Teknik Rekonstruksi Turndown Flap Tendon Achilles dan Flap Fasiokutan Sural pada Ruptur Tendon Achilles yang Disertai Kerusakan Masif Jaringan Lunak: Laporan Kasus

Main Authors: Rasyid, Hermawan Nagar, Primadhi, Andri, Prasetia, Renaldi
Format: Article info application/pdf eJournal
Language: eng
Published: Faculty of Medicine, Universitas Padjadjaran , 2016
Online Access: http://journal.fk.unpad.ac.id/index.php/mkb/article/view/737
http://journal.fk.unpad.ac.id/index.php/mkb/article/view/737/pdf
ctrlnum article-737
fullrecord <?xml version="1.0"?> <dc schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"><title lang="en-US">Teknik Rekonstruksi Turndown Flap Tendon Achilles dan Flap Fasiokutan Sural pada Ruptur Tendon Achilles yang Disertai Kerusakan Masif Jaringan Lunak: Laporan Kasus</title><creator>Rasyid, Hermawan Nagar</creator><creator>Primadhi, Andri</creator><creator>Prasetia, Renaldi</creator><subject lang="en-US"/><subject lang="en-US"/><description lang="en-US">Ruptur tendon achilles adalah cedera yang paling sering terjadi pada tendon ekstremitas bawah, meskipun merupakan tendon yang terbesar dan terkuat. Penelitian ini bertujuan menjelaskan teknik operasi dengan modifikasi augmentation pada penatalaksanaan ruptur tendon Achilles yang disertai kerusakan pada jaringan lunak yang luas. Kasus pada penelitian ini adalah seorang pasien (usia 30 tahun) dengan ruptur terbuka tendon Achilles akut dan terinfeksi, serta hilangnya tendon sampai dengan 5 cm, kecacatan tendon yang tidak menempel di bagian distal dan hilangnya sebagian tulang calcaneus. Kerusakan kulit diukur setelah dilakukan debridemen dengan rentan antara 8 cmx5 cm sampai dengan 15 cmx10 cm. Ruptur pada tendon dijahit dengan gastrosoleus turn down flap ke tulang calcaneus. Reverse sural artery digunakan untuk menutupi kulit. Flap yang dibuat berhasil hidup. Pasien dapat berjalan normal, dapat berdiri dengan ujung kaki, fleksi plantar yang aktif, dan dapat kembali beraktivitas dalam 2 bulan setelah operasi. Pasien memiliki rentang gerak penuh ke segala arah. Simpulan, debridemen, rekonstruksi tendon dalam satu tahap, dan reverse flow sural artery flap memberikan hasil yang memuaskan pada kasus robekan luas tendon Achilles dan kerusakan jaringan lunak yang luas. [MKB. 2016;48(1):58&#x2013;62]Kata kunci: Gastrosoleus turn down flap, ruptur, sural artery flap, tendon Achilles&#xA0;Achilles Tendon Turndown Flap Reconstruction and Fasciocutanous Sural Flap in Severe Tendon Achilles Loss with Massive Tissue Defect: a Case ReportAbstractAchilles tendon rupture is the most common ruptur of tendon in the lower limb despite being one of the toughest tendons. This rupture presents a complex problem to the treating surgeon especially if it is associated with tendon and soft tissue loss. The case in this study is one patient (male, age 30-year old) with a spectrum of acute and infected open tendon-achilles rupture that includes loss of tendon of up to 5 cm, tendon defect with no distal attachment, and partial loss of the calcaneum. The skin defect measured after debridement ranged from 8 x 5 cm to 15 x 10 cm. The ruptured tendon was sutured using gastrocnemius-soleus turn down flap technic to calcaneus bone. A reverse sural artery was used to provide soft tissue cover. The flap survived. The patient had normal gait, were able to stand on tip toes, had active plantar flexion, and had returned to his original occupation 2 months after reconstruction. He had full range of movement at the ankle. Augmented repair of Achilles tendon rupture with large soft tissue defect using gastrocnemius- soleus turn down flap and sural artery flap are stable enough to allow early weight-bearing with favorable clinical result for this patient. Conclusions is single stage tendon reconstruction and reverse flow sural artery flap give good functional outcome in complex Achilles tendon rupture with tendon and soft tissue loss. [MKB. 2016;48(1):58&#x2013;62] Key words: Achilles tendon, gastrocnemius-soleus turn down flap, rupture, sural artery flap&#xA0;DOI: 10.15395/mkb.v48n1.737</description><publisher lang="en-US">Faculty of Medicine, Universitas Padjadjaran</publisher><contributor lang="en-US"/><date>2016-03-31</date><type>Journal:Article</type><type>Other:info:eu-repo/semantics/publishedVersion</type><type>Other:</type><type>Other:</type><type>File:application/pdf</type><identifier>http://journal.fk.unpad.ac.id/index.php/mkb/article/view/737</identifier><source lang="en-US">Majalah Kedokteran Bandung; Vol 48, No 1 (2016); 58-62</source><source lang="id-ID">Majalah Kedokteran Bandung; Vol 48, No 1 (2016); 58-62</source><source>2338-6223</source><source>0126-074x</source><language>eng</language><relation>http://journal.fk.unpad.ac.id/index.php/mkb/article/view/737/pdf</relation><rights lang="en-US">Copyright (c) 2016 Majalah Kedokteran Bandung</rights><recordID>article-737</recordID></dc>
