RESUMO
Antecedentes y objetivo: Clásicamente el tratamiento de las lesiones agudas de la sindesmosis se ha realizado mediante tornillos. Hace unos años aparecieron implantes más flexibles que han evolucionado hasta el moderno TighRope® Knotless. El objetivo del presente estudio es comparar los resultados de ambos implantes. Material y métodos: Desde abril de 2019 hasta septiembre de 2020 reclutamos 68 pacientes diagnosticados de lesión aguda de la sindesmosis que fueron aleatorizados para tratamiento quirúrgico con tornillo o con TighRope® Knotless. Realizamos control posquirúrgico con tomografía axial computarizada, y a los 3, 6 y 12 meses se recogieron datos del rango articular, valores de escalas funcionales y se realizaron estudios de radiología simple. Resultados: Los pacientes tratados con tornillos no presentaban diferencias estadísticamente significativas en la escala AOFAS frente al grupo tratado con TighRope® Knotless a los 3 meses (83,1 vs. 81,80; p=1,03), ni a los 6 meses (88,27 vs. 88; p=0,26) ni a los 12 meses (93,03 vs. 92,10; p=0,93). Igualmente recogimos resultados similares en la escala de Olerud-Molander a los 3 meses (65 vs. 61,50; p=3,5), 6 meses (82,33 vs. 80,67; p=1,67) y 12 meses (92,67 vs. 90; p=2,67). Tampoco hubo diferencias en la tasa de malreducción posquirúrgica (ningún caso en ambos grupos), pérdida de reducción (3 en el grupo tratado con tornillo frente a 4 del grupo del TighRope® Knotless, p=0,54) o complicaciones (p=1). Conclusiones: El tratamiento de las lesiones agudas de la sindesmosis con tornillos o con TighRope® Knotless es similar tanto en resultados clínicos como radiológicos.(AU)
Background and aim: Classically acute syndesmosis injuries have been treated using screws. A few years ago more flexible implants appeared evolving to current TighRope® Knotless. The primary aim of this study is to compare clinical and radiographic outcome of both implants. Material and methods: From April 2019 to September 2020 68 patients diagnosed with acute syndesmosis injury were randomized to use screws or TighRope® Knotless. Syndesmosis reduction was assessed using bilateral CT potsoperatively. Outcomes were clinically and radiologically assessed at three, six, and twelve months after surgery. Results: No significant differences were identified in the AOFAS Scale between groups at three months (83.1 vs. 81.80; P=1.03), nor at six (88.27 vs. 88; P=.26) or at twelve (93.03 vs. 92.10; P=,93). There were also no differences in Olerud-Molander scale at three (65 vs. 61.50; P=3.5), six (82.33 vs. 80.67; P=1.67) and twelve months (92.67 vs. 90; P=2.67). Likewise, there were no differences in rate of postoperative malreduction (no cases in both groups), loss of reduction (three cases in screw group vs. four in TighRope® Knotless group, P=.54) or complications (P=1). Conclusions: Treatment of acute syndesmosis injuries with screws or the TighRope® Knotless implant is similar in both clinical and radiological results.(AU)
Assuntos
Humanos , Parafusos Ósseos , Articulação do Tornozelo , Traumatismos do Tornozelo/tratamento farmacológico , Fraturas do Tornozelo , Tornozelo/cirurgia , Ferimentos e Lesões , Traumatologia , Ortopedia , Cirurgia GeralRESUMO
Antecedentes y objetivo: Clásicamente el tratamiento de las lesiones agudas de la sindesmosis se ha realizado mediante tornillos. Hace unos años aparecieron implantes más flexibles que han evolucionado hasta el moderno TighRope® Knotless. El objetivo del presente estudio es comparar los resultados de ambos implantes. Material y métodos: Desde abril de 2019 hasta septiembre de 2020 reclutamos 68 pacientes diagnosticados de lesión aguda de la sindesmosis que fueron aleatorizados para tratamiento quirúrgico con tornillo o con TighRope® Knotless. Realizamos control posquirúrgico con tomografía axial computarizada, y a los 3, 6 y 12 meses se recogieron datos del