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有限开放式跟腱修复术后无器械引导的临床结果和并发症。

Clinical Outcomes and Complications Following Limited Open Achilles Repair Without an Instrumented Guide.

机构信息

Duke University Medical Center, Durham, NC, USA.

Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.

出版信息

Foot Ankle Int. 2021 Mar;42(3):294-304. doi: 10.1177/1071100720962493. Epub 2020 Nov 4.

Abstract

BACKGROUND

We report the clinical outcomes and complications following our limited open incision Achilles tendon repair technique without instrument guides.

METHODS

A total of 33 patients were included in this study. We recorded pre- and postoperative scores on the Foot and Ankle Disability Index (FADI), visual analog scale (VAS), and the Foot and Ankle Outcome Score (FAOS). Subgroup analyses were performed for acute (<2 weeks) and subacute (2-6 weeks) Achilles tendon repairs. A value <.05 was considered significant for all statistical analyses.

RESULTS

The median time from injury to surgery was 10.0 days (range, 1-45 days). At a median follow-up of 3.7 years (range, 1.0-9.8 years), the average pre- and postoperative outcome scores improved significantly for the following: FADI index (49.1-98.4, < .001), VAS (4.8-0.2, < .001), FAOS Pain (54.8-99.2, < .001), FAOS Symptoms (84.6-97.0, < .001), FAOS activities of daily living (61.4-97.2, < .001), FAOS Sports and Recreational Activity (39.5-98.5, < .001), and FAOS quality of life (39.7-88.7, < .001). There were no significant differences between pre- and postoperative outcome scores between the acute and subacute Achilles repair groups. There were no wound complication, reruptures, or reoperations in the entire cohort.

CONCLUSION

Patients showed improvements in postoperative patient-reported outcome scores with minimal complications. There was no significant difference in outcomes for acute vs subacute repairs. Our limited open incision Achilles tendon repair, which required no additional targeting instrumentation, had favorable midterm results.

LEVEL OF EVIDENCE

Level IV, retrospective case series.

摘要

背景

我们报告了一种不使用器械导向的有限开放式跟腱切开修复技术的临床结果和并发症。

方法

本研究共纳入 33 例患者。我们记录了足部和踝关节残疾指数(FADI)、视觉模拟评分(VAS)和足部和踝关节结局评分(FAOS)的术前和术后评分。对急性(<2 周)和亚急性(2-6 周)跟腱修复进行亚组分析。所有统计分析均以 P 值<.05 为差异有统计学意义。

结果

从受伤到手术的中位数时间为 10.0 天(范围,1-45 天)。在中位数 3.7 年(范围,1.0-9.8 年)的随访中,以下方面的平均术前和术后结果评分显著改善:FADI 指数(49.1-98.4,<.001)、VAS(4.8-0.2,<.001)、FAOS 疼痛(54.8-99.2,<.001)、FAOS 症状(84.6-97.0,<.001)、FAOS 日常生活活动(61.4-97.2,<.001)、FAOS 运动和娱乐活动(39.5-98.5,<.001)和 FAOS 生活质量(39.7-88.7,<.001)。急性和亚急性跟腱修复组之间的术前和术后结果评分无显著差异。整个队列中均无伤口并发症、再断裂或再手术。

结论

患者的术后患者报告结果评分有所提高,且并发症较少。急性与亚急性修复之间的结果无显著差异。我们的有限开放式跟腱切开修复术不需要额外的靶向器械,具有良好的中期结果。

证据等级

IV 级,回顾性病例系列。

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