Purpose: We investigated whether percutaneous suturing of Achilles tendon ruptures showed better results and superiority in terms of clinical outcomes when compared to open suturing. Methods: We conducted a case-contr...Purpose: We investigated whether percutaneous suturing of Achilles tendon ruptures showed better results and superiority in terms of clinical outcomes when compared to open suturing. Methods: We conducted a case-control study. Between 2009 and 2014, we performed surgical revisions of closed acute Achilles tendon ruptures in our hospital in 146 patients, of which 71 patients (2012-2014) received percutaneous suturing using Dresden instruments, and 75 patients (2009-2012) underwent open suturing. After a minimum period of 1 year post surgery, we performed clinical follow-up in 25 patients of each of the groups using the AOFAS hind foot score and the SF-12 questionnaire. Furthermore, we implemented a clinical questionnaire with a reference population of 200 healthy individuals. Results: Mean age in the total population of 146 patients was 47 years (range 21 to 83 years) at the time of surgery. The duration of the surgical procedure with percutaneous suturing was significantly shorter (24 versus 43 minutes, p < 0.0001), the complication rate was significantly lower (2.81% versus 10.7%, p < 0.0001), and the time of hospitalisation was significantly shorter (3 versus 4 days, p < 0.0001) when compared to open suturing. During follow-up, no significant differences between the two groups were observed in terms of descriptive parameters. Furthermore, ultrasound examinations of both follow-up populations did not show any significant difference. From a clinical perspective, the good to very good results achieved with open suturing (as measured with the AOFAS hind foot score and the SF-12 questionnaire) have not been significantly improved with percutaneous suturing. The additional use of a new clinical score (with the reference population) demonstrated good to very good consistency with the established scores. Conclusion: In our population, percutaneous Achilles tendon suturing showed significantly lower complication rates and significantly shorter procedure times when compared to open suturing. However, percutaneous suturin展开更多
Although catheterization of the subclavian vein is a common procedure, it might be associated with life-threatening complications including accidental cannulation of subclavian artery. Rash sheath removal could result...Although catheterization of the subclavian vein is a common procedure, it might be associated with life-threatening complications including accidental cannulation of subclavian artery. Rash sheath removal could result in fatal hemorrhage. We report a case of inadvertent 6F sheath cannulation of the right subclavian artery during a radiofrequency catheter ablation procedure and successful repair of the cannulation by Angio-Seal STS plus （St. Jude Medical, St. Paul, MN, US）, a collagen-base vascular closure device.展开更多
[目的]比较经皮修复与开放修复治疗急性闭合性跟腱断裂的临床效果。[方法]回顾性研究2015年7月—2020年2月于本院手术治疗的急性闭合性跟腱断裂72例患者的临床资料。根据医患沟通结果,38例改良Ma-Griffith经皮修复(微创组),另外34例采...[目的]比较经皮修复与开放修复治疗急性闭合性跟腱断裂的临床效果。[方法]回顾性研究2015年7月—2020年2月于本院手术治疗的急性闭合性跟腱断裂72例患者的临床资料。根据医患沟通结果,38例改良Ma-Griffith经皮修复(微创组),另外34例采用传统开放修复(开放组)。比较两组围手术期和随访资料。[结果]微创组手术时间[(45.5±5.9) min vs (49.0±7.0) min, P<0.05]、切口总长度[(5.5±0.8) cm vs (7.9±0.9) cm, P<0.05]、术中失血量[(16.1±4.1) ml vs (25.9±4.9) ml, P<0.05]、下地行走时间[(4.0±1.6) d vs (7.0±1.7) d, P<0.05]、切口愈合等级[甲/乙/丙, 38/0/0 vs 30/4/0, P<0.05]、住院时间[(8.2±1.9) d vs (12.0±2.5) d, P<0.05]均显著优于开放组。微创组腓肠神经损伤发生率显著高于开放组(20.1%vs 2.9%, P<0.05),但微创组术后切口感染发生率显著低于开放组(0.0%vs 11.8%, P<0.05)。所有患者平均随访(15.9±2.8)个月,微创组术后完全负重活动时间显著早于开放组[(59.3±4.7) d vs (87.8±4.4) d, P<0.05]。随术后时间推移,两组VAS评分显著减小(P<0.05),而AOFAS评分及踝关节活动度显著增加(P<0.05)。在术后1个月,微创组的VAS [(1.9±0.6) vs (3.9±0.8), P<0.05]、AOFAS [(86.0±3.4) vs (74.7±5.0),P<0.05]、ATRS评分[(89.2±4.0) vs (77.2±4.0), P<0.05]及踝关节活动度[(48.7±3.6)°vs (39.7±4.1)°, P<0.05]均显著优于开放组(P<0.05),但是,末次随访时两组间上述指标的差异均无统计学意义(P>0.05)。[结论]经皮修复术作为一种微创手术,虽然腓肠神经损伤的风险较高,但与开放修复术相比,能明显降低跟腱断裂后的感染率,促进术后早期功能恢复。展开更多
