Krackow法缝合无结减张固定治疗急性跟腱断裂

The knotless Krackow method suture tension-reduced fixation for treatment of acute closed achilles tendon ruptures

目的 探讨Krackow法缝合无结减张固定治疗急性跟腱断裂的疗效。方法 采用Krackow法缝合无结减张固定治疗31例急性跟腱断裂患者。记录手术时间、术后负重及并发症发生情况,观察术后切口愈合、皮肤感觉情况,采用AOFAS踝-后足评分及Arner-Lindholm标准评定疗效。结果 患者均获得随访,时间6~17个月。手术时间28~35 min。所有患者术后第3天拆除石膏、穿跟部垫高的跟腱靴,开始扶拐部分负重,1周内均达到完全负重。切口均甲级愈合,均未发生排异反应、感染、皮肤麻木或坏死及腓肠神经损伤等并发症。末次随访时,MRI检查显示跟腱均连续;AOFAS踝-后足评分88~100分,其中优29例,良2例,优良率31/31;采用Arner-Lindholm评分评价疗效:优22例,良9例,优良率31/31。结论 Krackow法缝合无结减张固定治疗急性跟腱断裂,术后并发症少,患者可早期负重,疗效满意。

Objective To investigate the curative effect of knotless Krackow method suture tension-reduced fixation in the treatment of acute achilles tendon rupture.Methods The 31 patients with acute achilles tendon ruptures were treated by knotless Krackow method suture tension-reduced fixation.The operative time,postoperative weight-bearing and complications were recorded.The wound healing and skin sensation were observed.AOFAS ankle-hindfoot function score and Arner-Lindholm criteria were used to evaluate the curative effect.Results All patients were followed up for 6~17 months.The operation time was 28~35 min.On the 3rd day after surgery,all the patients had removed their plaster,wore the achilles tendon boot with the heel padded high,and began to hold the weight of the crutches,and achieved full weight-bearing within 1 week.All the incisions got grade A healing,there was no rejection reaction,infection,skin numbness or necrosis,sural nerve injury and other complications.At the last follow-up,MRI showed that the achilles tendon was continuous,and the AOFAS ankle-hindfoot score was 88~100 points,of which 29 cases were excellent and 2 cases were good,with an excellent and good rate of 31/31.Arner-Lindholm score was used to evaluate the curative effect:22 cases were excellent,9 cases were good,and the excellent-good rate was 31/31.Conclusions Knotless Krackow method suture tension-reduced fixation for the treatment of acute achilles tendon rupture has fewer postoperative complications,and patients can bear weight early,with satisfactory curative effect.