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钢丝有限环内固定在早期跟腱断裂中的应用。

Application of internal fixation of steel-wire limited loop in early Achilles tendon rupture.

机构信息

Department of Orthopaedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, Zhejiang, China.

出版信息

Asian Pac J Trop Med. 2013 Nov;6(11):902-7. doi: 10.1016/S1995-7645(13)60161-3.

Abstract

OBJECTIVE

To explore the clinical effect and safety of internal fixation of steel-wire limited loop in early Achilles tendon rupture.

METHODS

Seventy-six patients respectively with early transected and avulsed types of Achilles tendon rupture were selected and treated with internal fixation of steel-wire limited loop. The patients began to take exercise for their lower limbs through continous passive motion as early as possible after surgical repair, and the loops were removed after 3-5 months. Six months later, the condition of complications including Achilles tendon re-rupture, wound fistula, wound infection and skin necrosis, cutaneous sensation in sural nerve dominance region, time back to preinjury work or learning as well as time to physical activities were observed. One year later, the therapeutic effect was evaluated, and the maximum circumferences of bilateral legs and ruptured plane circumferences of Achilles tendon were measured.

RESULTS

The wound of all patients healed well, no complications like Achilles tendon re-rupture, wound fistula, wound infection and skin necrosis occured, and the cutaneous sensation in sural nerve dominance region was normal. The mean time back to preinjury work or learning as well as to pysical activities of all patients were respectively 10 and 22 weeks. Seventy out of 76 patients (92.1%) achieved an excellent effect, and 6 (7.9%) good effect. The excellent and good rate came up to 100%. The maximum circumference in the affected leg decreased to 2 mm averagely compared with the offside, while the ruptured plane circumferences of Achilles tendon in the affected side increased to 2.2 mm compared with the offside.

CONCLUSIONS

For early Achilles tendon rupture, internal fixation of steel-wire limited loop can recover the ankle function better, return to the preinjury state in the shortest time, and has few complications.

摘要

目的

探讨钢丝有限环内固定治疗早期跟腱断裂的临床效果及安全性。

方法

选择 76 例不同类型的急性跟腱断裂患者,采用钢丝有限环内固定治疗。术后早期开始下肢连续被动运动,术后 3~5 个月取出环。术后 6 个月观察并发症,包括跟腱再断裂、切口窦道、感染、皮肤坏死、腓肠神经支配区皮肤感觉、重返术前工作或学习时间、恢复体育活动时间。术后 1 年评估疗效,测量双侧小腿最大周径和跟腱断裂平面周径。

结果

所有患者伤口均愈合良好,无跟腱再断裂、切口窦道、感染、皮肤坏死等并发症,腓肠神经支配区皮肤感觉正常。所有患者重返术前工作或学习时间和恢复体育活动时间分别为 10 周和 22 周。76 例患者中,优 70 例(92.1%),良 6 例(7.9%)。优良率为 100%。患侧小腿最大周径较健侧平均缩小 2mm,跟腱断裂平面周径较健侧增加 2.2mm。

结论

钢丝有限环内固定治疗早期跟腱断裂,可更好地恢复踝关节功能,使患者在最短时间内恢复到术前状态,并发症少。

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