Achillon微创跟腱吻合器治疗29例闭合性跟腱断裂  

Repair of 29 cases of closed Achilles tendon ruptures by Achillon~ minimally invasive Achilles tendon suture system

作　　者：任小宝[1] 陈翔宇[1] 孙溦[1] 郭国宁[1] 黄崧[1] 

机构地区：[1]第三军医大学西南医院急救部,重庆400038

出　　处：《第三军医大学学报》2011年第6期641-643,共3页Journal of Third Military Medical University

摘　　要：目的探讨经2 cm的微创切口应用Achillon微创跟腱吻合器治疗新鲜闭合性跟腱断裂的临床效果。方法采用Achillon跟腱缝合器治疗29例急性闭合性跟腱断裂患者并随访。根据术前查体和MRI检查结果,判断跟腱断裂部位,在断裂部位采用2 cm微创切口显露断端,置入Achillon吻合器夹持跟腱近侧断端,引入缝线;同法在跟腱断裂远端置入缝线,拉出缝线打结,术后石膏托外固定6周。结果 29例患者中有2例因跟腱断端呈马尾状而在术中转为小切口下跟腱Bunnell缝合。26例获得随访,时间14~48个月,平均23个月,按照Arner-indholm疗效评定标准,优23例（88.5%）,良3例（11.5%）,无伤口感染或跟腱愈合不良。结论经2 cm的微创切口应用Achillon吻合器治疗新鲜闭合性跟腱断裂具有对合可靠,创伤小,对皮肤损伤小,再断裂及感染机会少,功能恢复快的优点,是治疗闭合性跟腱断裂的较好方法。Objective To evaluate the clinical effect of Achillon minimally invasive Achilles tendon suture system on repairing acute closed Achilles tendon ruptures through 2-cm-long incision.Methods Twenty-nine patients with acute closed Achilles tendon ruptures were treated with Achillon minimally invasive Achilles tendon suture system,and the clinical effect was evaluated by follow-ups.Based on the results of presurgical physical examination and MRI,the rupture parts of Achilles tendons were located.The rupture end of each rupture part was exposed through 2-cm-long incision,and Achillon minimally invasive Achilles tendon suture system was put in to hold the proximal rupture end of Achilles tendon.Then suture threads were introduced to both proximal and distal rupture ends,pulled out and knotted together.The ankle was cast with gypsum for 6 weeks after surgery.Results Two out of twenty-nine patients underwent minimally invasive Bunnell suture during surgery as the rupture parts of Achilles tendons were like horsetails.Twenty-six cases were successfully followed-up for 14 to 48 months（average 23 months）,and Arner-Lindholm score showed that the surgical results were perfect for 23 cases（88.5%） and good for 3 cases（11.5%）.The patients did not suffer infection or Achilles tendon malunion.Conclusion Repair of acute closed Achilles tendon ruptures with Achillon minimally invasive Achilles tendon suture system through 2-cm-long incision is reliable in wound healing with few,if any,invasions to skin.The risk of skin injury,re-rupture and infection is low,and the ankle function recovery is fast.Therefore,Achillon minimally invasive Achilles tendon suture system is a good choice to repair acute closed Achilles tendon ruptures.

关 键 词：跟腱断裂 缝合技术 微创 Achillon 

分 类 号：R197.39[医药卫生—卫生事业管理] R686.1[医药卫生—公共卫生与预防医学]