摘要
[目的]比较三种小切口修复急性闭合性跟腱断裂的临床效果。[方法]回顾性分析2016年1月—2021年10月在本院小切口缝合急性闭合性跟腱断裂的98例患者的临床资料。依据术前医患沟通结果,47例采用3孔回形法,28例采用3孔Bunnell法;23例采用6孔Bunnell法。比较三组围手术期、随访资料。[结果]三组间患者手术时间、术中失血量、下地行走时间、切口愈合等级、住院时间的差异均无统计学意义(P>0.05)。3孔法切口总长度明显短于6孔法(P<0.05)。3孔回形组术后完全负重时间显著早于3孔Bunnell、6孔Bunnell组(P<0.05)。随时间推移,三组VAS评分均显著减少(P<0.05),而AOFAS评分、ATRS评分、足跖屈-背伸ROM均显著增加(P<0.05)。术后1个月,三组间上述指标的差异均无统计学意义(P>0.05),但术后6个月时3孔回形组AOFAS、ATRS评分均显著优于3孔Bunnell、6孔Bunnell组(P<0.05),但三组足跖屈-背伸ROM的差异无统计学意义(P>0.05)。末次随访时,三组间上述指标的差异均无统计学意义(P>0.05)。随访过程中,三组均无跟腱再断裂等并发症发生。[结论]急性闭合性跟腱断裂3种不同的缝合方法远期治疗效果相似,但3孔法回形法切口小,更利于跟腱功能的早期恢复。
[Objective]To compare the clinical outcomes of three small-incisions suture repairs of acute closed Achilles tendon rupture.[Methods]A retrospective study was conducted on 98 patients who received small-incision repair for acute closed Achilles tendon rupture in our hospital from January 2016 to October 2021.According to the results of preoperative doctor-patient communication,47 patients were treated with 3-incision simple suture(3ISS),28 patients were treated with 3-incision Bunnell suture(3IBS),while the remaining 23 patients were with the 6-incision Bunnell suture(6IBS).The perioperative period and follow-up data of the three groups were compared.[Results]There were no significant differences in operation time,intraoperative blood loss,postoperative walking time,incision healing grade and hospital stay among the three groups(P<0.05).The 3ISS and 3IBS had significantly shorter total incision length than the 6IBS group(P<0.05).The 3ISS group resumed full weight-bearing activity significantly earlier than the 3IBS and 6IBS groups(P<0.05).The VAS scores decreased significantly(P<0.05),while AOFAS score,ATRS score and plantar-dorsal flexion range of motion(ROM)significantly increased in all the 3 groups over time(P<0.05).Although there was no significant difference in the abovesaid items among the three groups a month after operation(P>0.05),the 3ISS group proved significantly superior to the 3IBS and 6IBS group in terms of the AOFAS and ATRS scores(P<0.05),whereas not in plantar-dorsal flexion ROM at 6 months postoperatively(P>0.05).However,there was no significant difference in the abovementioned indexes among the three groups at the last follow-up(P>0.05).During the follow-up,no complications such as Achilles tendon re-rupture occurred in anyone of the three groups.[Conclusion]Although the 3 different suture methods have similar long-term clinical outcomes on acute closed Achilles tendon rupture,the 3-incision simple suture is more conducive to the early recovery of Achilles tendon function with smaller incision.
作者
石楠
马国续
巩凡
李晓亮
赵子航
赵飞
SHI Nan;MA Guo-xu;GONG Fan;LI Xiao-liang;ZHAO Zi-hang;ZHAO Fei(Department of Hand and Foot Surgery and Reconstructive Microsurgery,People's Hospital of Ningxia Hui Autonomous Region,Ningxia Medical University,Yinchuan 750002,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2023年第16期1476-1481,共6页
Orthopedic Journal of China
关键词
跟腱断裂
小切口
缝合方法
Achilles tendon rupture
small incision
suture method
