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使用可吸收缝线经皮修复跟腱:结果与并发症

Percutaneous Achilles tendon repair with absorbable suture: Outcomes and complications.

作者信息

Campillo-Recio D, Comas-Aguilar M, Ibáñez M, Maldonado-Sotoca Y, Albertí-Fitó G

机构信息

Hospital Universitari Quiron Dexeus, Barcelona, Spain.

Hospital Universitari Quiron Dexeus, Barcelona, Spain.

出版信息

Rev Esp Cir Ortop Traumatol. 2023 Jan-Feb;67(1):56-61. doi: 10.1016/j.recot.2022.06.008. Epub 2022 Jul 6.

DOI:10.1016/j.recot.2022.06.008
PMID:35809780
Abstract

BACKGROUND AND OBJECTIVE

The purpose of this study is to evaluate the clinical outcomes and complications of percutaneous Achilles tendon repair with absorbable sutures.

MATERIAL AND METHODS

Prospective cohort study including 52 patients treated for Achilles tendon ruptures (January 2016 to March 2019).

INCLUSION CRITERIA

≥18 years of age, non-insertional Achilles tendon ruptures. Diagnosis based on clinical criteria, confirmed by ultrasonography. Assessment using Visual Analogue Scale (VAS), Achilles Tendon Rupture Score (ATRS) and ultrasound. Re-rupture rate and postoperative complications were collected.

RESULTS

VAS scoring (SD) at 1, 3, 6 and 12 months follow-up (FU) were 2.63 (0.83), 1.79 (1.25), 0.69 (1.09) and 0.08 (0.39), respectively. Mean (SD) ATRS score was 92.45 points at 6 months (6.27) and 94.04 points at 12 months FU (4.59). Three re-ruptures (5.77%) occurred with a mean time between surgery and re-rupture of 108.75 days (SD 28.4), all of them within 4-month FU. No ruptures at the time to return to sports activity. Thirteen complications (25%) (3 re-ruptures, 1 superficial wound infection and 9 transitory sural nerve injuries).

CONCLUSIONS

Percutaneous Achilles tendon repair with absorbable sutures in patients with acute Achilles tendon ruptures has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, these would be avoided with conservative treatment. Conservative treatment associated with an early weight-bearing rehabilitation protocol should be considered a viable option for patients with Achilles tendon ruptures, specially in cooperative young patients.

摘要

背景与目的

本研究旨在评估使用可吸收缝线经皮修复跟腱的临床疗效及并发症。

材料与方法

前瞻性队列研究,纳入2016年1月至2019年3月间接受跟腱断裂治疗的52例患者。

纳入标准

年龄≥18岁,非止点性跟腱断裂。根据临床标准诊断,并经超声检查确认。采用视觉模拟评分法(VAS)、跟腱断裂评分(ATRS)及超声进行评估。收集再断裂率及术后并发症情况。

结果

随访1、3、6和12个月时的VAS评分(标准差)分别为2.63(0.83)、1.79(1.25)、0.69(1.09)和0.08(0.39)。随访6个月时平均(标准差)ATRS评分为92.45分(6.27),随访12个月时为94.04分(4.59)。发生3例再断裂(5.77%),手术至再断裂的平均时间为108.75天(标准差28.4),均发生在4个月的随访期内。恢复体育活动时未发生再断裂。出现13例并发症(25%)(3例再断裂、1例表浅伤口感染和9例短暂性腓肠神经损伤)。

结论

急性跟腱断裂患者使用可吸收缝线经皮修复跟腱显示出良好的功能结果,但并发症发生率较高。尽管大多数并发症为短暂性腓肠神经症状,但保守治疗可避免这些症状。对于跟腱断裂患者,尤其是合作的年轻患者,与早期负重康复方案相关的保守治疗应被视为一种可行的选择。

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