Erdinç ACAR, B. Alper GÜLTEKİN

De Quervain Tenosinovit Cerrahisinde Longitudinal İnsizyon mu? Transvers İnsizyon Mu?

GİRİŞ ve AMAÇ: Cerrahi uygulanan De Quervain tendinitli hastalarda, longitudinal insizyon ile transvers insizyon arasında fark olup olmadığı değerlendirildi. YÖNTEM ve GEREÇLER: Çalışmaya, Aralık 2017 ile Mayıs 2019 tarihleri arasında De Quervain tenosinovit cerrahisi yapılan 17 hasta (12 bayan, 5 erkek) dahil edildi. Birinci gruba longitudinal insizyon (7 bayan, 2 erkek), ikinci gruba transvers veya oblik insizyon (5 bayan, 3 erkek) uygulandı. Bu hastalarda yineleme oranı ve memnuniyet oranları değerlendirildi. Cerrahi sonrası damar-sinir hasarı, yara yeri enfeksiyonu, yarada belirgin skar dokusu gelişimi ve eklem hareket açıklığında kısıtlanma gibi komplikasyonlar değerlendirilmiştir. BULGULAR: Hastaların yaş ortalaması 41,2 (22-69). Hastaların 12’si (%70,6) bayan, 5’i (%29,4) erkek idi. Hastalar ortalama 10 ay (8-14) takip edildi. Her 2 grupta da yineleme izlenmedi. Hastaların tamamı, cerrahi tedaviden memnun kaldıklarını belirtti. Her 2 grupta da ciddi komplikasyon görülmedi. İkinci gruptaki bir hastada belirgin skar dokusu gelişimi izlendi (p=0.03) TARTIŞMA ve SONUÇ: De Quervain tenosinovit cerrahisi; cerrahi deneyimin ön planda olduğu, nüks ve komplikasyon gelişmemesi açısından yararlı bir yöntem olmakla birlikte, uygulanan iki ayrı cerrahi insizyon arasında hipertrofik skar dokusu gelişimi olan bir hasta dışında fark olmadığı görüldü.

Longitudinal Incision Versus Transverse Incision in De Quervain’s Tenosynovitis Surgery

INTRODUCTION: In this study, we aimed to compare longitudinal incision versus transverse incision in surgical treatment of De Quervain’s tenosynovitis. METHODS: Between December 2017 and May 2019, a total of 17 patients who were operated for De Quervain’s tenosynovitis were included. The patients were divided into two groups as Group 1 (n=9) undergoing longitudinal incision and as Group 2 (n=8) undergoing transverse incision. The recurrence rate and patient satisfaction were recorded. Postoperative complications including vessel and nerve damage, wound infection, scar formation, and limited range of motion of the joint were evaluated. RESULTS: Of the patients, 12 (70.6%) were females and five (29.4%) were males with a mean age of 41.2 (range, 22 to 69) years. There were seven females and two males in Group 1 and there were five females and three males in Group 2. The mean follow-up was 10 (range, 8 to 14) months. No recurrence was observed in any of the patient groups. The rate of patient satisfaction was 100% in both groups. No significant surgery-related complication was seen. An evident scar formation was observed in only one patient in Group 2 (p=0.03). DISCUSSION AND CONCLUSION: Surgical treatment of De Quervain’s tenosynovitis is an effective and safe method without recurrence or postoperative complications in experienced hands. Our study results suggest no significant difference between the longitudinal incision and transverse incision, except for hypertrophic scar formation through the transverse incision.

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