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跟腱断裂的微创开放修复技术:临床及等速运动评估

Mini open open repair techniques in Achilles tendon rupture: clinical and isokinetic evaluation.

作者信息

Munegato Daniele, Gridavilla Giulia, Guerrasio Stefano, Turati Marco, Cazzaniga Carlo, Zanchi Nicolò, Zatti Giovanni, Bigoni Marco

机构信息

Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.

Department of Orthopedic Surgery and Traumatology, Manzoni General Hospital, Lecco, Italy.

出版信息

Muscles Ligaments Tendons J. 2018 Jan 10;7(3):554-561. doi: 10.11138/mltj/2017.7.3.554. eCollection 2017 Jul-Sep.

Abstract

BACKGROUND

The aim of the study was to compare the mini-open to the classic open repair techniques for Achilles tendon ruptures.

METHODS

We retrospectively evaluated at a minimum of 2 years follow-up 32 subcutaneous Achilles tendon ruptures; 17 underwent mini-open surgery (Group A) and 15 the open technique (Group B).

RESULTS

No difference in Achilles Tendon Total Rupture Score and in modified Leppillahti score was observed. With respect to the contralateral side the width of the operated Achilles tendon was 4.07 mm thicker in Group A and 7.67 mm in Group B (<.05); the calf circumference reduction was respectively 10 mm and 23.75 mm (<.05). Iso-kinetic peak force measurement of the calf muscle strength showed a loss of 8.21% in Group A versus 17.25% in Group B ( <.05). The mean Patient Satisfaction Score was 96.76 in Group A and 88.67 in Group B (<.01); respectively 82.3% 66.7% of patients were able to return to previous levels of sporting activity. There were two post-operative complications in Group B and one in Group A.

CONCLUSION

Mini-open technique minimizes the risk of complications, leads to an improved tendon healing process and functional recovery with higher patient satisfaction.

LEVEL OF EVIDENCE

IV.

摘要

背景

本研究旨在比较微创开放性与传统开放性修复技术治疗跟腱断裂的效果。

方法

我们对32例皮下跟腱断裂患者进行了至少2年的随访回顾性评估;17例接受了微创开放性手术(A组),15例接受了开放性手术(B组)。

结果

跟腱总断裂评分和改良Leppillahti评分无差异。与对侧相比,A组手术侧跟腱宽度增厚4.07mm,B组增厚7.67mm(<.05);小腿周径减少分别为10mm和23.75mm(<.05)。小腿肌肉力量的等速峰值力测量显示,A组损失8.21%,B组损失17.25%(<.05)。患者平均满意度评分A组为96.76,B组为88.67(<.01);分别有82.3%和66.7%的患者能够恢复到以前的体育活动水平。B组有2例术后并发症,A组有1例。

结论

微创开放性技术可将并发症风险降至最低,改善肌腱愈合过程和功能恢复,提高患者满意度。

证据级别

IV级。

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