Roturas del tendón de Aquiles operadas con técnica percutánea: resultados quirúrgicos y complicaciones posoperatorias. [Achilles tendon ruptures operated on with percutaneous technique: surgical results and post-operative complications.]

Francisco Javier Sanchez Villanueva, Hernan Hoffmann Heise, Carlos Bustamante San Martin

Resumen


Introducción

Las roturas del tendón de Aquiles han presentado un alza considerable en los últimos años. El tratamiento de estas lesiones puede ser conservador o quirúrgico. A pesar de la amplia literatura, no existe un gold standard en el tratamiento de estas lesiones. Las opciones quirúrgicas incluyen la cirugía abierta, mini-open y técnica percutánea.

El objetivo de nuestro trabajo es caracterizar la presentación clínica y mostrar resultados quirúrgicos y complicaciones en pacientes con rotura de tendón de Aquiles tratados en forma quirúrgica con técnica percutánea.

Materiales y métodos

Se realizó un estudio descriptivo retrospectivo. Se incluyeron  pacientes adultos tratados en la Clínica Universitaria de Puerto Montt y se obtuvieron datos clínicos y epidemiológicos. Todos los pacientes fueron operados con técnica percutánea con raquetas de Dresden.

Resultados

Se obtuvieron 60 pacientes. Todos presentaron dolor, asociado a signo de Thompson y gap palpable en el 92% de los casos. En 7 pacientes (12%) se solicitaron imágenes complementarias. El tiempo promedio de espera hasta la cirugía fue 4,28 días. 7 pacientes presentaron complicaciones post operatorias, todas ellas menores.

Discusión

Las roturas del tendón de Aquiles va en alza debido a población activa de mayor edad y a deportistas de fin de semana.  El diagnóstico es clínico, sin embargo, algunos pacientes pueden requerir imágenes complementarias para el diagnóstico. La evidencia nos demuestra que el tratamiento quirúrgico es superior al tratamiento conservador clásico. En comparación con la técnica abierta, la técnica percutánea presenta mejores resultados estéticos y menos complicaciones.

 

Abstract


Introduction: Achilles tendon ruptures have increased considerably in recent years. Treatment of these lesions can be either conservative or surgical. Despite extensive literature, no gold standard exists. Surgical options include open surgery, mini-open surgery and percutaneous technique. The objective of this study was to characterize the clinical presentation and to report surgical results and complications in patients with ruptured Achilles tendon treated surgically with percutaneous technique.

Methods: A retrospective descriptive study was carried out. Adult patients were included, and clinical and epidemiological data were obtained. All patients were operated on with percutaneous technique using the Dresden Instrument.


Results: Sixty patients were enrolled. All presented pain, and 92% had also associated Thompson’s sign and palpable gap. Complementary images were requested in 7 patients (12%). Average time until surgery was 4.28 days. Seven patients presented minor post-operative complications.


Conclusions: Achilles tendon ruptures are a prevalent pathology in older active population and weekend athletes. Diagnosis is mostly clinical; however, some patients may require complementary images for diagnosis. Strong evidence in the literature suggests that surgical treatment is superior to the classic conservative treatment. In comparison with open surgery, percutaneous technique has shown better aesthetic results and fewer complications.


Palabras clave


Tendón de Aquiles; técnica percutánea; complicaciones quirúrgicas. Achilles tendon; percutaneous technique; surgical complications.

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Referencias


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DOI: http://dx.doi.org/10.15417/issn.1852-7434.2018.83.2.796

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URL de la licencia: http://creativecommons.org/licenses/by-nc-sa/4.0/deed.es

Registro de la Propiedad Intelectual Nº 5353562 (en línea).

ISSN 1852-7434 (en línea).

Esta Revista está bajo una Licencia Creative Commons Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional. (CC-BY-NC-SA 4.0)