三种经皮缝合技术修复急性跟腱断裂的比较
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宁夏回族自治区人民医院

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Comparison of three percutaneous suture techniques in repairing acute achilles tendon rupture
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1.People&2.amp;3.#39;4.&5.s Hospital of Ningxia Hui Autonomous Region;6.ningxiahuizuzizhiqurenminyiyuan

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    摘要:

    摘要:[目的]比较三种经皮缝合技术修复急性闭合性跟腱断裂的临床效果。[方法]回顾性分析2016年1月-2021年10月在我院进行手术治疗的急性闭合性跟腱断裂患者98例。依据术前医患沟通结果,47例采用3孔回形法;28例采用3孔Bunnell法;23例采用6孔Bunnell法。比较三组围手术期、随访和踝关节功能资料。[结果]三组间患者手术时间、术中失血、下地行走时间、住院时间均无统计学差异(p>0.05)。3孔法切口总长度明显短于6孔法(P<0.05)。3孔回形组术后完全负重时间早于3孔Bunnell组和6孔Bunnell组(P<0.05),但3孔Bunnell组和6孔Bunnell组之间无明显差异。三组间术后1个月VAS评分、AOFAS评分、ATRS评分没有差异(P>0.05),但3孔回形组术后6个月VAS评分、AOFAS评分、ATRS评分显著优于3孔Bunnell组和6孔Bunnell组(P<0.05)。末次随访时三组患者VSA评分、AOFAS评分、ATRS评分无明显差异(P>0.05),三组间VAS评分随时间降低(P<0.05),AOFAS评分、ATRS随时间升高(P<0.05)。三组间术后1个月、6个月及末次随访时足跖屈-背伸ROM无明显统计学差异(P>0.05),随着术后随访时间延长三组足跖屈-背伸ROM显著增加(P<0.05)。三组术后末次随访均无跟腱二次断裂等并发症发生。[结论] 急性闭合性跟腱断裂3种不同的缝合方法远期治疗效果相似,但3孔法回形法切口小,更利于跟腱功能的早期恢复。

    Abstract:

    Abstract: [Objective] To compare the clinical effects of three percutaneous suture techniques in repairing acute closed achilles tendon rupture. [Methods] Retrospective analysis of 98 patients with acute closed achilles tendon rupture who underwent surgical treatment in our hospital from January 2016 to October 2021. According to the results of preoperative doctor-patient communication, 47 cases were treated with 3-hole loop method. 28 cases were treated with 3-hole Bunnell method; 23 cases were treated with 6-hole Bunnell method. Perioperative period, follow-up and ankle function data of the three groups were compared. [Results] There was no significant difference in operation time, blood loss, walking time and hospitalization time among the three groups (p>0.05). The total incision length of 3-hole method was significantly shorter than that of 6-hole method (P<0.05). The complete weight-bearing time of 3-hole loop group was earlier than that of 3-hole Bunnell group and 6-hole Bunnell group (P<0.05), but there was no significant difference between 3-hole Bunnell group and 6-hole Bunnell group. There was no difference in VAS score, AOFAS score and ATRS score between the three groups at 1 month after operation (P>0.05), but the VAS score, AOFAS score and ATRS score of 3-hole loop group at 6 months after operation were significantly better than those of 3-hole Bunnell group and 6-hole Bunnell group (P<0.05). At the last follow-up, there was no significant difference in VSA score, AOFAS score and ATRS score among the three groups (P>0.05), but VAS score decreased with time (P<0.05) and AOFAS score and ATRS increased with time (P<0.05). There was no significant difference in plantar flexion-extension ROM among the three groups at 1 month, 6 months and the last follow-up after operation (P>0.05), but the ROM of plantar flexion-extension in the three groups increased significantly with the prolongation of the follow-up time after operation (P<0.05). No complications such as secondary rupture of Achilles tendon occurred in the last follow-up of the three groups. [Conclusion] The long-term therapeutic effect of three different suture methods for acute achilles tendon rupture is similar, but the incision of 3-hole loop method is smaller, which is more conducive to the early recovery of achilles tendon function.

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  • 收稿日期:2022-07-30
  • 最后修改日期:2022-10-31
  • 录用日期:2023-01-12
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