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一种通过有限切开手术联合单锚钉和“环线”缝合技术治疗急性跟腱断裂的新的微创外科技术。

A new less invasive surgical technique in the management of acute Achilles tendon rupture through limited-open procedure combined with a single-anchor and "circuit" suture technique.

作者信息

Zhang Hao, Liu Pei-Zhao, Zhang Xin, Ding Chen, Cui Hao-Chen, Ding Wen-Bin, Wang Ren-Kai, Wu Da-Jiang, Wei Qiang, Qin Sheng, Wu Xue-Lin, Tong Da-Ke, Wang Guang-Chao, Tang Hao, Ji Fang

机构信息

Department of Orthopaedics, Changhai Hospital, Second Military Medical University, No 168 Changhai road, Shanghai, 200433, China.

出版信息

J Orthop Surg Res. 2018 Aug 10;13(1):198. doi: 10.1186/s13018-018-0895-x.

Abstract

BACKGROUND

Traditional incision repair and minimally invasive repair for acute Achilles tendon repair have limitations. This study aimed to present our series of 23 patients with acute Achilles tendon rupture that was repaired using two small incisions to assist the anchor repair of the tear and a new "circuit" suture technique.

METHODS

This was a retrospective study of 23 patients with acute Achilles tendon rupture treated with the new technique at Changhai Hospital between January 2015 and December 2016 and followed up for 14-33 months. Clinical outcome was assessed using the AOFAS, Leppilahti, and Arner-Lindholm scores. Complications, range of motion (ROM), and time to return to work and light sport activity were assessed.

RESULTS

The AOFAS score was 85-96 at 3 months and 92-100 at 12 months. The 3-month ROM was 27°-37°, and the 12-month ROM was 36°-48°. The Leppilahti score was 85-95 at 3 months and 90-100 at 12 months. The recovery time of the patients was 10-18 weeks. The postoperative recovery time to exercise was 16-24 weeks. There was only one case of deep venous thrombosis. According to the Arner-Lindholm assessment criteria, patient outcomes were rated as excellent in 20 (87.0%) cases, good in three (13.0%) cases, and poor in 0 cases. The excellent-to-good rate was 100%.

CONCLUSION

The limited-open procedure combined with a single-anchor and "circuit" suture technique could be used to repair torn Achilles sites, with a low occurrence of complications. This new and minimally invasive technique could be an alternative in the management of acute Achilles tendon rupture.

摘要

背景

急性跟腱断裂的传统切开修复和微创修复存在局限性。本研究旨在介绍我们采用两个小切口辅助锚钉修复撕裂处及一种新的“环行”缝合技术对23例急性跟腱断裂患者进行修复的系列病例。

方法

这是一项对23例急性跟腱断裂患者的回顾性研究,这些患者于2015年1月至2016年12月在长海医院接受了新技术治疗,并随访14 - 33个月。使用美国足踝外科协会(AOFAS)、莱皮拉hti和阿纳-林德霍尔姆评分评估临床结果。评估并发症、活动范围(ROM)以及恢复工作和轻度体育活动的时间。

结果

3个月时AOFAS评分为85 - 96分,12个月时为92 - 100分。3个月时ROM为27° - 37°,12个月时为36° - 48°。3个月时莱皮拉hti评分为85 - 95分,12个月时为90 - 100分。患者恢复时间为10 - 18周。术后恢复运动的时间为16 - 24周。仅1例发生深静脉血栓形成。根据阿纳-林德霍尔姆评估标准,20例(87.0%)患者结果评定为优秀,3例(13.0%)为良好,0例为差。优良率为100%。

结论

有限切开手术联合单锚钉和“环行”缝合技术可用于修复跟腱撕裂部位,并发症发生率低。这种新的微创技术可作为急性跟腱断裂治疗的一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/751d/6086049/811da5168d48/13018_2018_895_Fig1_HTML.jpg

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