Önkol ve El Bilek Fleksör Tendon Yaralanmalarında Dikiş Tekniklerinin Karşılaştırılması

ÖZET Giriş/Amaç: Ön kol fleksör tendon yaralanması sonrası tendon onarımlarında farklı dikiş teknikleri uygulanmaktadır. Ancak literatürde sonuçları hakkında fazla bilgi yoktur. Fleksör tendon onarımlarının ana hedefleri güçlü onarım ve erken mobilizasyondur. Bu çalışmanın amacı bu bölgede fleksör tendon onarımlarında tek başına modifiye Kessler tekniği ile çalışan epitenon sütür tekniği ile modifiye Kessler sütür sonuçlarını karşılaştırmak ve postoperatif başarı oranlarını değerlendirmektir. Yöntemler: Bu çalışma Mart 2017-Kasım 2020 tarihleri arasında gerçekleştirildi. Çalışma 68 hastadan oluştu. Bu hastaların 34'üne sadece modifiye Kessler tekniği ile onarım uygulandı. Diğer 34 hastaya, devam eden bir epitenon sütür ile modifiye Kessler sütür ile takviye uygulandı. Ameliyat sonrası 5. günde fizyoterapist eşliğinde pasif fleksiyon egzersizlerine başlandı. 10. günden sonra fizyoterapist gözetiminde tekrar aktif fleksiyon egzersizlerine başlandı. Bir ay boyunca bilek immobilizasyonu uygulandı. Hastaların 12 aylık takiplerinde tendonların fonksiyonları Tang derecelendirmesine göre değerlendirildi. Bulgular: Devam eden epitenon sütür grubu ile modifiye Kessler sütür grubundaki hastalar, adezyon, hareket kısıtlılığı ve Tang derecelendirme değişkenleri açısından Modifiye Kessler grubundaki hastalardan daha iyi sonuçlar gösterdi. Sonuç: Ön kol fleksör tendon onarımı sonrası hastaların çoğunda iyi sonuçlar elde edildi. Özellikle çalışan epitenon sütür tekniği ile modifiye Kessler sütür bu hastalarda daha güçlü bir onarım sağlamakta ve rehabilitasyonu kolaylaştırarak sonuçları iyileştirmektedir.

Anahtar Kelimeler:

Tendon Onarımı, Modifiye Kessler sütür, Running sütür, Önkol

Comparison of Suture Techniques in Forearm and Wrist Flexor Tendon Injury

ABSTRACT Background/Aims: Different suturing techniques are performed in tendon repairs after forearm flexor tendon injury. But there is not much information about their results in the literature. The main goals of flexor tendon repairs are strong repair and early mobilization. The aim of this study was to compare the results of the modified Kessler technique alone and modified Kessler suture with a running epitenon suture technique in flexor tendon repairs in this region and to evaluate the postoperative success rates. Methods: This study was conducted between March 2017 and November 2020. The study comprised of 68 patients. Repair was performed only by the modified Kessler technique to 34 of these patients. The other 34 patients underwent reinforcement with modified Kessler suture with a running epitenon suture. Passive flexion exercises accompanied by a physiotherapist were started on the 5th day after surgery. After the 10th day, active flexion exercise was started again under the supervision of a physiotherapist. Wrist immobilization was performed for one month. The function of the tendons was evaluated according to Tang grading during 12-month follow-up of the patients. Results: Patients in the modified Kessler suture with a running epitenon suture group showed better results than those in the Modified Kessler group, for the adhesion, limitation of motion and Tang grading variables. Conclusions: Good results were obtained in most of the patients following forearm flexor tendon repair. Especially the modified Kessler suture with a running epitenon suture technique provides a stronger repair in these patients and improves outcomes by facilitating rehabilitation.

Keywords:

Tendon Repair, Modifiye Kessler sutur, Running suture, Forearm Tendon Onarımı, Modifiye Kessler sütür, Running sütür, Önkol,

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