微创手术与传统手术治疗急性跟腱断裂的比较研究  

Minimally invasive versus traditional treatment for the acute Achilles tendon rupture:a comparative study

作　　者：梁晓军[1] 赵宏谋[1] 李毅[1] 鹿军[1] 潘文杰[1] 王琳[1] 

机构地区：[1]西安交通大学医学院附属红会医院足踝外科,西安710054

出　　处：《中国骨与关节外科》2013年第5期438-441,共4页Chinese Journal of Bone and Joint Surgery

基　　金：西安市卫生局课题(J2010C05)

摘　　要：背景：急性跟腱断裂的临床治疗方案目前尚存争议,微创治疗因为切口相关并发症较少而逐渐被应用于临床,而微创手术与传统手术治疗急性跟腱断裂的比较性研究较少。目的：比较应用跟腱龙（Achillon）跟腱吻合器与Krachow法跟腱端端吻合术治疗急性闭合性跟腱断裂的临床疗效。方法：回顾性研究2009年3月至2011年12月收治的急性闭合性跟腱断裂患者146例,其中37例应用Achillon跟腱吻合器治疗,为微创手术组,男26例,女11例,年龄19~64岁,平均41.6岁;53例应用Krachow法跟腱端端吻合术治疗,为传统手术组,男36例,女17例,年龄21~67岁,平均43.5岁。比较两组患者的切口愈合时间、并发症发生率、踝关节活动度、单足提踵试验结果及整体满意率,并通过美国足踝外科协会（AOFAS）踝与后足评分进行疗效评估。结果：微创手术组37例和传统手术组53例全部获得随访,随访时间为14~57个月,平均32.9个月。微创手术组的再断裂率与传统手术组比较无统计学差异（5.4%vs.1.9%,P=0.38）;传统手术组的伤口延迟愈合率显著高于微创手术组（17.6%vs.0%,P〈0.01）。两组患者的单足提踵试验阳性率（16.2%vs.11.3%）、踝关节活动度减小率（18.9%vs.17.0%）、整体满意率（83.8%vs.71.7%）均无统计学差异。两组患者的AOFAS踝与后足评分的各项指标和总分比较均无统计学差异。结论：Achillon跟腱吻合器治疗跟腱断裂可有效降低切口相关并发症发生率,且未增加跟腱再断裂率,跟腱功能与Krachow法跟腱端端吻合术无统计学差异。Background： For now, the treatment for the acute Achilles tendon rupture is remaining controversial. Minimally invasive techniques are reported with few incision related complications, thus are gradually being accepted in clinics. However, there are few comparative studies on the minimally invasive technique tendon rupture. Objective： To compare the clinical outcomes of minimally chow） in treating the acute Achilles tendon rupture. and the traditional operation in treating the acute Achilles invasive technique （Achillon） and traditional operation （Kra- Methods： To retrospectively study the 146 cases of acute Achilles tendon ruptures treated in our department from March 2009 to December 2011. Of the 146 cases, 37 cases （26 males and 11 females） with an average 41.6 （19-61） years old were treated with the Achillon, they were of the minimally invasive operation group; and 53 cases （36 males and 17 females） with an average of 43.5 （21-67） years old were treated with the Krachow, they were of the traditional operation group. The healing time of the incision, complication rate, range of motion of the ankle joint, single heel rise rate, and the overall satis- faction rate of the 2 groups were compared. And the curative effects were evaluated with the American Orthopaedic Foot ＆ Ankle Society （AOFAS） ankle-hindfoot scale. Results： All the 37 cases and the 53 cases in the 2 groups were followed-up, the mean follow-up period was 32.9 （14-57） months. There was no statistical difference in the rerupture rate between the 2 groups （5.4% vs. 1.9%, P--0.38）, while the inci- sion delayed union rate of the traditional operation group was significantly higher than the minimally invasive group （17.6% vs. 0%, P〈0.01）. The single heel rise positive rates （16.2% vs. 11.3%）, reducing rates of the range of motion of the ankle joint （18.9% vs. 17.0%）, and the overall satisfaction rates （83.8% vs. 71.7%） of the 2 groups have no statistical difference. The indi- cators and the

关 键 词：急性跟腱断裂 微创 手术治疗 

分 类 号：R687.2[医药卫生—骨科学]