Li Chunjiang, Feng Xiaona, Li Wenhong
Department of Emergency, Tangshan No.2 Hospital, Orthopedic Hospital Affiliated to North China Coal Medical College, Tangshan Hebei, P.R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Jan;25(1):47-9.
To summarize the clinical application and experience of repairing acute avulsion-type achilles tendon rupture by locking-loop stereoscopic suture.
Between January 2006 and June 2010, 41 cases of acute avulsion-type achilles tendon rupture were treated by locking-loop stereoscopic suture. Among 41 patients, 33 were male and 8 were female with an average age of 41 years (range, 18-56 years); the locations were left side in 27 cases and right side in 14 cases. There was palpable defect in 33 cases, 7 cases underwent B-ultrasound, and 1 case underwent MRI to confirm the diagnosis. The time from injury to operation was 36 hours to 7 days. All cases were restored by locking-loop stereoscopic suture.
All incisions healed by first intention. Thirty-one cases were followed up 12 months to 3 years and 10 months with an average of 17 months. The muscle strength reached grade 5; the patients could walk normally, and the heel raising was powerful at 1 year after operation. The circumference difference between wrong leg and good leg was less than 3 cm, and the ankle dorsiflexion was 20-30 degrees, plantar flexion was 40-50 degrees. No re-rupture of achilles tendon or deep infection occurred during follow-up period. At last follow-up, according to evaluation of curative effects by Arner-Lindholm standard, the results were excellent in 21 cases and good in 10 cases with an excellent and good rate of 100%.
Locking-loop stereoscopic suturing is a safe and effective method with avulsion-type control ability, tensile strength, little effect on the blood supply of the achilles tendon for repairing acute avulsion-type achilles tendon rupture.
总结锁环立体缝合法修复急性撕脱型跟腱断裂的临床应用及经验。
2006年1月至2010年6月，采用锁环立体缝合法治疗41例急性撕脱型跟腱断裂患者。41例患者中，男33例，女8例，平均年龄41岁（18 - 56岁）；左侧27例，右侧14例。33例可触及缺损，7例行B超检查，1例行MRI检查以明确诊断。受伤至手术时间为36小时至7天。所有病例均采用锁环立体缝合法修复。
所有切口均一期愈合。31例患者随访12个月至3年10个月，平均17个月。术后1年肌力达5级，患者可正常行走，提踵有力。患侧与健侧小腿周径差小于3 cm，踝关节背伸20 - 30度，跖屈40 - 50度。随访期间未发生跟腱再断裂及深部感染。末次随访时，按Arner - Lindholm标准评定疗效，优21例，良10例，优良率100%。
锁环立体缝合法修复急性撕脱型跟腱断裂具有控制撕脱、抗张强度好、对跟腱血供影响小等优点，是一种安全有效的方法。
