摘要
目的比较使用跟腱吻合器经通道微创与传统开放修复急性跟腱断裂的疗效。方法回顾性分析本院2017年10月至2020年1月收治的23例急性跟腱断裂患者的临床资料,根据患者自主选择术式分为开放组(n=14)与通道组(n=9)。通道组采用跟腱微创吻合器经通道修复术,开放组采用传统开放缝合术,比较两组手术时间、切口长度、住院时间、住院总费用、术后MRI跟腱恢复情况及术后踝关节功能。结果所有患者均获得随访,随访时间3~16个月,平均(8.61±2.20)个月,随访期间,两组均未发生跟腱再断裂,MRI显示跟腱断端连续性好。通道组1例出现一过性腓肠神经支配区的感觉缺失,1周后症状自行消失;开放组出现1例切口局部坏死,跟腱外露,经换药后愈合。通道组切口长度小于开放组,住院时间短于开放组,差异均有统计学意义(P<0.05);两组手术时间比较差异无统计学意义;通道组住院总费用高于开放组,差异有统计学意义(P<0.05);末次随访时,两组AOFAS评分比较差异无统计学意义。结论两种术式修复急性跟腱断裂均有良好疗效,使用吻合器经通道微创修复切口小,可减少伤口并发症,缩短住院时间,但吻合器价格昂贵,适用人群有限,临床应根据患者实际情况合理选择术式。
Objective To compare the difference of curative effect between minimally invasive by achilles tendon stapler and traditional open repair of acute achilles tendon rupture.Methods The data of 23 cases of acute achilles tendon rupture in our hospital from October 2017 to January2020 were retrospectively analyzed.According to the patient’s independent choice of surgery,they were divided into incision group(n=14)and miniinvasion group(n=9).The mini-invasion group was treated with minimally invasive achilles tendon anastomotor through channel repair.The incision group adopted traditional open suture.The operation time,incision length,hospitalization time and total hospitalization cost,and the achilles tendon recovery of MRI after operation,the ankle joint function were compared between the two groups.Results All patients were followed up;the followup period was 3-16 months,with an average of(8.61±2.20)months.There was no achilles tendon rerupture in both groups.MRI showed that the achilles tendon had good continuity at the broken end.In the mini-invasion group,1 case had transient sensory loss in the innervated area of the gastrocnemius,1 week later,the symptoms disappeared.In the incision group,there was 1 case of local skin necrosis and achilles tendon exposure,which healed after debridement.The length of incision in the mini-invasion group was shorter than that in the incision group,and the length of hospital stay was shorter than that in the incision group(P<0.05),the operation time of the two groups was similar,the difference was not statistically significant,the total cost of stay in the mini-invasion group was larger than that in theincision group,the difference was statistically significant(P<0.05),the AOFAS score of the two groups at the last follow-up visit was not statistically significant.Conclusion Two kinds of operation have good curative effect on the repair of acute Achilles tendon rupture.Using the stapler to repair the small incision through the channel can reduce the complications of the wound and
作者
林廷岳
谭述军
李志敏
陈强
LIN Tingyue;TAN Shujun;LI Zhimin;CHEN Qiang(Department of Orthopaedics,the First People's Hospital of Xiangtan City,Xiangtan,Hunan,411101,China)
出处
《当代医学》
2021年第21期107-110,共4页
Contemporary Medicine
关键词
急性跟腱断裂
微创手术
吻合器
通道技术
Acute achilles tendon rupture
Minimally invasive surgery
Stapler
Channel-assisted
