Instituto Dupuytren, Buenos Aires, Argentina.
Instituto Dupuytren, Buenos Aires, Argentina.
Foot Ankle Surg. 2020 Feb;26(2):209-217. doi: 10.1016/j.fas.2019.02.005. Epub 2019 Feb 25.
This study aims at evaluating a substantial number of patients treated with a percutaneous, paratenon preserving technique for Achilles tendon repair using three different incisions with clinical follow-up and magnetic resonance imaging (MRI).
Ninety patients with percutaneous Achilles tendon repair using the Dresden technique for acute rupture were evaluated. Fifteen patients were treated using a central approach, 15 patients using a posterolateral approach and the original posteromedial approach was used in 60 patients. All patients were followed clinically and with MRI after 1 and 6 months post-operatively.
Using the standard posteromedial approach no complications were seen. With the central approach 4 (27%) wound healing problems were observed and with the posterolateral approach 2 (13%) sural nerve lesions occurred. One patient (1.1%) had a rerupture. MRI revealed an increased diameter at the rupture site and distal to it as well as an increasingly homogeneous signal over time.
Percutaneous Achilles tendon repair with the Dresden technique yields excellent clinical results and a low complication rate. Modification of the original incision is discouraged.
本研究旨在评估大量接受经皮、保留腱旁组织技术治疗的跟腱断裂患者，采用三种不同切口进行临床随访和磁共振成像（MRI）检查。
评估了 90 例采用德累斯顿技术行急性跟腱断裂经皮修复的患者。15 例患者采用中央入路，15 例患者采用后外侧入路，60 例患者采用原始的后内侧入路。所有患者均在术后 1 个月和 6 个月进行临床和 MRI 随访。
采用标准后内侧入路无并发症发生。中央入路有 4 例（27%）出现伤口愈合问题，后外侧入路有 2 例（13%）出现腓肠神经损伤。1 例患者（1.1%）发生再断裂。MRI 显示断裂部位和远端的直径增加，信号逐渐均匀。
采用德累斯顿技术行经皮跟腱修复可获得良好的临床效果和较低的并发症发生率。不鼓励对原始切口进行修改。
