Can Wound-Site Complications Be Predicted after Open Repair in Acute Achilles Tendon Ruptures?

Yıl 2025, Cilt: 15 Sayı: 2, 82 - 85, 17.03.2025

Ortaç Güran , Furkan Hanege , Batuhan Gencer , Özgür Doğan

https://doi.org/10.16899/jcm.1642466

Öz

Background/Aims: To examine the correlation between wound-site complications that arise following open repair of acute achilles tendon ruptures and patient-related factors.
Methods: Age, gender, mechanism of injury, time from rupture to surgery, and postoperative complications were analyzed in 39 patients who underwent open surgery by a single orthopedic and traumatology team between 2019 and 2024.
Results: As the time until surgical intervention increased after tendon rupture, wound-site complications were encountered more frequently (p<0.001) There was no other significant relationship between patient-based parameters and wound-site complications (p>0.05 for each).
Conclusions: The most effective parameter in predicting wound-site complications after open rupture of the AT rupture is the elapsed time between injury and surgery, whereas factors such as age, gender and injury mechanisms are not able to predict wound-site complications in such cases. Patients should be operated on as soon as possible to minimize the risk of wound site problems, which is a common complication of Achilles tendon rupture treatments.

Anahtar Kelimeler

Achilles tendon, achilles tendon rupture, wound-site problem, open repair, length of stay before surgery

Etik Beyan

Our study was ethically approved by the Ethics Committee of the Ministry of Health, Ankara City Hospital No. 1 Clinical Research Ethics Committee with the ethics committee document dated 21/09/2022 and numbered E1-22-2908.

Destekleyen Kurum

None

Akut Aşil Tendon Kopmalarında Açık Onarım Sonrası Yara Yeri Komplikasyonları Öngörülebilir mi?

Öz

Amaç: Akut aşil tendon rüptürlerinin açık onarımı sonrasında ortaya çıkan yara yeri komplikasyonları ile hastaya bağlı faktörler arasındaki ilişkiyi incelemek.
Yöntemler: 2019-2024 yılları arasında tek bir ortopedi ve travmatoloji ekibi tarafından açık cerrahi uygulanan 39 hastada yaş, cinsiyet, yaralanma mekanizması, kopmadan cerrahiye kadar geçen süre ve ameliyat sonrası komplikasyonlar analiz edildi.
Sonuçlar: Tendon kopmasından sonra cerrahi müdahaleye kadar geçen süre arttıkça, yara yeri komplikasyonlarına daha sık rastlandı (p<0,001) Hasta bazlı parametreler ile yara yeri komplikasyonları arasında başka anlamlı bir ilişki yoktu (her biri için p>0,05).
Sonuç: Açık aşil tendon rüptüründen sonra yara yeri komplikasyonlarını öngörmede en etkili parametre yaralanma ile ameliyat arasında geçen süredir; yaş, cinsiyet ve yaralanma mekanizmaları gibi faktörler ise bu tür vakalarda yara yeri komplikasyonlarını öngörmede yetersiz kalabilir. Aşil tendon rüptürü tedavilerinin yaygın bir komplikasyonu olan yara yeri sorunları riskini en aza indirmek için hastalar mümkün olan en kısa sürede ameliyat edilmelidir.

Anahtar Kelimeler

Aşil tendonu, Aşil tendon rüptürü, yara yeri komplikasyonu, açık onarım, ameliyat öncesi süre

Etik Beyan

Çalışmamız Sağlık Bakanlığı Ankara Şehir Hastanesi 1 No'lu Klinik Araştırmalar Etik Kurul Başkanlığı'nın 21/09/2022 tarihli E1-22-2908 nolu etik kurul belgesinde oy birliği ile etik açıdan onaylanmıştır.

