Ding Wenge, Yan Weihong, Zhu Yaping, Liu Zhiwei
Department of Orthopaedic Surgery, 3rd Affiliated Hospital of Suzhou University, People's Republic of China.
Ulus Travma Acil Cerrahi Derg. 2012 Sep;18(5):405-10. doi: 10.5505/tjtes.2012.59376.
Achilles tendon rupture is a common injury, and its complications can impair function. Numerous operations have been described for reconstructing the ruptured tendon, but these methods can compromise microcirculation in the tendon and can seriously impair its healing. Suturing with a minimally invasive tenocutaneous technique soon after the rupture and systematic functional exercise can greatly reduce the possibility of complications.
Between June 1996 and February 2009, we treated 88 patients (54 males; age range, 21-66 years) with this method.
After follow-up ranging from 1-7 years, the mean American Orthopedic Foot and Ankle Society ankle-hind foot score was 95 (range, 90-98), and the maximum length of postoperative scarring was 3 cm. One patient re-ruptured his Achilles tendon one year after surgery in an accident, but after 10 months, the repaired tendon was still intact. In another patient, the nervus suralis was damaged during surgery by piercing the tension suture at the near end, causing postoperative numbness and swelling. The tension suture was quickly removed, and the patient recovered well with conservative treatment. No large irregular scars, such as those sustained during immobilization, were present over the Achilles tendon.
Minimally invasive percutaneous suturing can restore the original length and continuity of the Achilles tendon, is minimally invasive, and has fewer postoperative complications than other methods.
跟腱断裂是一种常见损伤，其并发症会损害功能。已有多种用于重建断裂跟腱的手术方法，但这些方法可能会损害跟腱的微循环并严重影响其愈合。在断裂后尽早采用微创经皮技术缝合并进行系统的功能锻炼可大大降低并发症的可能性。
1996年6月至2009年2月期间，我们用这种方法治疗了88例患者（54例男性；年龄范围21 - 66岁）。
随访1至7年后，美国矫形足踝协会踝 - 后足平均评分为95分（范围90 - 98分），术后瘢痕最大长度为3厘米。1例患者术后1年在一次意外中跟腱再次断裂，但10个月后，修复的跟腱仍完好无损。另1例患者在手术中因近端张力缝合针穿刺损伤腓肠神经，导致术后麻木和肿胀。张力缝合针很快被取出，经保守治疗患者恢复良好。跟腱部位未出现如固定期间产生的那种大的不规则瘢痕。
微创经皮缝合可恢复跟腱的原始长度和连续性，具有微创性，且术后并发症比其他方法少。
