改良小切口双津下缝合法治疗急性跟腱断裂

Modified small incision repair with double-Tsuge loop suture for treatment of acute achilles tendon rupture

目的探讨改良小切口双津下缝合法治疗急性跟腱断裂的临床疗效。方法采用改良小切口双津下缝合法治疗27例急性跟腱断裂患者。记录手术相关指标、住院天数和术后并发症发生情况。术后3、6个月采用Arner-Lindholm跟腱功能和AOFAS踝-后足功能评分评价疗效。结果患者在术后3、6个月均获得随访。切口均一期愈合,术后均无二次断裂、切口感染及腓肠神经损伤发生。Arner-Lindholm跟腱功能评分优良率:术后3个月为74.1%(20/27),术后6个月为92.6%(25/27)。AOFAS踝-后足评分:术前1 d为28~46(32.2±12.5)分,术后3个月为75~94(84.2±8.4)分,术后6个月为92~100(95.2±5.1)分。结论改良小切口双津下缝合法修复急性跟腱断裂可减少术后切口皮缘坏死和跟腱粘连的发生,踝关节活动恢复好,创伤小,康复快,临床疗效满意。

Objective To investigate the clinical effect of modified small incision repair with double-Tsuge loop suture for treatment of acute achilles tendon rupture.Methods Twenty seven patients with acute closed achilles tendon rupture were accepted modified small incision repair with double-Tsuge loop suture method.Operative related factors,length of hospital stay and postoperative complications were recorded.At 3,6 months after surgery,clinical evaluation of ankle function score of AOFAS ankle-hindfoot and Arner-Lindholm score were carried out in all patients.Results All cases were followed up at 3,6 months.All the incisions healed in one stage,no secondary rupture of achilles tendon,infection and sural nerve injury occurred during the period of follow-up.At 3,6 months postoperation,the excellent-good rate of Arner-Lindholm achilles function scores was 74.1%(20/27)and 92.6%(25/27),respectively.The AOFAS ankle-hindfoot scores were 28~46(32.2±12.5)points at 1 d before surgery,and 75~94(84.2±8.4),92~100(95.2±5.1)points at 3,6 months after surgery,respectively.Conclusions The modified small incision double-Tsuge loop suture method can reduce the incidence of skin margin necrosis and achilles tendon adhesion,the ankle joint activity is restored well,with less trauma and quick recovery,and the effect is satisfactory.