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改良经皮缝合与传统开放缝合修复急性闭合性跟腱断裂的疗效比较

[Effectiveness comparison between modified percutaneous suture and conventional open suture in repairing acute closed achilles tendon rupture].

作者信息

Chu Haikun, Xu Yanbin, Chu Haipeng, Xu Yajun, Zhou Fengji, Yu Xin, Li Hui, Ji Xiaofeng

机构信息

Department of Orthopaedics, China and Japan Union Hospital of Jilin University, Changchun Jilin, 130000, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Jun;26(6):708-11.

Abstract

OBJECTIVE

To investigate the effectiveness of modified percutaneous suture in repairing acute closed Achilles tendon rupture by comparing with conventional open suture.

METHODS

Between January 2006 and October 2009, 50 patients with acute closed Achilles tendon rupture were treated with modified percutaneous suture by making 5 small incisions at both sides of Achilles tendon and zigzag suture (improved group, n=22) and with Kessler suture (conventional group, n=28), respectively. No significant difference was found in gender, age, time from injury to operation between 2 groups (P > 0.05).

RESULTS

In improved group, the patients achieved healing of incisions by first intention after operation and no complication occurred; however, incision infection occurred in 1 case, Achilles tendon re-rupture in 1 case, and incision scar contracture in 2 cases in conventional group. The operation time of improved group [(38.7 +/- 6.6) minutes] was significantly shorter (t=-12.29, P=0.00) than that of conventional group [(52.3 +/- 6.9) minutes]; the blood loss of improved group [(4.9 +/- 2.0) mL] was significantly less (t=-25.20, P=0.00) than that of conventional group [(40.7 +/- 7.1) mL]. The patients were followed up 2-3 years (mean, 29.9 months). The American Orthopaedic Foot and Ankle Society (AOFAS) score was 99.6 +/- 1.0 in improved group and was 98.4 +/- 3.0 in conventional group, showing no significant difference between 2 groups (t=1.66, P=0.10).

CONCLUSION

Comparison with conventional open suture, modified percutaneous suture has some advantages, such as easy operation, less complications, rapid recovery of limb function, and so on. Modified percutaneous suture is one of the best choices for the treatment of acute closed Achilles tendon rupture.

摘要

目的

通过与传统开放缝合进行比较,探讨改良经皮缝合修复急性闭合性跟腱断裂的有效性。

方法

2006年1月至2009年10月,50例急性闭合性跟腱断裂患者分别采用改良经皮缝合(改良组,n = 22),即在跟腱两侧做5个小切口并采用锯齿状缝合,以及Kessler缝合(传统组,n = 28)进行治疗。两组患者在性别、年龄、受伤至手术时间方面差异无统计学意义(P > 0.05)。

结果

改良组患者术后切口一期愈合,无并发症发生;传统组有1例发生切口感染,1例跟腱再次断裂,2例切口瘢痕挛缩。改良组手术时间为(38.7±6.6)分钟,明显短于传统组的(52.3±6.9)分钟(t = -1十二点二九,P = 0.00);改良组失血量为(4.9±2.0)毫升,明显少于传统组的(40.7±7.1)毫升(t = -25.20,P = 0.00)。对患者进行2至3年(平均29.9个月)的随访。改良组美国矫形足踝协会(AOFAS)评分为99.6±1.0,传统组为98.4±3.0,两组间差异无统计学意义(t = 1.66,P = 0.10)。

结论

与传统开放缝合相比,改良经皮缝合具有操作简便、并发症少、肢体功能恢复快等优点。改良经皮缝合是治疗急性闭合性跟腱断裂的最佳选择之一。

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