Frantz Travis L, Everhart Joshua S, Jamieson Marissa, Fisk Erica, Fredrickson Saul, Kanney Jill, Miller Timothy L
Orthopaedic Resident, Department of Orthopedics, The Ohio State University Wexner Medical Center, Columbus, OH.
Assistant Professor, Department of Orthopedics, The Ohio State University Wexner Medical Center, Columbus, OH.
J Foot Ankle Surg. 2019 Jul;58(4):696-701. doi: 10.1053/j.jfas.2018.11.034. Epub 2019 May 10.
We sought to determine the early range of motion, complication rates, and 1-year patient-reported outcomes following Achilles tendon repair, using a modified gift-box suture loop technique. Sixty consecutive patients (49 males, mean age 36.2 ± 9.9 years) who underwent Achilles tendon repair with a modified gift-box suture loop technique performed by a single surgeon were prospectively enrolled. The range of motion at the final follow-up visit (mean 6 months) and the Achilles tendon rupture score (ATRS) and the complication rates at 1 year were obtained with 83% follow-up. The predictors of complications and ATRS were assessed. The mean operative time was 63.1 ± 10.8 minutes, which decreased throughout the case series (r = 0.46, p < .001). The mean plantarflexion at the final office evaluation was 31.7° ± 6.2°, dorsiflexion was 11.7° ± 6.3°, and total ankle arc of motion was 43.6° ± 9.7°; longer length of follow-up was associated with greater dorsiflexion (p = .008) and the total arc of motion (p = .008) but not with plantarflexion (p = .16). The overall rerupture rate was 1.7% (1 patient), wound complication rate was 1.7% (1 patient), and the overall complication rate was 6.7% (4 patients). No predictors of complications were identified. Complication rates did not differ between the first 30 (6.7%) cases and second 30 (6.7%) cases. The mean ATRS at 1 year was 81.8 ± 16.8 points. The rerupture and overall complication rates by 1 year were low. The range of motion, particularly dorsiflexion, improved through at least 6 months. Diabetic patients had lower 1-year ATRS than nondiabetic patients using this technique.
我们试图采用改良的礼盒式缝合环技术,确定跟腱修复术后的早期活动范围、并发症发生率以及患者报告的1年预后情况。前瞻性纳入了连续60例(49例男性,平均年龄36.2±9.9岁)接受由同一位外科医生采用改良礼盒式缝合环技术进行跟腱修复的患者。在83%的随访率下,获得了最终随访(平均6个月)时的活动范围、跟腱断裂评分(ATRS)以及1年时的并发症发生率。评估了并发症和ATRS的预测因素。平均手术时间为63.1±10.8分钟,在整个病例系列中呈下降趋势(r = 0.46,p <.001)。最终门诊评估时的平均跖屈角度为31.7°±6.2°,背屈角度为11.7°±6.3°,踝关节总活动弧度为43.6°±9.7°;随访时间越长,背屈角度(p =.008)和总活动弧度(p =.008)越大,但与跖屈角度无关(p =.16)。总体再断裂率为1.7%(1例患者),伤口并发症发生率为1.7%(1例患者),总体并发症发生率为6.7%(4例患者)。未发现并发症的预测因素。前30例(6.7%)和后30例(6.7%)的并发症发生率无差异。1年时的平均ATRS为81.8±16.8分。1年时的再断裂和总体并发症发生率较低。活动范围,尤其是背屈角度,至少在6个月内有所改善。采用该技术时,糖尿病患者1年时的ATRS低于非糖尿病患者。