梭形针线扣技术与Krackow缝合法对跟腱止点或近止点断裂跟腱功能恢复的疗效比较

Effect of spindle needle and thread technique and Krackow suture technique on functional recovery of Achilles tendon rupture at or near the Achilles tendon stop

目的:探讨梭形针线扣技术与Krackow缝合法在跟腱止点或近止点断裂患者中的应用效果及对患者跟腱功能的影响。方法:收集2021年1月至2022年12月衡水市第四人民医院手足外一科收治的106例跟腱止点或近止点断裂患者资料进行分析,利用随机数字表法分组,每组53例。研究组予以梭形针线扣技术结合远端经跟骨骨隧道线扣技术,对照组给予近端Krackow缝合结合远端经跟骨骨隧道线扣技术。比较患者的手术相关指标、跟腱功能优良率、跟腱完全断裂(ATRS)评分,并记录术后跟腱断裂和并发症发生率。结果:研究组的切口长度、切口愈合时间、住院时间均短于对照组[(4.55±1.03)cm比(6.72±1.30)cm]、[(3.44±1.08)d比(4.07±1.45)d]、[(3.86±1.13)d比(4.48±1.34)d](t_(切口长度)=9.525,t_(切口愈合时间)=2.537,t_(住院时间)=7.559,P<0.05)。术中出血量研究组[(133.53±20.39)ml]少于对照组[(157.14±23.26)ml](t=5.557,P<0.05)。研究组的优良率(94.34%)高于对照组(81.13%)(χ^(2)=4.296,P<0.05)。研究组术后3个月ATRS评分高于对照组(t=2.815,P<0.05)。研究组术后1、3个月的跟腱断裂发生率均低于对照组[(1.89%)比(13.21%)、(0.00%)比(7.55%)](χ^(2)_(1个月)=4.867,χ^(2)_(3个月)=4.157,P<0.05)。研究组的并发症发生率(1.89%)低于对照组(13.21%)(χ^(2)=4.867,P<0.05)。结论:梭形针线扣技术结合远端经跟骨骨隧道线扣技术治疗跟腱止点或近止点断裂患者的效果优于近端Krackow缝合结合远端经跟骨骨隧道线扣技术,可快速恢复患者的跟腱功能,降低术后近期跟腱断裂和并发症发生率。

Objective To investigate the application effect of fusiform needle and thread technique and Krackow suture in patients with Achilles tendon rupture at or near the Achilles tendon and their influence on the Achilles tendon function.Methods A total of 106 patients with Achilles tendon rupture at or near the Achilles tendon from January 2021 to December 2022 admitted to Department of Hands and Foot,the Fourth People′s Hospital of Hengshui were included as the study objects and grouped by random number table method,and each group had 53 patients.The control group was given proximal Krackow suture combined with distal transcalcaneal bone tunnel suture,and the study group was given spindle needle combined with distal transcalcaneal bone tunnel suture.Surgery-related indexes,the good rate of Achilles tendon function,and achilles tendon total rupture score(ATRS)scores of the two groups were compared,and the incidence of postoperative Achilles tendon rupture and complications were recorded.Results Incision length[(4.55±1.03)cm],incision healing time[(3.44±1.08)d]and hospitalization time[(3.86±1.13)d]in the study group were shorter than the control group[(6.72±1.30)cm,(4.07±1.45)min,(4.48±1.34)d](tincision length=9.525,tincision healing time=2.537,thospitalization time=7.559,P<0.05).The intraoperative blood loss[(133.53±20.39)ml]was lower than the control group[(157.14±23.26)ml](t=5.557,P<0.05).The excellent and good rate of the study group(94.34%)was higher than the control group(81.13%)(χ^(2)=4.296,P<0.05).The ATRS score of the study group was higher than the control group at 3 months after operation(t=2.815,P<0.05).The incidence of tendon rupture at 1 months(1.89%)and 3 months(0.00%)in the study group was lower than that in the control group(13.21%and 7.55%)(χ^(2)_(1 months)=4.867,χ^(2)_(3 months)=4.157,P<0.05).The complication rate of the study group(1.89%)was lower than the control group(13.21%)(χ^(2)=4.867,P<0.05).Conclusion The treatment effect of fusiform needle technique combined with distal transcalcaneal tunnel suture is better than that of proximal Krackow suture combined with distal transcalcaneal tunnel suture in the treatment of patients with Achilles tendon rupture at or near the Achilles tendon,which can quickly restore the Achilles tendon function of patients and reduce the incidence of recent postoperative Achilles tendon rupture and complications.