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土耳其外科医生与国际外科医生在2区屈肌腱修复手术趋势方面的比较。

Comparison of surgical trends in zone 2 flexor tendon repair between Turkish and international surgeons.

作者信息

Unsal Seyyid Serif, Yildirim Tugrul, Armangil Mehmet

机构信息

Ankara University Faculty of Medicine, Department of Orthopedics and Traumatology, Department of Hand Surgery, Ankara, Turkey.

Ankara University Faculty of Medicine, Department of Orthopedics and Traumatology, Department of Hand Surgery, Ankara, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2019 Nov;53(6):474-477. doi: 10.1016/j.aott.2019.07.003. Epub 2019 Aug 6.

Abstract

OBJECTIVES

The aim of this study was to evaluate Turkish trends in zone 2 flexor repair with regards to surgical technique, suture materials, anesthesia and post-operative rehabilitation and compare this with international surgeons by modifying Gibson's survey.

METHODS

A printed and online survey consisting of 19 questions modified from Gibson's survey was sent to 590 Turkish and international surgeons. The surgeon's years in practice, province of practice, residency type, number of zone 2 flexor tendon repairs done in a year, preferred surgical technique, suture material, complications and postoperative protocols were asked to the respondents.

RESULTS

A total of 194 surgeons completed the survey (a 25% response rate). Of those who completed the survey, 91 were international (mostly from far eastern countries) and 103 were Turkish surgeons. Years in practice and educational background had influence on the decision-making. There were differences between the Turkish and international surgeons in the core and epitendinous suture thickness preference and flexor tendon sheath repair. There was a statistically significant relationship between the province of practice and the use of WALANT (Wide awake local anesthesia no tourniquet) (p < 0.05). While the majority of respondents who preferred postoperative early passive motion protocol were from Turkey (61.5%), the majority of respondents who preferred early active motion protocol were practicing abroad (73.9%).

CONCLUSION

Despite some variations the surgeons involved in this study follow to a large extent the current literature.

摘要

目的

本研究旨在评估土耳其在2区屈肌腱修复方面在手术技术、缝合材料、麻醉和术后康复方面的趋势,并通过修改吉布森调查与国际外科医生进行比较。

方法

向590名土耳其和国际外科医生发送了一份由吉布森调查修改而来的包含19个问题的纸质和在线调查问卷。向受访者询问了外科医生的执业年限、执业省份、住院医师类型、一年中进行的2区屈肌腱修复数量、首选手术技术、缝合材料、并发症和术后方案。

结果

共有194名外科医生完成了调查(回复率为25%)。在完成调查的人中,91名是国际医生(大多来自远东国家),103名是土耳其外科医生。执业年限和教育背景对决策有影响。土耳其和国际外科医生在核心和腱周缝合厚度偏好以及屈肌腱鞘修复方面存在差异。执业省份与清醒局部麻醉无止血带(WALANT)的使用之间存在统计学显著关系(p < 0.05)。虽然大多数倾向于术后早期被动活动方案的受访者来自土耳其(61.5%),但大多数倾向于早期主动活动方案的受访者在国外执业(73.9%)。

结论

尽管存在一些差异,但参与本研究的外科医生在很大程度上遵循了当前的文献。

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本文引用的文献

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Recent evolutions in flexor tendon repairs and rehabilitation.屈肌腱修复与康复的最新进展。
J Hand Surg Eur Vol. 2018 Jun;43(5):469-473. doi: 10.1177/1753193418773008. Epub 2018 Apr 24.
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Zone II Flexor Tendon Repairs in the United States: Trends in Current Management.美国二区屈肌腱修复:当前治疗趋势
J Hand Surg Am. 2017 Feb;42(2):e99-e108. doi: 10.1016/j.jhsa.2016.11.022. Epub 2016 Dec 10.
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Flexor tendon repairs: techniques, eponyms, and evidence.屈肌腱修复术:技术、命名及证据
J Hand Surg Am. 2014 Sep;39(9):1846-53. doi: 10.1016/j.jhsa.2014.06.025.
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Flexor tendon repair rehabilitation protocols: a systematic review.屈肌腱修复康复方案:一项系统综述
J Hand Surg Am. 2013 Sep;38(9):1712-7.e1-14. doi: 10.1016/j.jhsa.2013.06.025.
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Current practice of primary flexor tendon repair: a global view.当前原发性屈肌腱修复的实践:全球视角。
Hand Clin. 2013 May;29(2):179-89. doi: 10.1016/j.hcl.2013.02.003. Epub 2013 Apr 3.

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