Cross Austin G, Khalil Lafi S, Tomlinson Maggie, Tramer Joseph S, Makhni Eric C, Cox Benjamin A
Cox Sports Medicine and Orthopedic Surgery, Mt. Pleasant, Michigan, U.S.A.
Henry Ford Hospital, Department of Orthopaedic Surgery, Detroit, Michigan, U.S.A.
Arthrosc Tech. 2023 Jan 18;12(2):e173-e180. doi: 10.1016/j.eats.2022.10.006. eCollection 2023 Feb.
Rupture of the Achilles tendon is a common injury seen in patients of varying ages and activity levels. There are many considerations for treatment of these injuries, with both operative and nonoperative management providing satisfactory outcomes in the literature. The decision to proceed with surgical intervention should be individualized for each patient, including the patient's age, future athletic goals, and comorbidities. Recently, a minimally invasive percutaneous approach to repair the Achilles tendon has been proposed as an equivalent alternative to the traditional open repair, while avoiding wound complications associated with larger incisions. However, many surgeons have been hesitant to adopt these approaches due to poor visualization, concern that suture capture in the tendon is not as robust, and the potential for iatrogenic sural nerve injury. The purpose of this Technical Note is to describe a technique using high-resolution ultrasound guidance intraoperatively during minimally invasive repair of the Achilles tendon. This technique minimizes the drawbacks of poor visualization associated with percutaneous repair, while providing the benefit of a minimally invasive approach.
跟腱断裂是一种在不同年龄和活动水平的患者中都较为常见的损伤。对于这些损伤的治疗有诸多需要考虑的因素，手术治疗和非手术治疗在文献中均能提供令人满意的结果。是否进行手术干预的决定应针对每位患者个体化制定，包括患者的年龄、未来的运动目标以及合并症。最近，一种微创经皮修复跟腱的方法被提议作为传统开放修复的等效替代方法，同时避免与较大切口相关的伤口并发症。然而，由于视野不佳、担心肌腱中的缝线固定不够牢固以及存在医源性腓肠神经损伤的可能性，许多外科医生一直对采用这些方法持犹豫态度。本技术说明的目的是描述一种在跟腱微创修复术中使用高分辨率超声引导的技术。该技术最大限度地减少了经皮修复相关的视野不佳的缺点，同时提供了微创方法的益处。
