带线锚钉半Kessler缝合法修复自发性跟腱断裂  

PART-Kessler TECHNIQUE WITH SUTURE ANCHOR IN REPAIR OF SPONTANEOUS Achilles TENDON RUPTURE

作　　者：祁洁[1] 段亮[1] 李伟伟[1] 卫文博[1] 

机构地区：[1]陕西省人民医院骨科,西安710068

出　　处：《中国修复重建外科杂志》2016年第2期165-168,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：陕西省自然基础研究计划资助项目(2014JQ4125)~~

摘　　要：目的探讨利用带线锚钉半Kessler缝合法修复自发性跟腱断裂的临床效果。方法 2011年1月-2013年12月采用带线锚钉半Kessler缝合法修复自发性跟腱腱性部位断裂患者31例。其中男23例,女8例;年龄16~53岁,平均38岁。左足15例,右足16例。致伤原因:体育运动中突发足跟部疼痛、行走无力22例,下楼踩空、滑倒、搬重物等原因9例。断裂部位距离跟骨止点3~6 cm,平均4.2 cm。受伤至手术时间为7 h^4 d,平均36.8 h。结果所有患者切口均Ⅰ期愈合,无腓肠神经损伤表现,跟腱修复部位与皮肤无粘连。31例患者均获随访,随访时间6~24个月,平均15个月。术后6个月所有患者均可顺利完成25次提踵活动;随访期间无跟腱再断裂发生。术后6个月健、患侧踝关节背伸及跖屈范围比较差异均无统计学意义(t=0.648,P=0.525;t=0.524,P=0.605)。术后6个月患侧小腿最大周径明显小于健侧(t=2.074,P=0.041),但术后12个月健、患侧比较差异无统计学意义(t=0.905,P=0.426)。术后6、12、18、24个月患者美国矫形足踝协会(AOFAS)评分均显著高于术前(P<0.05);术后除6个月评分低于其余各时间点(P<0.05)外,其余各时间点间差异均无统计学意义(P>0.05)。结论带线锚钉半Kessler缝合法修复自发性跟腱断裂,不但可提供强大的修复拉力,而且降低了缝线对肌腱的切割力,是一种可供选择的良好修复方法。Objective To summarize the application and experience of repairing spontaneous Achilles tendon rupture by part-Kessler technique with suture anchor. Methods Between January 2011 and December 2013, 31 patients with spontaneous Achilles tendon rupture were treated by part-Kessler technique with suture anchor. Of 31 cases, 23 were male and 8 were female, aged 16-53 years（mean, 38 years）. The left side was involved in 15 cases and the right side in 16 cases. The causes of injury included sudden heel pain and walking weakness during sports in 22 cases; no surefooted down-stairs, slip, and carrying heavy loads in 9 cases. The distance from broken site to the calcaneus adhension of Achilles tendon was 3-6 cm（mean, 4.2 cm）. The time from injury to operation was 7 hours to 4 days（mean, 36.8 hours）. Results All incisions healed by first intention without nerve injury or adhering with skin. The patients were followed up 6-24 months（mean, 15 months）. All patients could complete 25 times heel raising without difficulty at 6 months after operation. No Achilles tendon rupture occurred again during follow-up. At 6 months after operation, the range of motion of the ankle joint in dorsiflexion and plantar flexion showed no significant difference between normal and affected sides（t=0.648, P=0.525; t=0.524, P=0.605）. The circumference of the affected leg was significantly smaller than that of normal leg at 6 months after operation（t=2.074, P=0.041）, but no significant difference was found between affected and normal sides at 12 months after operation（t=0.905, P=0.426）. The American Orthopedic Foot and Ankle Society（AOFAS） scores at 6, 12, 18, and 24 months after operation were significantly higher than preoperative score（P〈0.05）; the score at 6 months after operation was significantly lower than that at other time points（P〈0.05）, but no significant difference was shown between the other time points（P〈0.05）. Conclusion Repairing spontaneous Achilles tendon rupture by partKessler techn

关 键 词：自发性跟腱断裂 带线锚钉 半Kessler缝合法 

分 类 号：R687.2[医药卫生—骨科学]