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跟腱断裂患者的手术疗效——一项回顾性研究

Surgical outcomes in patients with Achilles tendon rupture-a retrospective study.

作者信息

Kürüm Hüseyin, Tosun Hacı Bayram, Aydemir Faruk, Ayas Orhan, Orhan Kürüm Kübra, İpekten Funda

机构信息

Orthopaedics and Traumatology, Elazığ Fethi Sekin Training and Research Hospital, Elazığ, Turkey.

Department of Emergency, Elazığ Fethi Sekin Training and Research Hospital, Elazığ, Turkey.

出版信息

PeerJ. 2025 Jan 27;13:e18890. doi: 10.7717/peerj.18890. eCollection 2025.

Abstract

BACKGROUND

There are two main methods used to treat Achilles tendon rupture (ATR): conservative treatment and surgical intervention. Surgical techniques are divided into three main categories: open surgical repair, mini-open surgical repair, and percutaneous repair (PR). We aimed to compare clinical outcomes in individuals with ATR who were treated with PR, primary repair, and flexor hallucis longus augmentation (FHL-A) with those treated with V-Y plasty and FHL-A.

METHODS

The study involved 54 patients who underwent ATR surgical intervention retrospectively. Thirty-two of these were identified as acute and 22 were chronic rupture patients. PR was performed in 32 patients, primary repair and FHL-A in 14 patients, and V-Y plasty and FHL-A in eight patients.

RESULTS

The mean forward jump was 142.69 ± 7.14 cm in individuals who received PR, 137.71 ± 4.51 cm in those who received primary repair + FHL-A, and 123.88 ± 3.09 cm in those who received V-Y plasty + FHL-A ( < 0.001). The decrease in the mean vertical jump distance on the operated side compared to the contralateral extremity was 0.97 ± 0.93, 2.07 ± 0.99, and 3.00 ± 1.69 cm in individuals who underwent PR, primary repair + FHL-A, and V-Y plasty + FHL-A, respectively ( < 0.001). The decrease in the mean dorsiflexion of the operated side ankle compared to the contralateral extremity was found to be 4.34 ± 1.18, 1.93 ± 1.07, and 2.38 ± 0.92 degrees in individuals who underwent PR, primary repair + FHL-A, and V-Y plasty + FHL-A, respectively ( < 0.001).

CONCLUSION

Although no surgical technique is completely superior to another, better performance tests were observed after PR repair compared to open surgery in individuals involved in sports, but rerupture, dorsiflexion restriction, and painful ankle were disadvantages. FHL-A, which has gained popularity in recent years, showed better performance in tests by contributing to more stable and stronger ankles in sporting individuals with chronic ruptures who had undergone open surgery. FHL-A can be utilized in addition to primary surgical intervention in individuals with high performance expectations before and after injury.

摘要

背景

治疗跟腱断裂(ATR)主要有两种方法:保守治疗和手术干预。手术技术主要分为三大类:开放式手术修复、微创开放式手术修复和经皮修复(PR)。我们旨在比较接受PR、一期修复和拇长屈肌增强术(FHL - A)治疗的ATR患者与接受V - Y成形术和FHL - A治疗的患者的临床结局。

方法

本研究回顾性纳入了54例行ATR手术干预的患者。其中32例为急性断裂患者,22例为慢性断裂患者。32例患者接受PR,14例患者接受一期修复和FHL - A,8例患者接受V - Y成形术和FHL - A。

结果

接受PR的患者平均向前跳跃距离为142.69±7.14cm,接受一期修复+FHL - A的患者为137.71±4.51cm,接受V - Y成形术+FHL - A的患者为123.88±3.09cm(<0.001)。与对侧肢体相比,接受PR、一期修复+FHL - A和V - Y成形术+FHL - A的患者患侧平均垂直跳跃距离减少分别为0.97±0.93、2.07±0.99和3.00±1.69cm(<0.001)。与对侧肢体相比,接受PR、一期修复+FHL - A和V - Y成形术+FHL - A的患者患侧踝关节平均背屈减少分别为4.34±1.18、1.93±1.07和2.38±0.92度(<0.001)。

结论

虽然没有一种手术技术完全优于另一种,但在参与运动的个体中,与开放手术相比,PR修复后观察到更好的性能测试结果,但再断裂、背屈受限和踝关节疼痛是其缺点。近年来颇受欢迎的FHL - A在接受开放手术的慢性断裂运动个体中,通过使踝关节更稳定、更强壮,在测试中表现出更好的性能。对于损伤前后有较高性能期望的个体,FHL - A可在一期手术干预的基础上使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e93c/11781266/ab60e7bda10f/peerj-13-18890-g001.jpg

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