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马-格里菲思(Ma-Griffith)联合微创小切口与改良缝合技术治疗急性跟腱断裂的比较。

Comparison of Ma-Griffith combined with a minimally invasive small incision to a modified suture technique for the treatment of acute achilles tendon ruptures.

机构信息

Department of Orthopedics, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, 230601, Anhui, Hefei, People's Republic of China.

出版信息

BMC Musculoskelet Disord. 2022 Aug 30;23(1):822. doi: 10.1186/s12891-022-05769-w.

Abstract

BACKGROUND

The Achilles tendon is the strongest tendon in the human body, although it is also prone to injury and rupture. Currently, the best treatment method for acute Achilles tendon rupture remains controversial. The aim of this study was to compare the efficacy of the Ma-Griffith method combined with a minimally invasive small incision (M-G/MISI) with the modified suture technique (MST).

METHODS

We conducted a retrospective review of the medical records of all patients who underwent treatment for acute Achilles tendon rupture between January 2012 and January 2020 at our hospital. Demographic characteristics, operative details, and postoperative complications were recorded, and data were statistically analyzed to compare the treatment efficacy of the two operative methods.

RESULTS

A total of 67 patients were enrolled in the study, 34 of whom underwent M-G/MISI treatment, and 33 of whom underwent MST treatment. The intraoperative blood loss in the M-G/MISI group (16.47 ± 13.23 ml) was significantly lower than that in the MST group (34.55 ± 13.01 ml), and the difference was statistically significant (P ˂0.001). The incision in the M-G/MISI group (3.79 ± 1.81 cm) was significantly shorter than that in the MST group (5.79 ± 1.00 cm), and the difference was statistically significant (P˂0.001). The Achilles tendon rupture score and the American Orthopedic Foot and Ankle Society (AOFAS) score were higher than those of the MST group at the sixth month after the operation (P˂0.001). Postoperatively, there was 1 case of traumatic Achilles tendon rupture in the M-G/MISI group and 1 case each of infection and deep vein thrombosis in the modified suture group.

CONCLUSIONS

Compared with the MST group, the M-G/MISI group had better Achilles tendon and ankle function scores at 6 months postoperatively, and less bleeding and shorter incisions. M-G/MISI is less invasive than MST.

摘要

背景

跟腱是人体最强壮的肌腱,但它也容易受伤和断裂。目前,急性跟腱断裂的最佳治疗方法仍存在争议。本研究旨在比较 Ma-Griffith 法联合微创小切口(M-G/MISI)与改良缝合技术(MST)的疗效。

方法

我们对 2012 年 1 月至 2020 年 1 月在我院接受急性跟腱断裂治疗的所有患者的病历进行了回顾性分析。记录了患者的人口统计学特征、手术细节和术后并发症,并对数据进行了统计学分析,以比较两种手术方法的治疗效果。

结果

共有 67 例患者入组,其中 34 例采用 M-G/MISI 治疗,33 例采用 MST 治疗。M-G/MISI 组术中出血量(16.47±13.23ml)明显低于 MST 组(34.55±13.01ml),差异有统计学意义(P<0.001)。M-G/MISI 组切口长度(3.79±1.81cm)明显短于 MST 组(5.79±1.00cm),差异有统计学意义(P<0.001)。术后 6 个月,M-G/MISI 组的跟腱断裂评分和美国矫形足踝协会(AOFAS)评分均高于 MST 组(P<0.001)。术后,M-G/MISI 组有 1 例创伤性跟腱断裂,改良缝合组有 1 例感染和 1 例深静脉血栓形成。

结论

与 MST 组相比,M-G/MISI 组术后 6 个月的跟腱和踝关节功能评分更好,出血量更少,切口更短。M-G/MISI 比 MST 更具微创性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c12/9425948/a23646c548ed/12891_2022_5769_Fig1_HTML.jpg

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