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一种用于微创跟腱修复的简易缝线引导装置。

A simple suture-guiding device for minimally invasive Achilles tendon repair.

作者信息

Obut Sinan, Gultekin Alper, Unal Meric, Serarslan Ulaş, Tuhanioğlu Ümit

机构信息

1 Orthopaedics and Traumatology Department, Derince Research Hospital, Kocaeli, Turkey.

2 Faculty of Medicine, Sports Medicine Department, Suleyman Demirel University, Isparta, Turkey.

出版信息

J Orthop Surg (Hong Kong). 2017 Sep-Dec;25(3):2309499017739484. doi: 10.1177/2309499017739484.

Abstract

BACKGROUND

Our hypothesis is to utilize a simple suture-guiding device for minimally invasive repair of Achilles tendon without any extra cost with a minimal risk of rerupture. The purpose of this study is to investigate the results of our minimally invasive technique for Achilles tendon repair using a simple ovarian clamp for suture guiding.

MATERIALS AND METHODS

Twenty patients with acute Achilles tendon rupture were treated with minimally invasive repair by an expert orthopaedic surgeon. Instead of an Achillon device, an ovarian clamp was directed to the proximal and distal parts of the Achilles tendon. All data relating to daily activities, walking, climbing stairs, sports activity, American Orthopaedic Foot and Ankle Society (AOFAS) and Thermannscores were recorded. Sural nerve was evaluated with physical examination for paraesthesia, hyperaesthesia, lateralis cruris and foot pain in all patient controls.

RESULTS

The average AOFAS score was 97.06 (76-100). All patients had intact Achilles tendon at last control. No rerupture was observed. Average time taken to return to work was 30.8 days (28-60 days). After 6 months, all patients returned to their previous sports activities.

CONCLUSION

For Achilles tendon ruptures, minimally invasive repair techniques have shown successful results with low complication rates. Besides their success, some suture-guiding devices bring extra costs for patients or health insurance. Minimally invasive techniques may be performed with devices without any extra cost. Our new suture-guiding device provides knot placement under paratenon like Achillon device to improve outcomes, provides early return to work and minimizes the complications. Finally, our suture-guiding device has no extra cost.

摘要

背景

我们的假设是使用一种简单的缝线引导装置,以微创方式修复跟腱,无需额外费用且再断裂风险最小。本研究的目的是调查使用简单的卵巢钳进行缝线引导的跟腱修复微创技术的效果。

材料与方法

20例急性跟腱断裂患者由一名骨科专家进行微创修复治疗。使用卵巢钳而非跟腱修复装置对跟腱的近端和远端进行操作。记录所有与日常活动、行走、爬楼梯、体育活动、美国矫形足踝协会(AOFAS)评分和瑟曼评分相关的数据。对所有患者进行体格检查,评估腓肠神经有无感觉异常、感觉过敏、小腿外侧及足部疼痛。

结果

AOFAS平均评分为97.06(76 - 100)。在最后一次检查时,所有患者的跟腱均完整。未观察到再断裂情况。平均重返工作岗位的时间为30.8天(28 - 60天)。6个月后,所有患者均恢复了之前的体育活动。

结论

对于跟腱断裂,微创修复技术已显示出成功率高且并发症发生率低的结果。除了取得成功外,一些缝线引导装置会给患者或医疗保险带来额外费用。微创技术可以使用无需额外费用的装置来进行。我们的新型缝线引导装置能像跟腱修复装置一样在腱周放置结以改善治疗效果,能使患者早日重返工作岗位并将并发症降至最低。最后,我们的缝线引导装置无需额外费用。

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