El ekstansör tendon yaralanmalarında primer onarımın fonksiyonel sonuçlarının etiyolojik faktörler, eşlik eden yaralanmalar ve yaralanma yerlerine göre değerlendirilmesi

Amaç: Bu çalışmanın amacı, eldeki ekstansör tendon yaralanmalarının uygun primer onarım teknikleri ile cerrahi tedavisinin; yaralanma mekanizmasını, eşlik eden yaralanmaları ve yaralanma bölgelerini göz önünde bulundurarak bunların klinik ve fonksiyonel sonuçlara etkisini değerlendirmektir. Gereç ve Yöntem: Bu çalışma 2016-2020 yılları arasında Ortopedi ve Travmatoloji Kliniği'nde ameliyat edilen 103 hastanın retrospektif olarak değerlendirildiği kesitsel bir çalışmadır. Mevcut tedavi yöntemleri etiyolojik faktörler, anatomik bölgeler, yaralanan tendon sayısı ve eşlik eden yaralanmalar açısından değerlendirildi. Komplikasyonlar ve fonksiyonel sonuçlar anatomik bölgelere, yaralanma mekanizmasına ve ek yaralanmalara göre istatistiksel olarak değerlendirildi. Bulgular: 103 hastanın (ortalama yaş: 37,2 yaş) 114 ekstansör tendon yaralanması değerlendirildi. Ortalama takip süresi 26,8 aydı. Etiyolojik faktörler arasında en sık görüleninin kesici alet yaralanması (%57,3) olduğu görülmektedir. Keskin alet yaralanmalarında 8. hafta ve 12. ayda yapılan Miller sınıflamasına göre orta ve kötü sonuç ve komplikasyon varlığı diğer yaralanma tiplerine göre istatistiksel olarak anlamlı derecede düşük bulundu. Eşlik eden yaralanma (n: 21/103) ile komplikasyon oluşumu ve fonksiyonel sonuçlar arasında istatistiksel bir ilişki gözlendi. Yaralanma bölgelerine göre komplikasyonlar ile 8. Haftadaki fonksiyonel sonuçlar arasında fark bulunmazken, zon-2 yaralanmalarında 12. ayda istatistiksel olarak anlamlı derecede daha düşük fonksiyonel sonuçlar bulundu. Sonuç: Başarılı postoperatif iyileşme öncelikle yaralanma tipine ve ilişkili yaralanmalara bağlı olmakla birlikte, herhangi bir bölgede uygun onarım tekniği ile cerrahi sonrası erken mobilizasyon ile iyi ve mükemmel fonksiyonel sonuçlar elde edilebilir.

Anahtar Kelimeler:

Extansör Tendon, Tendon Onarımı, El Yaralanması, Ekstansör Bölgeler

Evaluation of functional results of primary repair in hand extensor tendon injuries according to etiological factors, associated injuries and injury sites

Purpose: The aim of this study was to evaluate the effect of surgical treatment of extensor tendon injuries in the hand with appropriate primary repair techniques on clinical and functional outcomes, taking into account the mechanism of injury, concomitant injuries and injury sites. Materials and Methods: This is a cross-sectional study in which 103 patients who were operated between 2016-2020 in Orthopedics and Traumatology Clinic were evaluated retrospectively. Existing treatment modalities were evaluated in terms of etiological factors, anatomical regions, number of injured tendons, and injuries. Complications and functional outcomes were statistically evaluated according to anatomical regions, mechanism of injury and additional injuries. Results: 114 extensor tendon injuries of 103 patients (mean age: 37.2 years) were evaluated. The mean follow-up period was 26.8 months. Among the etiological factors, it is seen that the most common one is sharp object injury (57.3%). According to the Miller classification performed at the 8th week and 12th month in sharp object injury, moderate and poor outcome and the presence of complications were found to be statistically significantly lower than other injury types. A statistical correlation was observed between the accompanying injury (n: 21/103) and the occurrence of complications and functional outcomes. While there is no difference between complications, depending on the body regions, and functional results at 8. week statistically significantly lower functional results were found in zone-2 injuries at 12 months. Conclusion: While successful postoperative recovery primarily depends on the type of injury and associated injuries, good and excellent functional results can be achieved with early mobilization after surgery with the appropriate repair technique in any region.

Keywords:

Extansor tendon, Tendon Repair, Hand Injury, Extansor Zones,

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