Aoki M, Ogiwara N, Ohta T, Nabeta Y
Department of Orthopaedic Surgery, Sapporo Medical University, Japan.
Am J Sports Med. 1998 Nov-Dec;26(6):794-800. doi: 10.1177/03635465980260061001.
Twenty-two closed Achilles tendon ruptures caused by sports injuries in 22 patients (average age, 37.6 years) were repaired with Kirschmayer core suture and cross-stitch epitenon suture, and early active ankle motion with weightbearing was implemented after surgery. This study was undertaken to evaluate the effectiveness of the repair technique and rehabilitation protocol by assessing clinical results and magnetic resonance imaging findings. The follow-up period averaged 24.6 months. Twenty of the tendons (91%) healed without rerupture, and two tendons (9%) suffered a partial rerupture at 23 and 56 days, respectively. Active ankle extension reached from the minus range to 0 degree in an average of 9.7 days, and ankle motion recovered to normal in an average of 6.0 weeks. Full weightbearing without heel raising became possible in an average of 16.4 days, and heel raising with both legs became possible in an average of 7.3 weeks. The patients returned to full sports activity in 13.1 weeks. The interval until the area of high-intensity signal at the tendon repair site on T2-weighted magnetic resonance imaging scans became intermediate-intensity signal averaged 6.9 weeks, and the tendon repair site became low-intensity signal in an average of 12.6 weeks, demonstrating excellent tendon healing. Treatment employing Kirschmayer core suture and cross-stitch epitenon suture may help athletes return to sports activity in a shorter period than that allowed by previous methods of repair for Achilles tendon ruptures.
对22例因运动损伤导致闭合性跟腱断裂的患者（平均年龄37.6岁）采用Kirschmayer核心缝合法和间断褥式缝合腱周膜进行修复，并在术后进行早期负重下的主动踝关节活动。本研究旨在通过评估临床结果和磁共振成像结果来评价该修复技术和康复方案的有效性。随访期平均为24.6个月。其中20根肌腱（91%）愈合且未再次断裂，2根肌腱（9%）分别在术后23天和56天发生部分再次断裂。主动踝关节背伸平均在9.7天内从负角度范围恢复到0度，踝关节活动平均在6.0周恢复正常。平均在16.4天可实现完全负重且不踮脚跟，平均在7.3周可实现双腿踮脚跟。患者在13.1周恢复到完全运动状态。在T2加权磁共振成像扫描中，肌腱修复部位高强度信号区域变为中等强度信号的平均间隔时间为6.9周，肌腱修复部位变为低强度信号的平均时间为12.6周，显示出良好的肌腱愈合情况。采用Kirschmayer核心缝合法和间断褥式缝合腱周膜进行治疗，可能有助于运动员比以往跟腱断裂修复方法所允许的时间更短地恢复运动。