文摘Purpose: We investigated whether percutaneous suturing of Achilles tendon ruptures showed better results and superiority in terms of clinical outcomes when compared to open suturing. Methods: We conducted a case-control study. Between 2009 and 2014, we performed surgical revisions of closed acute Achilles tendon ruptures in our hospital in 146 patients, of which 71 patients (2012-2014) received percutaneous suturing using Dresden instruments, and 75 patients (2009-2012) underwent open suturing. After a minimum period of 1 year post surgery, we performed clinical follow-up in 25 patients of each of the groups using the AOFAS hind foot score and the SF-12 questionnaire. Furthermore, we implemented a clinical questionnaire with a reference population of 200 healthy individuals. Results: Mean age in the total population of 146 patients was 47 years (range 21 to 83 years) at the time of surgery. The duration of the surgical procedure with percutaneous suturing was significantly shorter (24 versus 43 minutes, p < 0.0001), the complication rate was significantly lower (2.81% versus 10.7%, p < 0.0001), and the time of hospitalisation was significantly shorter (3 versus 4 days, p < 0.0001) when compared to open suturing. During follow-up, no significant differences between the two groups were observed in terms of descriptive parameters. Furthermore, ultrasound examinations of both follow-up populations did not show any significant difference. From a clinical perspective, the good to very good results achieved with open suturing (as measured with the AOFAS hind foot score and the SF-12 questionnaire) have not been significantly improved with percutaneous suturing. The additional use of a new clinical score (with the reference population) demonstrated good to very good consistency with the established scores. Conclusion: In our population, percutaneous Achilles tendon suturing showed significantly lower complication rates and significantly shorter procedure times when compared to open suturing. However, percutaneous suturin
文摘Although catheterization of the subclavian vein is a common procedure, it might be associated with life-threatening complications including accidental cannulation of subclavian artery. Rash sheath removal could result in fatal hemorrhage. We report a case of inadvertent 6F sheath cannulation of the right subclavian artery during a radiofrequency catheter ablation procedure and successful repair of the cannulation by Angio-Seal STS plus （St. Jude Medical, St. Paul, MN, US）, a collagen-base vascular closure device.
文摘[目的]比较经皮修复与开放修复治疗急性闭合性跟腱断裂的临床效果。[方法]回顾性研究2015年7月—2020年2月于本院手术治疗的急性闭合性跟腱断裂72例患者的临床资料。根据医患沟通结果,38例改良Ma-Griffith经皮修复(微创组),另外34例采用传统开放修复(开放组)。比较两组围手术期和随访资料。[结果]微创组手术时间[(45.5±5.9) min vs (49.0±7.0) min, P<0.05]、切口总长度[(5.5±0.8) cm vs (7.9±0.9) cm, P<0.05]、术中失血量[(16.1±4.1) ml vs (25.9±4.9) ml, P<0.05]、下地行走时间[(4.0±1.6) d vs (7.0±1.7) d, P<0.05]、切口愈合等级[甲/乙/丙, 38/0/0 vs 30/4/0, P<0.05]、住院时间[(8.2±1.9) d vs (12.0±2.5) d, P<0.05]均显著优于开放组。微创组腓肠神经损伤发生率显著高于开放组(20.1%vs 2.9%, P<0.05),但微创组术后切口感染发生率显著低于开放组(0.0%vs 11.8%, P<0.05)。所有患者平均随访(15.9±2.8)个月,微创组术后完全负重活动时间显著早于开放组[(59.3±4.7) d vs (87.8±4.4) d, P<0.05]。随术后时间推移,两组VAS评分显著减小(P<0.05),而AOFAS评分及踝关节活动度显著增加(P<0.05)。在术后1个月,微创组的VAS [(1.9±0.6) vs (3.9±0.8), P<0.05]、AOFAS [(86.0±3.4) vs (74.7±5.0),P<0.05]、ATRS评分[(89.2±4.0) vs (77.2±4.0), P<0.05]及踝关节活动度[(48.7±3.6)°vs (39.7±4.1)°, P<0.05]均显著优于开放组(P<0.05),但是,末次随访时两组间上述指标的差异均无统计学意义(P>0.05)。[结论]经皮修复术作为一种微创手术,虽然腓肠神经损伤的风险较高,但与开放修复术相比,能明显降低跟腱断裂后的感染率,促进术后早期功能恢复。
