小切口卵圆钳辅助穿针技术与Krackow缝合法修复急性跟腱断裂的疗效对比  

Effect comparison of small incision oval clamp assisted needle technique and Krackow suturing method in the repair of acute achilles tendon rupture

作　　者：杨永明[1] 史晓林[1] 王克华[1] 刘磊[1] 赵亚丽[1] 

机构地区：[1]河北省保定市第二医院,河北保定071051

出　　处：《中国医药导报》2014年第7期49-52,共4页China Medical Herald

基　　金：河北省医学科学研究课题计划(编号20130016)

摘　　要：目的比较急性跟腱断裂采用小切口卵圆钳辅助穿针技术治疗与Krackow缝合法治疗的效果。方法选择保定市第二医院2005年8月~2012年7月收治的急性闭合性跟腱断裂患者39例,其中使用小切口卵圆钳辅助穿针技术的患者16例（小切口组）,使用常规切口Krackow法缝合的患者23例（常规切口组）。术后石膏固定3周,同时进行功能锻炼,随访术后疗效及并发症。结果①术后跟腱再断裂、感染和深静脉血栓发生率两组差异无统计学意义（P〉0.05）;而常规切口组切口愈合不良发生率高于小切口组,差异有统计学意义（P〈0.05）。常规切口组总并发症发生率为26.1%（6/23）,小切口组总并发症发生率为6.3%（1/16）,差异有统计学意义（P〈0.05）。②术后3个月小切口组Arner-Lindholm功能评分优良率[87.5%（14/16）]高于常规切口组[47.8%（11/23）],差异有统计学意义（P〈0.05）;术后6个月、1年后两组间评分优良率差异无统计学意义（P〉0.05）。结论小切口卵圆钳辅助穿针技术和Krackow缝合法均适用于急性跟腱断裂修复。术后早期3个月内小切口卵圆钳辅助穿针技术较Krackow缝合法恢复快,术后6个月则无明显差别。小切口组并发症发生率低,但需严格掌握手术适应证。Objective To compare the effect of small incision oval clamp assisted needle technique and Krackow suturing method in the repair of acute achilles tendon rupture. Methods 39 cases of acute closed achilles tendon rupture from August 2005 to July 2012 in the Second Hospital of Baoding City were selected and divided into small incision group with 16 cases and conventiona incision group with 23 cases. The small incision group was treated with small incision oval clamp assisted needle technique, the conventiona incision group was treated with Krackow suturing method.Plaster immobilization was used for 3 weeks and functional exercise was carried out. Postoperative efficacy and complications was followed up. Results ①The differences of occurrence rate of achilles tendon rupture again, infection and deep vein thrombosis between the two groups was not statistically significant（P 0.05）; the incidence of poor healing of incision of conventiona incision group was higher than that of small incision group, the difference was statistically significant（P 0.05）. The total incidence of complications in conventiona incision group was 26.1 %（6/23）, the total incidence of complications in small incision group was 6.3 %（1/16）, the difference was statistically significant（P 0.05）. ②The excellent-good rate of Arner-Lindholm function scores in small incision group 3 months after the operation [87.5 %（14/16）] was higher than that in conventiona incision group[47.8 %（11/23）], the difference was statistically significant（P 0.05）; the difference of excellent-good rate of Arner-Lindholm function scores between the two groups 6 months, 1year after the operation were not statistically significant（P 0.05）. Conclusion Small incision oval clamp assisted needle technique and Krackow suturing method are all suitable for the repair of acute achilles tendon rupture. The repair of small incision oval clamp assisted needle technique within 3 months after the operation is faster than Krackow suturing method, but it

关 键 词：跟腱断裂 卵圆钳 KRACKOW缝合法 

分 类 号：R687.2[医药卫生—骨科学]