Revo带线锚钉经皮Carmont&Maffulli法缝合治疗急性闭合性跟腱断裂的临床研究

Clinical study of percutaneous Carmont & Maffulli suture in treatment of acute closed Achilles tendon rupture with Revo suture anchor

目的探讨Revo带线锚钉经皮Carmont＆Maffulli法缝合治疗急性闭合性跟腱断裂的临床疗效。方法回顾性分析自2009-03—2014-05采用Revo带线锚钉经皮Carmont＆Maffulli法缝合治疗21例急性闭合性跟腱断裂的临床资料。测量术后健侧及患侧最大跖屈肌力,记录小腿周径减少值及完全恢复运动的时间,末次随访时足踝关节功能依据AOFAS评分标准评定。结果本组均获得随访4~25个月,平均8个月。切口均一期愈合,无切口感染、皮肤坏死、跟腱再次断裂、腓肠神经损伤或其他并发症发生。末次随访时足踝关节功能依据AOFAS评分标准评定：优18例,良2例,可1例,优良率95.2%。健侧跖屈肌力平均29.7 kg,患侧跖屈肌力平均20.3 kg。患侧小腿周径平均减少1.42 cm,完全恢复运动时间平均6.2个月。结论采用Revo带线锚钉经皮Carmont＆Maffulli法缝合治疗急性闭合性跟腱断裂的疗效较好,固定牢靠,经皮修复减少了皮肤并发症。对于非体育专业的成人患者来说是一种较为理想的微创治疗方法。

Objective To investigate the clinical effect of percutaneous Carmont ＆ Maffulli suture in the treatment of acute closed rupture of Achilles tendon with Revo suture anchor. Methods A retrospective analysis of clinical data of Carmont ＆Maffulli method with Revo suture anchor for percutaneous repair of acute closed Achilles tendon rupture from March 2009 to May 2014 was performed. Twenty-one consecutive patients with acute closed rupture of Achilles tendon were recruited. The postoperative contralateral and ipsilateral maximum plantar flexor force were measured, the decreased value of calf circumference and the time to fully recovered movement were recorded. The American Orthopedic Foot and Ankle Society（AOFAS） score was used for evaluation of the ankle joint function at last follow-up. Results All patients were followed up for4 to 25 months, an average of 8 months. All patients had no wound infection, skin necrosis, re-ruptures, sural nerve injuries or other complications. At last follow-up, ankle function score based on AOFAS scores： excellent in 18 cases, good in 2 cases,general in 1 case, the excellent and good rate was 95.2%. The contralateral and ipsilateral plantar flexion strength was 29.7 kg,20.3 kg on average, the ipsilateral leg circumference decreased by 1.42 cm, complete recovery of motion for an average of 6.2months. Conclusion The technique of percutaneous Carmont ＆ Maffulli closure suture with the Revo suture anchors is effective and reliable in repairing the ruptured Achilles tendon, with less skin complications. For adult patients who are not sports professionals, it is an ideal minimally invasive treatment method.