使用缝线引导装置评估可吸收和不可吸收缝线修复跟腱断裂的效果。
Evaluation of absorbable and nonabsorbable sutures for repair of achilles tendon rupture with a suture-guiding device.
作者信息
Kocaoglu Baris, Ulku Tekin Kerem, Gereli Arel, Karahan Mustafa, Turkmen Metin
机构信息
Acibadem University Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul, Turkey
Acibadem University Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul, Turkey.
出版信息
Foot Ankle Int. 2015 Jun;36(6):691-5. doi: 10.1177/1071100714568868. Epub 2015 May 4.
BACKGROUND
The purpose of this study was to compare the functional and clinical results of Achilles tendon repairs with an Achilles tendon suture-guiding device using nonabsorbable versus absorbable sutures. We hypothesized that the absorbable suture would have clinical results comparable to those of the nonabsorbable suture for Achilles tendon repair with an Achilles tendon suture-guiding system.
METHODS
From January 2010 to September 2013, 48 consecutive patients who had sustained a spontaneous rupture of the Achilles tendon underwent operative repair with an Achilles tendon suture-guiding device using 2 different suture types. All ruptures were acute. The patients were divided equally into 2 groups according to suture type. In the nonabsorbable suture group, No. 2 braided nonabsorbable polyethylene terephthalate sutures were used, and in the absorbable suture group, braided absorbable polyglactin sutures were used. The average age of the patients was 38 years (range, 28-50 years). Functional outcome scores and complications were evaluated.
RESULTS
All patients had an intact Achilles repair after surgery. The American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot clinical outcome scores were 98 (range, 90-100) in the nonabsorbable suture group and 96.8 (range, 87-100) in the absorbable suture group. All patients returned to their previous work. The absorbable suture group had fewer postoperative complications (0%) than the nonabsorbable suture group (12.5%) (P < .05).
CONCLUSION
Use of an absorbable suture in the treatment of Achilles tendon repair by an Achilles tendon suture-guiding system was associated with a lower incidence of suture reaction; however, functionally the results were not notably different from those using a traditional nonabsorbable suture. We conclude that repair with absorbable sutures is appropriate for Achilles tendon ruptures.
LEVEL OF EVIDENCE
Level II, prospective comparative study.
背景
本研究旨在比较使用不可吸收缝线与可吸收缝线的跟腱缝合引导装置进行跟腱修复的功能和临床结果。我们假设，对于使用跟腱缝合引导系统进行的跟腱修复，可吸收缝线的临床结果与不可吸收缝线相当。
方法
2010年1月至2013年9月，48例连续发生自发性跟腱断裂的患者使用跟腱缝合引导装置进行手术修复，采用两种不同的缝线类型。所有断裂均为急性。根据缝线类型将患者平均分为两组。不可吸收缝线组使用2号编织不可吸收聚对苯二甲酸乙二酯缝线，可吸收缝线组使用编织可吸收聚乙醇酸缝线。患者的平均年龄为38岁（范围28 - 50岁）。评估功能结果评分和并发症。
结果
所有患者术后跟腱修复均完整。不可吸收缝线组美国矫形足踝协会（AOFAS）后足临床结果评分为98分（范围90 - 100），可吸收缝线组为96.8分（范围87 - 100）。所有患者均恢复了之前的工作。可吸收缝线组术后并发症（0%）少于不可吸收缝线组（12.5%）（P <.05）。
结论
在使用跟腱缝合引导系统治疗跟腱修复时，使用可吸收缝线与缝线反应发生率较低相关；然而，在功能上，结果与使用传统不可吸收缝线并无显著差异。我们得出结论，可吸收缝线修复适用于跟腱断裂。
证据水平
二级，前瞻性比较研究。
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