rango articular, valores de escalas funcionales y se realizaron estudios de radiología simple. Resultados: Los pacientes tratados con tornillos no presentaban diferencias estadísticamente significativas en la escala AOFAS frente al grupo tratado con TighRope® Knotless a los 3 meses (83,1 vs. 81,80; p=1,03), ni a los 6 meses (88,27 vs. 88; p=0,26) ni a los 12 meses (93,03 vs. 92,10; p=0,93). Igualmente recogimos resultados similares en la escala de Olerud-Molander a los 3 meses (65 vs. 61,50; p=3,5), 6 meses (82,33 vs. 80,67; p=1,67) y 12 meses (92,67 vs. 90; p=2,67). Tampoco hubo diferencias en la tasa de malreducción posquirúrgica (ningún caso en ambos grupos), pérdida de reducción (3 en el grupo tratado con tornillo frente a 4 del grupo del TighRope® Knotless, p=0,54) o complicaciones (p=1). Conclusiones: El tratamiento de las lesiones agudas de la sindesmosis con tornillos o con TighRope® Knotless es similar tanto en resultados clínicos como radiológicos.(AU)
Background and aim: Classically acute syndesmosis injuries have been treated using screws. A few years ago more flexible implants appeared evolving to current TighRope® Knotless. The primary aim of this study is to compare clinical and radiographic outcome of both implants. Material and methods: From April 2019 to September 2020 68 patients diagnosed with acute syndesmosis injury were randomized to use screws or TighRope® Knotless. Syndesmosis reduction was assessed using bilateral CT potsoperatively. Outcomes were clinically and radiologically assessed at three, six, and twelve months after surgery. Results: No significant differences were identified in the AOFAS Scale between groups at three months (83.1 vs. 81.80; P=1.03), nor at six (88.27 vs. 88; P=.26) or at twelve (93.03 vs. 92.10; P=,93). There were also no differences in Olerud-Molander scale at three (65 vs. 61.50; P=3.5), six (82.33 vs. 80.67; P=1.67) and twelve months (92.67 vs. 90; P=2.67). Likewise, there were no differences in rate of postoperative malreduction (no cases in both groups), loss of reduction (three cases in screw group vs. four in TighRope® Knotless group, P=.54) or complications (P=1). Conclusions: Treatment of acute syndesmosis injuries with screws or the TighRope® Knotless implant is similar in both clinical and radiological results.(AU)
Assuntos
Humanos , Parafusos Ósseos , Articulação do Tornozelo , Traumatismos do Tornozelo/tratamento farmacológico , Fraturas do Tornozelo , Tornozelo/cirurgia , Ferimentos e Lesões , Traumatologia , Ortopedia , Cirurgia GeralRESUMO
BACKGROUND AND AIM: Classically acute syndesmosis injuries have been treated using screws. A few years ago more flexible implants appeared evolving to current TighRope® Knotless. The primary aim of this study is to compare clinical and radiographic outcome of both implants. MATERIAL AND METHODS: From April 2019 to September 2020 68 patients diagnosed with acute syndesmosis injury were randomised to use screws or TighRope® Knotless. Syndesmosis reduction was assessed using bilateral CT potsoperatively. Outcomes were clinically and radiologically assessed at three, six, and twelve months after surgery. RESULTS: No significant differences were identified in the AOFAS Scale between groups at three months (83.1 vs. 81.80; P=1.03), nor at six (88.27 vs. 88; P=.26) or at twelve (93.03 vs. 92.10; P=.93). There were also no differences in Olerud-Molander scale at three (65 vs. 61.50; P=3.5), six (82.33 vs. 80.67; P=1.67) and twelve months (92.67 vs. 90; P=2.67). Likewise, there were no differences in rate of postoperative malreduction (no cases in both groups), loss of reduction (three cases in screw group vs. four in TighRope® Knotless group, P=.54) or complications (P=1). CONCLUSIONS: Treatment of acute syndesmosis injuries with screws or the TighRope® Knotless implant is similar in both clinical and radiological results.
