic muscle strength and endurance
• position sense measurement

Kaynakça

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