关节镜辅助下经皮Kessler缝合法修复新鲜闭合跟腱断裂术后护理

Postoperative care of patients with fresh closed ruptured achilles tendon by percutaneous repair using Kessler′s suture with assisted arthroscopy

目的探讨关节镜辅助下经皮Kessler缝合法修复新鲜闭合跟腱断裂术后患者的护理要点和康复重点。方法针对关节镜辅助下经皮Kessler缝合法跟腱断裂修复术后患者治疗特点和要求,制定预防术后并发症、防止发生跟腱再次断裂及循序渐进施行患肢功能锻炼的护理要点和康复重点。结果本组26例患者均得到有效随访。按Arner Lindholm疗效评分标准,本组优18例,良8例,优良率100%。全部病例无神经损伤、术后感染及跟腱再次断裂发生。MRI显示全部病例断裂跟腱均得到良好修复和塑型。结论关节镜辅助下经皮双组Kessler缝合法是治疗跟腱断裂的一种疗效较好的新术式。术后采用合理的整体护理和循序渐进的康复锻炼,对防止术后并发症发生及患者早日功能康复具有重要意义。

Objective To discuss the main points of postoperative care of patients with fresh closed ruptured achilles tendon by percutaneous repair using Kessler＇s suture with assisted arthroscopes. Methods Postoperative care of patients with fresh closed ruptured achilles tendon by percutaneous repair using Kessler＇s suture with assisted arthroscopes were performed with preventive of postoperation complications, especially repaired achilles tendon rupturing again, and rehabilitation exercise of affected limb. Results All patients were assessed clinically and evaluated with MRI and Arner Lindholm evaluation system. Arner Lindholm evaluation showed excellent in 18 cases, good in 8 cases. All patients had no complications including nerve distribution,infections, rerupture during the follow-up period. MRIs showed the ruptured achilles tendons repaired and remodeled very well in all patients. Conclusion The present method is the ideal surgical technique for repair of ruptured achilles tendon with good clinical results and short time good recovery, without any complication. It is very important of nursing carefully with prevention of postoperative complications and effective refunction of affected limb.