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改良缝合技术治疗急性闭合性跟腱断裂的疗效

[Effectiveness of modified suture technique in treatment of acute closed Achilles tendon rupture].

作者信息

Zhan Junfeng, Fang Jialiu, Zhang Jisen, Cheng Wendan, Lü Hao, Jing Juehua

机构信息

Department of Orthopedics, the Second Affiliated Hospital of Anhui Medical University, Hefei Anhui, 230601, P.R.China.

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出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Aug 15;31(8):952-956. doi: 10.7507/1002-1892.201702090.

Abstract

OBJECTIVE

To investigate the effectiveness of modified suture technique in the treatment of acute closed Achilles tendon rupture.

METHODS

Between December 2013 and December 2016, 29 cases with acute closed Achilles tendon rupture were treated with modified suture technique. There were 23 males and 6 females with an average age of 34 years (range, 22-45 years). All patients were sport injuries. The injury located at left side in 22 cases and right side in 7 cases. American Foot and Ankle Surgery Association (AOFAS) ankle and hind foot function score was 44.6±3.6. According to the Amer-Lindholm criteria, 29 cases were rated as poor. MRI showed the complete rupture of the Achilles tendon.

RESULTS

The operation time was 35-62 minutes (mean, 46 minutes). The intraoperative blood loss volume was 7-15 mL (mean, 10 mL). The incisions healed by first intention, and no sural nerve injury occured. All patients were followed up 5-38 months (mean, 18.4 months). AOFAS ankle and hind foot function score was 93.1±4.3 at 3 months after operation, showing significant difference when compared with the preoperative value ( =-49.581, =0.000). According to the Amer-Lindholm criteria, the results were excellent in 24 cases and good in 5 cases, and the excellent and good rate was 100%; there was significant difference between pre- and post-operation ( =-7.294, =0.000). MRI showed the continuous and integrity of Achilles tendon. No Achilles tendon rupture recurred during the follow-up period.

CONCLUSION

Modified suture technique in the treatment of acute closed Achilles tendon rupture owns the advantages of less trauma, lower recurrence rate of rupture, lower risk of the sural nerve injury, and satisfactory function recovery.

摘要

目的

探讨改良缝合技术治疗急性闭合性跟腱断裂的疗效。

方法

2013年12月至2016年12月,采用改良缝合技术治疗29例急性闭合性跟腱断裂患者。其中男性23例,女性6例,平均年龄34岁(22 - 45岁)。所有患者均为运动损伤。损伤位于左侧22例,右侧7例。美国足踝外科协会(AOFAS)踝与后足功能评分为44.6±3.6。根据Amer-Lindholm标准,29例均评定为差。MRI显示跟腱完全断裂。

结果

手术时间为35 - 62分钟(平均46分钟)。术中出血量为7 - 15毫升(平均10毫升)。切口一期愈合,未发生腓肠神经损伤。所有患者随访5 - 38个月(平均18.4个月)。术后3个月AOFAS踝与后足功能评分为93.1±4.3,与术前比较差异有统计学意义(=-49.581,=0.000)。根据Amer-Lindholm标准,结果优24例,良5例,优良率为100%;术前与术后比较差异有统计学意义(=-7.294,=0.000)。MRI显示跟腱连续性及完整性良好。随访期间无跟腱再次断裂发生。

结论

改良缝合技术治疗急性闭合性跟腱断裂具有创伤小、断裂复发率低、腓肠神经损伤风险低、功能恢复满意等优点。

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