传统与微创缝合急性闭合性跟腱断裂的比较
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庞晖,主治医师,研究方向:骨外科,(电话)13561598083,(电子信箱)29465370@qq.com

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R687

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Comparison of traditional and minimally invasive sutures for acute closed Achilles tendon tears
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    摘要:

    目的]比较传统与微创缝合术治疗修复急性闭合性跟腱断裂的临床效果。[方法]2016 年 5 月—2019 年 11 月,对 64 例(64 足)急性闭合性跟腱断裂患者行手术缝合修复术。依据术前医患沟通结果,30 例行传统切开缝合术,34 例行通道辅助微创修复系统(channel-assisted minimally invasive repair, CAMIR)缝合术。比较两组围手术期、随访和影像资料。[结果]微创组手术时间 [(56.40±4.21) min vs (78.24±8.75) min,P<0.05]、切口长度 [(3.75±0.50) cm vs (12.90±1.77) cm,P< 0.05]和术中出血量 [(12.29±1.75)ml vs(24.5±2.92)ml,P<0.05]均显著优于传统组。术后随访(23.80±3.75)个月。与术前相比,末次随访时两组 VAS 评分显著减少 (P<0.05),而 AOFAS 和 ATRS 评分显著增加 (P<0.05)。至末次随访时,微创组的 VAS 评分 [(0.99±0.30) vs (1.34±0.28),P<0.05] 和 AOFAS 评分 [(81.15±3.28) vs (77.27±2.21),P<0.05] 均显著优于传统组,但两组间 ATRS 评分的差异无统计学意义(P>0.05)。[结论]与传统切开缝合术相比,CAMIR 微创缝合具有创伤小、 术后功能恢复更好的的优势。

    Abstract:

    [Objective] To compare the clinical efficiency of traditional and minimally invasive sutures for acute closed Achilles tendon rupture. [Methods] From May 2016 to November 2019, 64 patients (64 feet) underwent surgical repair for acute closed Achilles tendon rup- ture in our hospitals. According to the results of preoperative doctor-patient communication, 30 patients were treated with traditional open suture, while the other 34 patients had the tendon sutured by channel-assisted minimally invasive repair (CAMIR) . The perioperative, fol- low-up and imaging documents were compared between the two groups. [Results] The CAMIR group proved significantly superior to the traditional group regarding to operation time [ (56.40±4.21) min vs (78.24±8.75) min, P<0.05] , incision length [ (3.75±0.50) cm vs (12.90± 1.77) cm, P<0.05] and intraoperative blood loss [ (12.29±1.75)ml vs (24.5±2.92) ml, P<0.05] . The postoperative follow-up period lasted for (23.80±3.75) months on average. The VAS scores decreased significantly (P<0.05) , while the AOFAS and ATRS scores increased sig- nificantly in both groups at the latest follow-up compared with those before operation (P<0.05) . At the latest follow-up, the CAMIR group was significantly better than the traditional group in terms of VAS score [ (0.99±0.30) vs (1.34±0.28) , P<0.05] and AOFAS score [ (81.15± 3.28) vs (77.27±2.21) , P<0.05] , nevertheless there was no a statistically significant difference in ATRS scores between the two groups (P> 0.05) . [Conclusion] Compared with traditional open suture, the minimally invasive suture by using CAMIR has the advantages of less trau- ma and better postoperative functional recovery.

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庞晖,崔健,李建军,等. 传统与微创缝合急性闭合性跟腱断裂的比较[J]. 中国矫形外科杂志, 2022, 30 (4): 325-328. DOI:10.3977/j. issn.1005-8478.2022.04.08.
PANG Hui, CUI Jian, LI Ji? an-jun, et al. Comparison of traditional and minimally invasive sutures for acute closed Achilles tendon tears[J]. ORTHOPEDIC JOURNAL OF CHINA , 2022, 30 (4): 325-328. DOI:10.3977/j. issn.1005-8478.2022.04.08.

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  • 收稿日期:2021-07-01
  • 最后修改日期:2021-08-12
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  • 在线发布日期: 2023-06-10
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