RESUMO
BACKGROUND AND AIM: Classically acute syndesmosis injuries have been treated using screws. A few years ago more flexible implants appeared evolving to current TighRope® Knotless. The primary aim of this study is to compare clinical and radiographic outcome of both implants. MATERIAL AND METHODS: From April 2019 to September 2020 68 patients diagnosed with acute syndesmosis injury were randomized to use screws or TighRope® Knotless. Syndesmosis reduction was assessed using bilateral CT potsoperatively. Outcomes were clinically and radiologically assessed at three, six, and twelve months after surgery. RESULTS: No significant differences were identified in the AOFAS Scale between groups at three months (83.1 vs. 81.80; P=1.03), nor at six (88.27 vs. 88; P=.26) or at twelve (93.03 vs. 92.10; P=,93). There were also no differences in Olerud-Molander scale at three (65 vs. 61.50; P=3.5), six (82.33 vs. 80.67; P=1.67) and twelve months (92.67 vs. 90; P=2.67). Likewise, there were no differences in rate of postoperative malreduction (no cases in both groups), loss of reduction (three cases in screw group vs. four in TighRope® Knotless group, P=.54) or complications (P=1). CONCLUSIONS: Treatment of acute syndesmosis injuries with screws or the TighRope® Knotless implant is similar in both clinical and radiological results.
RESUMO
Objetivos. La rotura distal del tendón del bíceps braquial es una lesión poco frecuente. El objetivo de nuestro estudio es evaluar los resultados de las roturas distales de dicho tendón, intervenido quirúrgicamente por vía anterior entre noviembre de 1998 y diciembre de 2003. Material y método. Estudio retrospectivo con 12 pacientes y 13 lesiones, con un seguimiento medio de 37 meses (12-60). La edad media fue de 37,6 años, y todos los pacientes eran del sexo masculino. Todas las lesiones se localizaron en el brazo dominante, excepto un caso de rotura bilateral. Todos fueron intervenidos a través de un abordaje anterior. Diez lesiones (76,9%) se suturaron con arpones, dos (15,4%) con túneles óseos y una (7,7%) se suturó con un anclaje con endobutton. Todos los pacientes, excepto uno, fueron inmovilizados con una férula de escayola braquioantebraquial posterior durante las dos primeras semanas postoperatorias. En cinco pacientes se continuó con esta inmovilización y en seis se sustituyó por una ortesis articulada. Resultados. Se evaluaron los parámetros de: movilidad, fuerza, dolor y satisfacción personal. Todos los pacientes presentaron una movilidad completa. Once pacientes (91,6%) recuperaron la fuerza totalmente. Como complicaciones se encontró una paresia transitoria del nervio radial. La satisfacción personal fue excelente en once pacientes (91,6%) y buena en un paciente (8,4%). No existió ninguna nueva re-ruptura. Conclusiones. Los resultados clínicos y funcionales han sido en la mayoría de los pacientes excelentes, por lo que se recomienda la sutura con arpones por vía anterior (AU)
Purpose. Distal ruptures of the brachial biceps tendon are an infrequent injury. The purpose of this paper is to assess the outcome of distal ruptures of the tendon addressed surgically through an anterior approach between November 1998 and December 2003. Materials and methods. Retrospective study of 12 patients and 13 injuries with a mean follow-up of 37 months (range: 12-60). Mean age was 37.6 years and all patients were male. All injuries were located in the dominant arm, except for one case in which the rupture was bilateral. All were operated with an anterior approach. In ten injuries (76.9%) harpoon sutures were used, in two (15.4%) bone tunnels and in one instance (7.7%) an endobutton anchor. All patients but one were immobilized with a brachioantebrachial plaster splint during the first two weeks post-op. In five patients, this immobilization was continued, whereas in four it was replaced by an articulated brace. Results. Range of movement, strength, pain and personal satisfaction were the parameters assessed. All patients had full mobility. Eleven patients (91.6%) recovered their full strength. As far as complications are concerned, we had a transient radial nerve palsy. Personal satisfaction was excellent in eleven patients (91.6%) and good in one (8.4%). There was no re-rupture. Conclusions. Our clinical and functional results are excellent, for which reason we recommend harpoon suturing with an anterior approach (AU)
