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利用同种异体移植物和混合外固定器修复狗的跟腱新技术。

Novel Achilles tendon repair technique utilizing an allograft and hybrid external fixator in dogs.

机构信息

Colorado Canine Orthopedics, Colorado Springs, CO, USA.

Northlake Veterinary Surgery, Clarkston, GA. USA.

出版信息

Open Vet J. 2022 May-Jun;12(3):335-340. doi: 10.5455/OVJ.2022.v12.i3.5. Epub 2022 May 23.

Abstract

BACKGROUND

Achilles mechanism rupture is a surgical condition involving primary tenorrhaphy with various described means of surgical augmentation and bolstering.

AIM

To report complications and outcomes with a novel Achilles repair technique in dogs using a superficial digital flexor tendon (SDFT) or deep digital flexor tendon (DDFT) allograft.

METHODS

Medical records were reviewed for dogs with chronic rupture or deterioration of the Achilles mechanism. Fibrous tissue was excised and either primary tenorrhaphy or reattachment of the tendon(s) to the calcaneus was performed. The surgical repair was supplemented by an SDFT or DDFT allograft, and postoperative immobilization was provided using a transarticular hybrid external skeletal fixator. Complications were classified as minor, major, or catastrophic, and function was classified as full, acceptable, or unacceptable, based on established guidelines.

RESULTS

Complications occurred with 6 out of 12 repairs, including 1 minor, 6 major, and 2 catastrophic complications. The two catastrophic complications were the recurrence of tarsal hyperflexion and lameness at 20 weeks and 18 months following surgery. Of the 12 surgeries performed, 2 resulted in full function, 8 with acceptable function, and 2 with unacceptable function at last follow-up 17-98 weeks postsurgery (mean = 45 weeks) for a success rate of 10/12 cases.

CONCLUSION

The use of SDFT or DDFT allografts, coupled with an external fixator, can provide a moderate rate of full or acceptable functional outcomes and appears a viable treatment. However, complications were frequent and without a comparison group no conclusions can be drawn about the inferiority or superiority of this technique to other techniques for Achilles mechanism repair in dogs.

摘要

背景

跟腱断裂是一种外科病症,涉及初级腱缝合术,以及各种描述的外科增强和支撑方法。

目的

报告使用同种异体的浅背侧屈肌腱(SDFT)或深背侧屈肌腱(DDFT)对犬慢性跟腱断裂或恶化进行新型跟腱修复的并发症和结果。

方法

对患有慢性跟腱断裂或恶化的犬进行回顾性病历分析。切除纤维组织,行初级腱缝合术或肌腱(s)与跟骨重新连接。手术修复辅以 SDFT 或 DDFT 同种异体移植物,并使用关节内混合外骨骼固定器提供术后固定。根据既定指南,将并发症分为轻微、严重和灾难性,功能分为完全、可接受和不可接受。

结果

12 例修复中有 6 例出现并发症,包括 1 例轻微、6 例严重和 2 例灾难性并发症。灾难性并发症中的 2 例是术后 20 周和 18 个月出现跗关节过度伸展和跛行。12 例手术中,2 例功能完全,8 例功能可接受,2 例功能不可接受,最后随访时间为术后 17-98 周(平均 45 周),成功率为 10/12 例。

结论

使用 SDFT 或 DDFT 同种异体移植物,结合外固定器,可提供中等比例的完全或可接受的功能结果,似乎是一种可行的治疗方法。然而,并发症频繁,由于没有对照组,无法得出该技术在治疗犬跟腱断裂方面优于或劣于其他技术的结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dff6/9270943/7c794f39a48c/OpenVetJ-12-335-g001.jpg

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