Results of percutaneous repair of Achilles tendon rupture at Traumatology department of University hospital "Sisters of charity"

Abstract

Uvod: Ahilova tetiva, najsnažnija tetiva u ljudskom tijelu podložna je ozljedama te u modernim vremenima, kad popularnost rekreativnog bavljenja sportom intenzivno raste, ruptura Ahilove tetive postaje jedan od učestalijih medicinskih problema današnjeg društva. Glavni cilj ovog istraživanja je utvrditi rezultate liječenja rupture Ahilove tetive perkutanom metodom na Klinici za traumatologiju KBC-a „Sestre milosrdnice“ u usporedbi s otvorenom metodom te s rezultatima svjetskih i regionalnih zdravstvenih ustanova. Ispitanici i metode: Provedeno je retrospektivno istraživanje koje je uključivalo ukupno 316 ispitanika koji su podvrgnuti operacijskom liječenju rupture Ahilove tetive u razdoblju od 2013. do 2021. Pretraživanjem arhive iz povijesti bolesti su dobiveni podatci o vrsti operativnog zahvata, mehanizmu ozljede, dobi i spolu ispitanika, vremenu hospitalizacije i o mogućim komplikacijama operacijskog liječenja (infekcije, rerupture, ozljeda suralnog živca). Svi su podatci uneseni u tablicu programa Excel gdje se izvela jednostavna statistička obrada, a za složeniju statističku obradu je korišten program MedCalc za procjenu uspjeha perkutane metode. Istraživanje je u potpunosti provedeno na Klinici za traumatologiju KBC-a „Sestre milosrdnice“. Rezultati: Kao glavne mjere ishoda uzete su komplikacije operativnog liječenja te broj dana hospitalizacije. Utvrđeno je kako nije pronađena statistički značajna razlika u prednostima jedne nad drugom metodom po pitanju ozljede suralnog živca (p=1). Postoji statistički značajna prednost perkutane metode gledajući broj infekcija (χ2=0,8; P=0,005). Medijan dana hospitalizacije za 4 dana je veći kod otvorenog pristupa nego kod perkutanog (Z=14,2;P<0,001). Zbog malenog apsolutnog broja ispitanika s rerupturama kao i premalog omjera ispitanika s rerupturom u odnosu na veličinu promatrane populacije se ne može ustanoviti statistički značajna prednost perkutane metode. Zaključak: Rezultati perkutane metode za liječenje rupture Ahilove tetive na Klinike za traumatologiju KBC-a „Sestre milosrdnice“ su jednaki ili bolji u usporedbi s rezultatima regionalnih i svjetskih zdravstvenih ustanova, a perkutana metoda se preporučuje kao metoda izbora u liječenju zbog manjeg broja komplikacija.Introduction: The Achilles tendon, the strongest tendon in the human body, is prone to injury and in modern times, when the popularity of recreational sports is growing rapidly, Achilles tendon rupture is becoming one of the most common medical problems in modern society. The main goal of this study is to determine the results of treatment of Achilles tendon rupture by percutaneous method at the Traumatology department of University hospital "Sisters of charity" in comparison with the open method and the results of global and regional health institutions. Subjects and Methods: A retrospective study was conducted involving a total of 316 subjects who underwent surgical treatment for Achilles tendon rupture between 2013 and 2021. Data obtained from medical history of these patients included type of surgical procedure, mechanism of injury, age and sex of the subjects, time of hospitalization and possible complications of surgical treatment (infections, reruptures, sural nerve injuries). All data was put into an Excel spreadsheet where simple statistical processing was performed, and for more complex statistical processing, MedCalc was used to assess the success of the percutaneous method. The research was conducted entirely at the Traumatology department of University hospital "Sisters of charity". Results: Complications of surgical treatment and the number of days of hospitalization were taken as the main outcome measures. It was found that no statistically significant difference was found in one surgical procedure over the other in terms of sural nerve injury (p=1). There is a statistically significant advantage of the percutaneous method when looking the number of infections (χ2 = 0.8; P = 0.005). The median of days spent in hospital was 4 days higher in the open approach than in the percutaneous approach (Z = 14.2; P <0.001). Due to the small absolute number of subjects with reruptures as well as the insufficient ratio of subjects with reruptures in relation to the size of the observed population, a statistically significant advantage of the percutaneous method cannot be established. Conclusion: The results of the percutaneous method for the treatment of Achilles tendon rupture at the Traumatology department of University hospital "Sisters of charity" are equal or better compared to the results of regional and global health institutions, and the percutaneous method is recommended as the method of choice due to fewer complications