Comparación entre la cirugía abierta y el método mínimamente invasivo para roturas agudas del tendón de Aquiles.

• Autores: Ignacio Ricardo Arzac Ulla, Adrian De Silvestri, Gustavo Fiorentini
• Localización: Revista de la Asociación Argentina de Ortopedia y Traumatología, ISSN 1852-7434, Vol. 81, Nº. 4, 2016, págs. 274-280
• Idioma: español
• DOI: 10.15417/573
• Títulos paralelos:
  • Comparison between open surgery and minimally invasive method for acute Achilles tendon ruptures
• Enlaces
  • Texto completo (pdf)
• Resumen
  • español

    Introducción. La reparación quirúrgica puede realizarse mediante cirugía abierta o por técnicas mínimamente invasivas. La técnica percutánea combina las ventajas del tratamiento quirúrgico abierto con el tratamiento ortopédico. El objetivo de este trabajo es comparar la técnica mínimamente invasiva de Dresden descripto por Amlang con la cirugía abierta convencional.Material y métodos. Estudio comparativo de 15 casos de roturas de tendón de Aquiles operados con técnica abierta convencional y 15 casos operados con la técnica percutánea de Dresden. Se evaluaron características del intraoperatorio y hospitalización, resultados funcionales de acuerdo a score AOFAS, ARPS (achilles ruptura performance score), escala visual análoga y rango de movilidad de tobillo.Resultados. Se mencionan los resultados comparativos del tiempo quirúrgico, trofismo, longitud de cicatriz, diferencia comparativa en el perímetro del gemelo. El AOFAS a 5 meses: Grupo A: 90 puntos, y grupo B: 95 puntos. Retorno a la actividad laboral: Grupo A, 7 meses promedio, Grupo B: 3,53 meses promedio. Retorno a actividad deportiva: en el grupo A: media 12,22 meses; Grupo B: media 6,53 meses.Conclusión: La reparación percutánea de Dresden, es una buena opción para las roturas de tendón de Aquiles; con buena evolución clínico-funcional minimizando los riesgos de re rotura y lesiones del nervio sural. 

  • English

    Introduction: Surgical repair can be performed by open or minimally invasive surgery techniques. The percutaneous technique combines the advantages of open treatment with orthopedic surgery. The aim of this study is to compare minimally invasive technique described by Amlang with conventional open surgery.Material and methods: A comparative study from 15 cases of Achilles tendon ruptures operated with conventional open surgery and 15 cases operated with percutaneous Dresden technique. Intraoperative characteristics and hospitalization, functional outcomes according to AOFAS score, ARPS (achilles rupture performance score), visual analog scale and range of motion of the ankle were evaluated.Results: Comparative results of surgical time, muscle trophism, length of scar, comparative difference in the twin perimeter calf. The AOFAS score at 5 months: Group A: 90 points, and group B: 95 points. Return to work: Group A, 7 months on average, Group B: average 3.53 months. Return to sport: in Group A: mean 12.22 months; Group B: mean 6.53 months.Conclusion: Dresden technique is a good option for Achilles tendon ruptures; with good clinical and functional evolution minimizing the risk of breakage and sural nerve injury.

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