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使用可吸收缝线的经皮跟腱修复术: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 Mar-Apr;67(2):139-143. doi: 10.1016/j.recot.2022.08.009. Epub 2022 Sep 9.

DOI:10.1016/j.recot.2022.08.009
PMID:36096468
Abstract

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

A prospective cohort study including patients treated for an achilles tendon rupture from January 2016 to March 2019 was conducted.

INCLUSION CRITERIA

≥18 years of age, non-insertional (2-8cm proximal to insertion) achilles tendon ruptures. Open or partial ruptures were excluded. The diagnosis was based on clinical criteria and confirmed by ultrasonography in all patients. Epidemiological data, rupture and healing risk factors, previous diagnosis of tendinopathy, pre-rupture sport activity, job information, mechanism of rupture and the time in days between lesion and surgery were collected. Patients were assessed using visual analogue scale (VAS) at the 1, 3, 6 and 12-month follow-up. The achilles tendon rupture score (ATRS) were assessed at the 6 and 12 month follow-up. Ultrasound was performed at the 6-month follow-up. The re-rupture rate and postoperative complications were also collected.

CONCLUSIONS

In our experience, percutaneous achilles tendon repair with absorbable sutures in patients with an acute achilles tendon rupture has shown good functional results but with a high incidence of complications. Although most complications were transitory sural nerve symptoms, this complication would be avoided in patients treated conservatively. For this reason, conservative treatment associated with an early weightbearing rehabilitation protocol should be considered a viable option for patients with achilles tendon ruptures, mainly in cooperative young patients.

摘要

目的

本研究旨在评估使用可吸收缝线进行经皮跟腱修复的临床疗效及并发症。

材料与方法

进行一项前瞻性队列研究,纳入2016年1月至2019年3月期间接受跟腱断裂治疗的患者。

纳入标准

年龄≥18岁,非止点性(距止点近端2 - 8cm)跟腱断裂。排除开放性或部分断裂。所有患者的诊断均基于临床标准并经超声检查确认。收集流行病学数据、断裂和愈合危险因素、既往肌腱病诊断、断裂前的体育活动、工作信息、断裂机制以及损伤至手术的天数。在1、3、6和12个月随访时使用视觉模拟量表(VAS)对患者进行评估。在6个月和12个月随访时评估跟腱断裂评分(ATRS)。在6个月随访时进行超声检查。还收集再断裂率和术后并发症。

结论

根据我们的经验,急性跟腱断裂患者使用可吸收缝线进行经皮跟腱修复已显示出良好的功能结果,但并发症发生率较高。尽管大多数并发症是短暂的腓肠神经症状,但保守治疗的患者可避免此并发症。因此,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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