language eng
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author Rasyid, Hermawan Nagar
Primadhi, Andri
Prasetia, Renaldi
title Teknik Rekonstruksi Turndown Flap Tendon Achilles dan Flap Fasiokutan Sural pada Ruptur Tendon Achilles yang Disertai Kerusakan Masif Jaringan Lunak: Laporan Kasus
publisher Faculty of Medicine, Universitas Padjadjaran
publishDate 2016
url http://journal.fk.unpad.ac.id/index.php/mkb/article/view/737
http://journal.fk.unpad.ac.id/index.php/mkb/article/view/737/pdf
contents Ruptur tendon achilles adalah cedera yang paling sering terjadi pada tendon ekstremitas bawah, meskipun merupakan tendon yang terbesar dan terkuat. Penelitian ini bertujuan menjelaskan teknik operasi dengan modifikasi augmentation pada penatalaksanaan ruptur tendon Achilles yang disertai kerusakan pada jaringan lunak yang luas. Kasus pada penelitian ini adalah seorang pasien (usia 30 tahun) dengan ruptur terbuka tendon Achilles akut dan terinfeksi, serta hilangnya tendon sampai dengan 5 cm, kecacatan tendon yang tidak menempel di bagian distal dan hilangnya sebagian tulang calcaneus. Kerusakan kulit diukur setelah dilakukan debridemen dengan rentan antara 8 cmx5 cm sampai dengan 15 cmx10 cm. Ruptur pada tendon dijahit dengan gastrosoleus turn down flap ke tulang calcaneus. Reverse sural artery digunakan untuk menutupi kulit. Flap yang dibuat berhasil hidup. Pasien dapat berjalan normal, dapat berdiri dengan ujung kaki, fleksi plantar yang aktif, dan dapat kembali beraktivitas dalam 2 bulan setelah operasi. Pasien memiliki rentang gerak penuh ke segala arah. Simpulan, debridemen, rekonstruksi tendon dalam satu tahap, dan reverse flow sural artery flap memberikan hasil yang memuaskan pada kasus robekan luas tendon Achilles dan kerusakan jaringan lunak yang luas. [MKB. 2016;48(1):58–62]Kata kunci: Gastrosoleus turn down flap, ruptur, sural artery flap, tendon Achilles Achilles Tendon Turndown Flap Reconstruction and Fasciocutanous Sural Flap in Severe Tendon Achilles Loss with Massive Tissue Defect: a Case ReportAbstractAchilles tendon rupture is the most common ruptur of tendon in the lower limb despite being one of the toughest tendons. This rupture presents a complex problem to the treating surgeon especially if it is associated with tendon and soft tissue loss. The case in this study is one patient (male, age 30-year old) with a spectrum of acute and infected open tendon-achilles rupture that includes loss of tendon of up to 5 cm, tendon defect with no distal attachment, and partial loss of the calcaneum. The skin defect measured after debridement ranged from 8 x 5 cm to 15 x 10 cm. The ruptured tendon was sutured using gastrocnemius-soleus turn down flap technic to calcaneus bone. A reverse sural artery was used to provide soft tissue cover. The flap survived. The patient had normal gait, were able to stand on tip toes, had active plantar flexion, and had returned to his original occupation 2 months after reconstruction. He had full range of movement at the ankle. Augmented repair of Achilles tendon rupture with large soft tissue defect using gastrocnemius- soleus turn down flap and sural artery flap are stable enough to allow early weight-bearing with favorable clinical result for this patient. Conclusions is single stage tendon reconstruction and reverse flow sural artery flap give good functional outcome in complex Achilles tendon rupture with tendon and soft tissue loss. [MKB. 2016;48(1):58–62] Key words: Achilles tendon, gastrocnemius-soleus turn down flap, rupture, sural artery flap DOI: 10.15395/mkb.v48n1.737
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