微创Kessler缝合治疗急性闭合性跟腱断裂的疗效观察

Effectiveness of minimally invasive Kessler suture in treatment of acute closed Achilles tendon rupture

目的评价应用微创Kessler缝合的方法治疗急性闭合性跟腱断裂的临床疗效。方法通过回顾广西医科大学第二附属医院2014年1月至2018年10月收治的39例急性闭合性跟腱断裂的患者资料,手术中采用横行小切口显露跟腱断端,Kessler缝合法经皮缝合修复断裂跟腱,35例患者得到随访,平均19个月(6~24个月)。评价指标包括手术时间、切口长度、术后并发症及Arner-Lindholm疗效评定。结果平均手术时间为37 min,切口总长度平均3.1 cm,无腓肠神经损伤、切口不愈合、伤口感染、皮肤粘连、跟腱再断裂等并发症;按照Arner-lindholm评分标准评价:优33例,良2例,优良率为100%。结论微创Kessler缝合治疗急性闭合性跟腱断裂的方法具有手术时间短、损伤小、恢复快、疗效好的优点,大大降低了传统开放跟腱修复术切口并发症的发生率,并可有效避免术中腓肠神经损伤,是一种较为理想的急性闭合性跟腱断裂的治疗方法。

【Objective】To evaluate the clinical efficacy of using minimally invasive Kessler suture in the treatment of acute closed Achilles tendon rupture.【Methods】Thirty-nine patients with acute closed Achilles tendon rupture admitted to our hospital from January 2014 to October 2018 were retrospectively reviewed.Transverse minimally invasive incision was used to expose the broken end of Achilles tendon.Kessler suture was used to repair the ruptured Achilles tendon percutaneously.Thirty-five patients were followed up for an average of 19 months(6-24 months).The evaluation indexes included operation time,incision length,postoperative complications and Arner-Lindholm efficacy evaluation.【Results】The average operation time was 37 minutes.The average length of incision was 3.1 cm.There were no complications such as sural nerve injury,wound unhealing,wound infection,skin adhesion and Achilles tendon re-rupture.According to Arner-lindholm score,33cases were excellent,2 case was good,and the excellent and good rate was 100%.【Conclusion】Minimally invasive Kessler suture used for acute closed Achilles tendon rupture has the advantages of short operation time,less injury,fast recovery and good curative effect.It greatly reduces the incidence of incision complications of traditional open repair of Achilles tendon and completely avoids sural nerve injury during operation.It is an ideal treatment for acute closed Achilles tendon rupture.