两种方法治疗闭合跟腱断裂的疗效比较

Comparison efficacy of two surgical methods for treatment of closed achilles tendon ruptures

目的比较卵圆钳配合骨锚钉技术和传统大切口术式治疗闭合跟腱断裂的疗效。方法将37例闭合跟腱断裂患者按照术式不同分为观察组(采用卵圆钳配合骨锚钉技术治疗,17例)和对照组(采用传统大切口术式治疗,20例)。记录两组术中出血量、手术时间、住院时间、并发症发生情况、术后完全负重下地时间。采用AOFAS踝-后足评分评价踝关节功能恢复情况。结果患者均获得随访,时间6~12个月。术中出血量、住院时间观察组明显少(短)于对照组(P<0.05);手术时间观察组短于对照组,但差异无统计学意义(P>0.05)。并发症发生率两组比较差异无统计学意义(P>0.05)。术后完全负重下地时间观察组明显早于对照组(P<0.05)。踝关节功能恢复情况:术后3、6个月的AOFAS踝-后足评分优良率观察组均明显高于对照组(P<0.05)。结论与传统大切口术式相比,卵圆钳配合骨锚钉技术治疗闭合跟腱断裂术中出血量少,住院时间短,患者完全负重下地时间早,踝关节功能恢复好,临床疗效满意。

Objective To compare the efficacy of oval forceps combined with bone anchor technique and conventional large incision technique in the treatment of closed achilles tendon rupture.Methods According to different treatment methods,37 patients with closed achilles tendon ruptures were divided into observation group(17 cases treated with oval forceps combined with bone anchor technique)and control group(20 cases treated by conventional large incision).The intraoperative bleeding,operation time,length of hospital stay,occurrence of complications,and postoperative time of full weight-bearing in both groups were recorded.Recovery of ankle function was evaluated by AOFAS ankle-hindfoot score.Results All patients were followed up for 6~12 months.Intraoperative bleeding,length of hospital stay:the observation group was significantly less(shorter)than the control group(P<0.05).Operation time:the observation group was shorter than the control group,but the difference was not statistically significant(P>0.05).Complication incidence rate had statistical difference between the two groups(P>0.05).Postoperative time of full weight-bearing:the observation group was significantly earlier than the control group(P<0.05).At 3,6 months after operation,the excellent and good rate of AOFAS ankle-hindfoot score in the observation group was significantly higher than that in the control group(P<0.05).Conclusions Compared with the conventional large incision surgical approach,the oval forceps combined with bone anchor technique for closed achilles tendon rupture results in less intraoperative bleeding,shorter hospital stay,earlier full weight-bearing time on the ground and better functional recovery of the ankle.The clinical outcome is satisfactory.