Destekleyen Kurum

Yok

Kaynakça

• 1. Hanege F. Yumuşak Doku Travmaları ve Tendon Yaralanmaları. In: Doğan Ö, Gencer B, editors. Ortopedik Aciller Tanı ve Tedavi Kılavuzu. Chapter in Turkish. Ankara: Akademisyen Yayınevi; 2022. p.159.
• 2. Sheth U, Wasserstein D, Jenkinson R, Moineddin R, Kreder H, Jaglal SB. The epidemiology and trends in management of acute Achilles tendon ruptures in Ontario, Canada: a population-based study of 27 607 patients. Bone Joint J. 2017;99-B(1):78-86.
• 3. Holm C, Kjaer M, Eliasson P. Achilles tendon rupture--treatment and complications: a systematic review. Scandinavian Journal of Medicine & Science in Sports. 2015;25(1): e1-10.
• 4. Orthobullets.com [https://www.orthobullets.com/foot-and-ankle/7021/achilles-tendon-rupture]. Achilles Tendon Rupture. [updated 5 Jan 2025; cited 18 Feb 2025]. Available from: www.orthobullets.com.
• 5. Deng S, Sun Z, Zhang C, et al. Surgical Treatment Versus Conservative Management for Acute Achilles Tendon Rupture: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Foot and Ankle Surgery. 2017;56(6): 1236-43.
• 6. İnci F, Yavuz İA. Akut Aşil Tendon Rüptür Tedavisinde Mini-açık ve Perkütan Tamir Yöntemlerinin Karşılaştırılması. Med J SDU 2022; 29(1): 101-10.
• 7. Eliasson P, Agergaard AS, Couppe C, Svensson R, Hoeffner R, Warming S, et al. the ruptured achilles tendon elongates for 6 months after surgical repair regardless of early or late weightbearing in combination with ankle mobilization: a randomized clinical trial. Am J Sports Med 2018;46:2492–502
• 8. Park SH, Lee HS, Young KW, Seo SG. Treatment of Acute Achilles Tendon Rupture. Clin Orthop Surg. 2020;12(1):1-8.
• 9. Gencer B, Doğan Ö, Igdir V, Çulcu A, Caliskan E, Biçimoğlu A. Searching for a New Parameter in the Healing of Tibia Pilon Fractures: Fracture Area Measurement. J Am Podiatr Med Assoc. 2022;112(4):20-137.
• 10. Fan L, Hu Y, Zhou L and Fu W (2024) Surgical vs. nonoperative treatment for acute Achilles’ tendon rupture: a meta-analysis of randomized controlled trials. Front. Surg. 11:1483584.
• 11. Maffulli N, Waterston SW, Squair J, Reaper J, Douglas AS. Changing incidence of Achilles tendon rupture in Scotland: a 15-year study. Clin J Sport Med 1999;9:157– 60
• 12. Möller A, Astron M, Westlin N. Increasing incidence of Achilles tendon rupture. Acta Orthop Scand 1996; 67: 479–81.
• 13. Leppilahti J, Puranen J, Orava S. Incidence of Achilles tendon rupture. Acta Orthop Scand 1996;67:277–279.
• 14. Lantto I, Heikkinen J, Flinkkilä T, Ohtonen P, Leppilahti J. Epidemiology of Achilles tendon ruptures: increasing incidence over a 33-year period. Scand J Med Sci Sports 2015;25:133–8.
• 15.Józsa L, Kvist M, Bálint BJ, et al. The role of recreational sport activity in Achilles tendon rupture. A clinical, pathoanatomical, and sociological study of 292 cases. Am J Sports Med 1989;17:338–43.
• 16. Levi N. The incidence of Achilles tendon rupture in Copenhagen. Injury 1997;28:311–3.
• 17. The risk of soft tissue complications from open reduction and internal fixation is thought to rise 24 h post injury; as such the Association for Osteosynthesis (AO) group recommend delaying surgery until at least day 4 post injury. Muller M, Allgover M, Schneider R, Willengger H. Manual of internal fixation. Berlin: Springer; 1992. p. 600.
• 18. Westberg M, Snorrason F, Frihagen F. Preoperative waiting time increased the risk of periprosthetic infection in patients with femoral neck fracture. Acta Orthop. 2013;84(2):124-9.