摘要
目的探讨新式3D打印导板辅助微创治疗新鲜闭合性跟腱断裂的临床疗效。方法回顾性分析2019年1月至2020年1月期间徐州仁慈医院足踝外科采用3D打印导板辅助微创手术治疗的14例新鲜闭合性跟腱断裂患者资料。男13例,女1例;平均年龄为39.1岁(18~63岁)。跟腱断裂部位位于跟骨结节止点上方2~6 cm,平均3 cm,均为体部断裂。术中在新式3D打印导板辅助下完成跟腱断端缝合修复,术后联合康复科在加速康复外科理念指导下进行康复锻炼。记录患者的切口长度、手术时间、术中出血量、末次随访时踝关节功能及随访期间并发症发生情况等。结果本组患者的切口长度平均为2.5 cm(2.0~3.5 cm);手术时间为30~60 min,平均45 min;术中出血量为10~20 mL,平均15 mL。14例患者术后获13~16个月(平均14个月)随访。1例患者切口边缘表皮发黑坏死,经伤口换药后愈合。随访期间无排线反应、腓肠神经损伤及跟腱再断裂等并发症发生。末次随访时美国足踝外科协会踝-后足功能评分平均为98分(93~99分),优13例,良1例;根据Arner-Lindholm法评定疗效:优12例,良1例,差1例。结论新式3D打印导板辅助微创治疗新鲜闭合性跟腱断裂具有切口微创、并发症少、操作简单、踝关节功能恢复良好及手术操作可重复性强等优点。
Objective To investigate the clinical efficacy of a new 3D printed guide plate in the minimally invasive treatment of fresh closed Achilles tendon rupture.Methods From January 2019 to January 2020,14 fresh closed Achilles tendon ruptures were treated by minimally invasive surgery at Department of Foot and Ankle Surgery,Xuzhou Renci Hospital.There were 13 males and one female,with an average age of 39.1 years(from 18 to 63 years).The rupture of the Achilles tendon body,3 cm in length on average,was located 2 to 6 cm above the attachment of the calcaneal tuberosity.The ruptured Achilles tendon was repaired by suture with the aid of the new 3D printed guide plate.After operation,in cooperation of the Rehabilitation Department,we performed rehabilitation exercise under the guidance of the concept of Enhanced Recovery After Surgery(ERAS).The length of incision,operation time,intraoperative blood loss,ankle function at the last follow-up and follow-up complications were recorded.Results In this cohort,incision length averaged 2.5 cm(from 2.0 to 3.5 cm),operation time 45 min(from 30 to 60 min),and intraoperative blood loss 15 mL(from 10 to 20 mL).The 14 patients were followed up for 13 to 16 months(average,14 months)after operation.In one patient,the epidermis at the incision edge became black and necrotic,which was healed after dressing change.Follow-ups observed no such complications as suture rejection,sural nerve injury,or Achilles tendon re-rupture.The American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot scores at the last follow-up averaged 98 points(from 93 to 99 points),yielding 13 excellent cases and one good case;according to the Arner-Lindholm evaluation,the efficacy was excellent in 12 cases,good in one and poor in one.Conclusion The minimally invasive treatment of fresh closed Achilles tendon rupture with our new 3D printed guide plate has exhibited advantages of minimally invasive incision,limited complications,simple manipulation,good functional recovery of the ankle joint and strong reproduci
作者
陈占斌
曹广超
王岩岩
杨龙
石荣剑
Chen Zhanbin;Cao Guangchao;Wang Yanyan;Yang Long;Shi Rongjian(Department of Foot and Ankle Surgery,Xuzhou Renci Hospital,Xuzhou 221000,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2021年第9期817-820,共4页
Chinese Journal of Orthopaedic Trauma
关键词
跟腱
断裂
外科手术
微创性
导板
3D打印技术
Achilles tendon
Ruptures
Surgical procedures,minimally invasive
Guide plates
3D printing technology
