缝线锚钉与传统钢丝缝合法修复跟腱近止点断裂的病例对照研究

Case-control study on the reconstruction of near distal tendo achillis rupture by suture anchors and traditional steel wire

目的:比较应用新型缝线锚钉与传统钢丝缝合法修复跟腱近止点断裂的临床疗效。方法:回顾性分析2007年6月至2011年2月56例跟腱近止点断裂患者的临床资料。锚钉组31例,男22例,女9例;年龄16～52岁,平均35.5岁;采用缝线锚钉对其进行修复。钢丝组25例,男19例,女6例;年龄22～53岁,平均37.6岁;采用传统钢丝缝合法对其进行修复。术后不同时期对患者进行不同内容的康复训练。记录锚钉与钢丝置入的位置,并对2组患者的手术时间、术后并发症和跟腱功能等进行比较,采用Arner-Lindholm标准对跟腱功能恢复情况进行评估。结果:平均随访时间24.2个月,所有患者获随访。术中均无医源性神经、血管、肌腱等损伤。锚钉组在手术时间及术后并发症上均低于钢丝组,差异有统计学意义(t=8.75,P=0.00;χ2=5.42,P=0.02);锚钉组的术后跟腱功能优于钢丝固定组,差异有统计学意义(χ2=7.65,P=0.02)。结论:应用缝线锚钉修复跟腱近止点断裂,与传统的钢丝缝合法比较优势明显,是一种可靠而有效的治疗方法。

Objective：To compare the curative effects of newly suture anchors and traditional steel wire for the reconstruction of near distal tendo achillis rupture.Methods：The clinical data of 56 patients with near distal tendo achillis rupture from June 2007 to February 2011 were retrospectively analyzed.Among 31 patients receiving reconstruction by suture anchors,22 patients were male and 9 patients were female,with a mean age of 35.5 years （ranging from 16 to 52 years）.Among 25 patients treated with traditional steel wire,19 patients were male and 6 patients were female,with a mean age of 37.6 years （ranging from 22 to 53 years）.The different rehabilitation was conducted for every patient at different times after operation.The position of suture anchor and steel wire were recorded.The clinical data such as operative time,complications of the surgery and the function of stendo achillis were analyzed.The healing of stendo achillis and functional recovery were assessed by Arner -Lindholm standard.Results：All the patients were followed up with an average during of 24.2 months.There were no intraoperative injuries on blood vessels,nerve and tendon.The average operative time and postoperative complications of suture anchors were lower than there of the traditional steel wire（t=8.75,P=0.00;χ2=5.42,P=0.02）.The functional recovery of tendo achillis repaired by suture anchors was better than that in the group of traditional steel wire（χ2=7.65,P=0.02）.Conclusion：Compared to the traditional steel wire,suture anchor demonstrate the superior performance on repairing rupture of the near distal tendo achillis,which is a reliable and effective treatment methods.