摘要
目的:探讨超声引导下小切口横穿联合交叉固定技术治疗急性闭合性跟腱断裂的临床疗效。方法:自2015年1月至2017年5月,采用超声引导下小切口横穿联合交叉固定技术治疗20例急性闭合性跟腱断裂患者,其中男13例,女7例;年龄28~49(31.3±4.5)岁;20例均为单侧;左侧15例,右侧5例。受伤至手术时间1~5(2.5±0.7)d。观察并记录患者手术时间、术后并发症情况,比较术前及术后12个月AOFAS评分。结果:所有患者获得随访,时间12~27(15.2±4.9)个月。手术时间33~65(43.7±5.6)min。20例中1例创口局部持续渗出,经换药好转,其余均Ⅰ期愈合。术后均未出现腓肠神经激惹症状及跟腱再断裂。AOFAS评分由术前的65.2±7.4提高到术后12个月的97.7±4.7(t=22.5,P<0.01);优18例,良2例。结论:超声引导下小切口横穿联合交叉固定技术治疗跟腱断裂,在保证小切口优势的同时,保护了腓肠神经,确保了跟腱吻合固定的质量,是治疗急性闭合性跟腱断裂的理想方法。
Objective:To explore clinical effects of ultrasound-guided minimal traverse-cross technique repair for acute closed Achilles tendon ruptures.Methods:From January 2015 to March 2017,20 patients with acute closed Achilles tendon rupture were treated by minimal traverse-cross technique repair with ultrasound guided.Among them,including 13 males and 7 females,aged from 28 to 49 years old with an average of(31.3±4.5)years old.All patients were single side injury.Fifteen patients on the left side and 5 patients were on the right side.The time from injury to operation ranged from 1 to 5 days with an average of(2.5±0.7)days.Operative time,postoperative complications were observed,and AOFAS score before and after operation at 12 months were compared.Results:All patients were followed up for 12 to 27 months with an average of(15.2±4.9)months.Operative time ranged from 33 to 65 min with an average of(43.7±5.6)min.Incision of one patient were continued oozing and improved after changing dressings,other patients were healed at stageⅠ.No sural nerve irritation symptoms and palindromic rapture of heel tendon occurred.AOFAS score was improved from 65.2±7.4 before operation to 97.7±4.7 after operation at 12 months(t=22.5,P<0.01);18 patients got excellent results and 2 good.Conclusion:Ultrasound-guided minimal traverse-cross technique repair for acute closed Achilles tendon ruptures,which promise minimal incision,protect sural nerve,ensure quality of tendon anastomosis and fixation,and is a ideal method for repairing acute closed Achilles tendon ruptures.
作者
郑鑫
陈滔
黄杨
宫小康
江浪清
李永生
陈伟杰
阮建伟
王海宝
ZHENG Xin;CHEN Tao;HUANG Yang;GONG Xiao-kang;JIANG Lang-qing;LI Yong-sheng;CHEN Wei-jie;RUAN Jian-wei;WANG Hai-bao(Department of Hand and Foot Surgery in Orthopaedics Center,Taizhou Municipal Hospital,Taizhou 318000,Zhejiang,China)
出处
《中国骨伤》
CAS
CSCD
2019年第8期712-716,共5页
China Journal of Orthopaedics and Traumatology
关键词
超声检查
介入性
跟腱
外科手术
微创性
Ultrasonography,interventional
Achilles tendon
Surgical procedures,minimally invasive
