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跟腱断裂一期修复技术:移植物与非移植物的比较性回顾研究

Achilles tendon rupture primary repair technique: A comparative retrospective study between graft versus no-graft.

作者信息

Mzeihem Majd, El Bachour Joseph, Hemdanieh Maya, El Baba Bachar, Tamim Hani, Nassereddine Mohamad

机构信息

Faculty of Medicine, American University of Beirut, Beirut, Lebanon.

Department of Orthopedics Surgery, American University of Beirut Medical Center, Beirut, Lebanon.

出版信息

J Clin Orthop Trauma. 2024 Apr 20;51:102417. doi: 10.1016/j.jcot.2024.102417. eCollection 2024 Apr.

Abstract

INTRODUCTION

Achilles tendon rupture is one of the most common musculoskeletal injuries and accounts to 20 % of all large tendon ruptures The surgical choice of a procedure might play a role in the incidence of postoperative complications. This study aimed to estimate and compare the incidence of complications occurring within a 30-day window following primary surgical repair of the Achilles tendon with or without a graft.

METHODS

A retrospective cohort study was conducted using the ACS NSQIP database from 2005 to 2021. Patients were divided into 2 cohorts (primary surgical repair with and without graft).

RESULTS

A total of 7010 patients were included in the analysis. Among the graft group, 10.9 % reported any complication which was double the percentage of complications in the no graft group. Only 3.8 % of the no graft patients had reported systemic complications compared to 8.3 % in the graft group. Chronic steroid use was found to be an effect modifier in the incidence of any complications after primary surgical repair when comparing graft versus no graft (P-value 0.016).

CONCLUSION

Surgical repairwith tendon graft develops more complications than repairing without graft. Therefore, it is imperative for physicians to strive for an early diagnosis, as any delay in treatment significantly raises the likelihood of complications.

LEVELS OF EVIDENCE

.

摘要

引言

跟腱断裂是最常见的肌肉骨骼损伤之一,占所有大型肌腱断裂的20%。手术方式的选择可能对术后并发症的发生率产生影响。本研究旨在评估和比较在有或没有移植的情况下,初次手术修复跟腱后30天内发生并发症的发生率。

方法

使用2005年至2021年的美国外科医师学会国家外科质量改进计划(ACS NSQIP)数据库进行回顾性队列研究。患者被分为两个队列(有移植和无移植的初次手术修复)。

结果

共有7010名患者纳入分析。在移植组中,10.9%的患者报告有任何并发症,这是无移植组并发症发生率的两倍。无移植组只有3.8%的患者报告有全身并发症,而移植组为8.3%。在比较移植与非移植初次手术修复后任何并发症的发生率时,发现长期使用类固醇是一个影响因素(P值为0.016)。

结论

肌腱移植手术修复比无移植修复产生更多并发症。因此,医生必须努力实现早期诊断,因为任何治疗延迟都会显著增加并发症的可能性。

证据水平

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