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经通道微创修复急性闭合性跟腱断裂的疗效分析
Analysis of the efficacy of minimally invasive repair of acute closed Achilles tendon rupture through channels
投稿时间:2023-12-06  
DOI:10.3969/j.issn.1672-5972.2024.03.008
中文关键词:  通道辅助微创修复系统  急性闭合性跟腱断裂  缝合术
英文关键词:Channel assisted minimally invasive repair system  Acute closed Achilles tendon rupture  Suture technique
基金项目:
作者单位邮编
付志彬 成都体育学院附属体育医院骨关节科四川 成都610041 610041
唐小梅 四川省民政康复医院康复治疗科四川 成都610041 610041
周凌 成都体育学院附属体育医院骨关节科四川 成都610041 610041
辜刘伟 成都体育学院附属体育医院骨关节科四川 成都610041 610041
邓又山 成都体育学院附属体育医院骨关节科四川 成都610041 610041
朱绍灵 成都体育学院附属体育医院骨关节科四川 成都610041 610041
罗世科 成都体育学院附属体育医院骨关节科四川 成都610041 610041
吴青松 成都体育学院附属体育医院骨关节科四川 成都610041 610041
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中文摘要:
      目的 探讨行通道辅助微创修复系统缝合术修复急性闭合性跟腱断裂的临床疗效。方法 将2017年3月至2021年9月收入成都体育学院附属体育医院的90例急性闭合性跟腱断裂患者进行回顾性分析。根据术前医患沟通结果,分为微创组(45例)和开放组(45例)。微创组采用微创跟腱断裂通道吻合器吻合术,开放组采用切开改良Kessler断端吻合术。比较两组患者的手术时间、切口长度、并发症;分别比较两组患者术后1、6、12个月的疼痛视觉模拟评分(visual analogue scale, VAS)、美国骨科足踝协会后足与踝评分(American Orthopaedic Foot and Ankle Society, AOFAS)和足跖屈-背伸活动度(range of motion, ROM)。结果 微创组及开放组患者均获12 ~ 24个月的随访,平均为(18.4±5.6)个月。微创组的手术时间较开放组手术时间明显少,微创组手术切口长度较开放组手术切口长度明显短,两组比较差异有统计学意义(P<0.05)。微创组术中、术后并发症明显低于开放组,两组比较差异有统计学意义(P<0.05),微创组及开放组患者术后1个月的VAS评分,差异有统计学意义(P<0.05);术后6、12个月的VAS评分,差异无统计学意义(P>0.05)。两组患者术后1、6个月的AOFAS评分,差异有统计学意义(P<0.05);术后12个月AOFAS评分比及术后6、12个月的足跖屈-背伸活动度比较,差异无统计学意义(P>0.05)。结论 采用微创跟腱断裂通道吻合器修复急性闭合性跟腱断裂,具有微创、并发症少、早期康复等优势。
英文摘要:
      Objective To explore the clinical efficacy of the channel-assisted minimally invasive repair system for the repair of acute closed Achilles tendon rupture.Methods A retrospective analysis was conducted on 90 patients with acute closed Achilles tendon rupture, who were admitted to the Affiliated Sports Hospital of Chengdu Sport University from March 2017 to September 2021. According to the results of preoperative doctor-patient communication, they were divided into minimally invasive group (45 cases) and open group (45 cases). Minimally invasive Achilles tendon rupture channel anastomosis was performed in the minimally invasive group, and modified incision Kessler fracture end anastomosis was performed in the open group. The operation time, incision length and complications were compared between the two groups. Visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS), and range of motion (ROM) of the two groups were compared respectively at 1 month, 6 months and 12 months after surgery.Results Patients in the minimally invasive and open groups were followed up for 12-24 months, with an average of (18.4 ± 5.6) months. The operation time and the length of the surgical incision in the minimally invasive group were significantly shorter than that in the open group, there was a significant difference between the two groups, with statistical significance (P<0.05). The intraoperative and postoperative complications in the minimally invasive group were significantly lower than those in the open group, and the difference between the two groups was statistically significant (P<0.05). The VAS scores of patients in the minimally invasive and open groups at one month after surgery were significantly different (P<0.05); the VAS scores at 6 and 12 months after surgery showed no statistically significant difference (P>0.05). The difference in AOFAS scores between the two groups of patients at 1 and 6 months after surgery was statistically significant (P<0.05); there was no statistically significant difference (P>0.05) in the AOFAS score ratio at 12 months after surgery and the plantar flexion dorsiflexion range of motion at 6 and 12 months after surgery.Conclusion The use of the minimally invasive Achilles tendon rupture channel stapler for repairing acute closed Achilles tendon rupture has advantages such as minimally invasive, fewer complications, and early rehabilitation.
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