De quervain tenosinovitinde endoskopik yardımlı tek portal birinci Ekstensor kompartman gevşetme
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Tarih
2022
Yazarlar
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dergipark
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç Dequervain tenosinovitinde konservatif yöntemler fayda sağlamadığında cerrahi tedaviler uygulanmaktadır. Tekniklerin ilerlemesiyle geleneksel açık cerrahiler yerini endoskopik yöntemlere bırakmaktadır. Amacımız tek portal üzerinden endoskop yardımıyla uygulanan birinci ekstansor kompartman gevşetme uygulanan hastalarımızın sonuçlarını sunmaktır. Gereç ve Yöntem Aynı cerrah tarafından 2019-2021 tarihleri arasında De Quervain tenosinoviti nedeniyle konservatif yöntemlerden fayda görmeyen 8 hastaya endoskopik 13 hastaya ise geleneksel açık yöntemle birinci ekstensor kompartman gevşetme uygulanmıştır. Hastaların demografik özellikleri, ameliyat öncesinde ve sonrası 2. hafta 6. hafta ve 12. haftalarda VAS, qDASH skorları ve kavrama güçleri retrospektif olarak elde edildi. Ek olarak 12. Haftada insizyon skarlarının uzunluğu ölçüldü ve hastalar tarafından kozmetik olarak yara yerleri puanlandırılarak (1 en kötü, 5 en iyi olacak şekilde) veriler kaydedildi. Sonuçlar Çalışmada toplam 17 kadın 4 erkek hasta olmak üzere toplam 21 hasta değerlendirilmiştir. Şikayet başlangıcından ameliyata kadar geçen süre 82 gün olarak saptanmış ve gruplar arasında anlamlı fark saptanmamıştır (p>0,05). Her iki grupta da hastaların ameliyat öncesi VAS, qDASH ve güç ölçümlerinde farklılık gözlenmemiştir. Endoskopik gevşetme uygulanan grupta ameliyat sonrası 2. haftadaki VAS skorlarının anlamlı olarak daha düşük olduğu görülmüş ancak sonraki takiplerde VAS ve qDASH skorları ve kas gücü değerlendirmelerinde fark saptanmamıştır (p=0,001). Skar boyutunun endoskopik grupta anlamlı derecede daha az olduğu ve hasta skar memnuniyetlerinin de yüksek olduğu görülmüştür (p=0,001). Sonuç De Quervain tenosinovitinin cerrahi tedavisinde birinci ekstensor kompartman gevşetmenin endoskop yardımıyla yapılması erken dönemde daha düşük VAS skoru ve kozmetik açıdan daha iyi sonuçlar sağlamaktadır. Anahtar Kelimeler: Endoskopik, De Quervain, Tenosinovit, El bileği, Minimal invaziv
Introduction In De Quervain's tenosynovitis, surgical treatments are performed when conservative methods are not succeeded. With the advancement of techniques, traditional open surgeries are being replaced by endoscopic methods. Our aim is to present the results of our patients who underwent single portal endoscopic first extensor compartment release. Materials and Methods The same surgeon performed endoscopic first extensor compartment release to 8 and traditional open surgery on 13 patients who did not benefit from conservative management due to De Quervain tenosynovitis between 2019-2021. Retrospectively, demographic characteristics of the patients, Visual Analog Scale (VAS), quick Disabilities of the Arm, Shoulder, and Hand (qDASH) scores and grip strength were obtained preoperatively at the 2nd, 6th, and 12th week postoperatively. In addition, at the 12th week, the length of the incision scars was measured, and the patients scored the cosmetic scars (1 as the worst, 5 as the best). Results A total of 21 patients, 17 female and 4 male patients, were evaluated in the study. The mean time from the onset of the complaint to the surgery was 82 days, and no significant difference was found between the groups (p>0.05). There was no difference in the patient's preoperative VAS, qDASH and strength measurements in both groups. It was observed that the VAS scores at the 2nd week postoperatively were significantly lower in the endoscopic release group, but no difference was found in the VAS and qDASH scores and muscle strength evaluations in the subsequent follow-ups (p=0.001). It was observed that the scar size was significantly less in the endoscopic group and the patient's scar satisfaction was also high (p=0,001). Conclusion In the surgical treatment of De Quervain's tenosynovitis, the first extensor compartment release with an endoscope provides a lower VAS score and better cosmetic results in the early period.
Introduction In De Quervain's tenosynovitis, surgical treatments are performed when conservative methods are not succeeded. With the advancement of techniques, traditional open surgeries are being replaced by endoscopic methods. Our aim is to present the results of our patients who underwent single portal endoscopic first extensor compartment release. Materials and Methods The same surgeon performed endoscopic first extensor compartment release to 8 and traditional open surgery on 13 patients who did not benefit from conservative management due to De Quervain tenosynovitis between 2019-2021. Retrospectively, demographic characteristics of the patients, Visual Analog Scale (VAS), quick Disabilities of the Arm, Shoulder, and Hand (qDASH) scores and grip strength were obtained preoperatively at the 2nd, 6th, and 12th week postoperatively. In addition, at the 12th week, the length of the incision scars was measured, and the patients scored the cosmetic scars (1 as the worst, 5 as the best). Results A total of 21 patients, 17 female and 4 male patients, were evaluated in the study. The mean time from the onset of the complaint to the surgery was 82 days, and no significant difference was found between the groups (p>0.05). There was no difference in the patient's preoperative VAS, qDASH and strength measurements in both groups. It was observed that the VAS scores at the 2nd week postoperatively were significantly lower in the endoscopic release group, but no difference was found in the VAS and qDASH scores and muscle strength evaluations in the subsequent follow-ups (p=0.001). It was observed that the scar size was significantly less in the endoscopic group and the patient's scar satisfaction was also high (p=0,001). Conclusion In the surgical treatment of De Quervain's tenosynovitis, the first extensor compartment release with an endoscope provides a lower VAS score and better cosmetic results in the early period.
Açıklama
Anahtar Kelimeler
Dequervain, El Bileği, Endoskopik, Cerrahi, Stenozan, Tenosinovit
Kaynak
Sakarya Medical Journal
WoS Q Değeri
Scopus Q Değeri
Cilt
12
Sayı
3
Künye
TURAN, K. De Quervain Tenosinovitinde Endoskopik Yardımlı Tek Portal Birinci Ekstensor Kompartman Gevşetme. Sakarya Tıp Dergisi, 12(3), 468-473.
