[VY-plasty for chronic quadriceps tendon rupture]. / VY-Plastik bei chronischer Ruptur der Quadrizepssehne.
Oper Orthop Traumatol
; 2024 Aug 28.
Article
em De
| MEDLINE
| ID: mdl-39196361
ABSTRACT
OBJECTIVE:
Lengthening of the quadriceps tendon for dehiscence in chronic rupture. INDICATIONS Chronic rupture of the quadriceps tendon with delayed diagnosis or failure of primary refixation with a dehiscence between 1 and 5â¯cm. CONTRAINDICATIONS Dehiscence of more than 5â¯cm. SURGICAL TECHNIQUE Reopen the old incision and lengthen it to about 20-25â¯cm if necessary. Visualize the rupture. Debridement of the tendon and the insertion. Measurement of the dehiscence. Creation of a V-flap and reinforcement with a holding seam. Gradual mobilization of the Vflap distally and reinforcement with two strong suture cords (braided suture size 5). Drilling of three obliquely ascending drill holes through the patella. Transosseous threading of the two reinforcement cords through the three drill holes. Knotting the reinforcement cords on the patella. Closure of the gap between the patella and the superficial tendon leaflet with a #2 braided suture. Closure of the gap between the Vflap and the quadriceps tendon. POSTOPERATIVE MANAGEMENT Six weeks of partial weight-bearing with 20â¯kg in a straight orthosis. Mobility weeks 1-4 E/F 0-0-60, weeks 5 and 6 E/F 0-0-90.RESULTS:
We were able to follow-up 8 patients (mean age 63.1⯱ 4.5 years), who underwent this surgery in the manner described. All patients were able to perform an active extension postoperatively. The Lysholm score increased from 46.4 (±â¯5.4) points preoperatively to 81.6 (±â¯6.5) points postoperatively. No further rupture was detectable in the ultrasound examination at latest follow-up after an average of 27 (18-36) months.
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Ano de publicação:
2024
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Article