Author/Editor     Čretnik, Andrej
Title     Ocena zdravljenja pretrganja Ahilove kite po izvirni metodi podkožnega prešitja
Type     monografija
Place     Ljubljana
Publisher     Medicinska fakulteta
Publication year     2002
Volume     str. 65
Language     slo
Abstract     237 consecutive patients with a closed acute rupture of the Achilles tendon were included in the multicentre study. There were 132 prospectively followed patients in the first hospital, where all the patients were operated on with the percutaneous suturing under local anesthesia and 105 patients in the second hospital where all the patients were treated with the open operative repair under general or spinal anesthesia. Functional outcome and the complication rate were assessed with the follow-up of minimally two years. The results showed significantly less major complications in the group of percutaneous repair in comparison with the group of open operative repair (4,5% versus 12,4%) (p=0,03), particularly necrosis (0% versus 5,6%) (p=0,019), as well as lower total number of the complications (11% versus 23%) (p=0,013). There were slightly more reruptures (3,7% versus 2,8%) and suralis nerve disturbances (4,5% versus 2,8%) in the group of percutaneous repair with no statistical significance. Functional score assessment showed no statistical significance with good result in 91 % patients in the group of percutaneous repair and in 88% patients in the group of open operative repair. Patients in the group of open operative repair had finally significantly greater thickness of the operated Achilles tendon (p=0,0005) and greater loss of dorsiflexion of the ankle (p=0,003). Patients in the group of percutaneous repair were more satisfied in their subjective assessment (p=0,024). The average costs in the group of percutaneous repair were about one third of those in open operative group. The results of the study support the choice of percutaneous suturing under local anesthesia as the method of comparable functional results to the open repair with significantly lower rate of complications and lower costs.
Descriptors     RUPTURE
SUTURE TECHNIQUES
ACHILLES TENDON
POSTOPERATIVE COMPLICATIONS
ANESTHESIA, LOCAL
ANESTHESIA, SPINAL
RANGE OF MOTION, ARTICULAR
FOLLOW-UP STUDIES
MULTICENTER STUDIES