Dresden微创缝合技术与切开缝合治疗急性跟腱断裂的比较  

Dresden technique versus open surgery for acute Achilles tendon ruptures

作　　者：朱前拯[1] 王闯[2] 陈星佐[1] 徐小东[1] 王立强[1] 陈瀛[1] 杨雨润[1] 杨欢[1] 林朋[1] Zhu Qianzheng;Wang Chuang;Chen Xingzuo;Xu Xiaodong;Wang Liqiang;Chen Ying;Yang Yurun;Yang Huan;Lin Peng(Department of Orthopaedics, China Japan Friendship Hospital, Beijing 100029, China;Department of Or-thopaedics, Shahe Hospital, Changping District, Beijing 102206, China)

机构地区：[1]中日友好医院骨科三部,北京100029 [2]北京市昌平区沙河医院骨科,102206

出　　处：《中华创伤骨科杂志》2019年第4期358-361,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的比较Dresden微创缝合技术与切开缝合治疗急性跟腱断裂的疗效。方法回顾性研究2013年1月至2017年6月中日友好医院骨科三部因急性跟腱断裂入院行跟腱缝合手术的67例患者资料,根据治疗方法不同分为微创组(32例,采用Dresden微创缝合技术缝合)和切开组(35例,采用切开缝合)。术后比较观察两组手术时间、手术切口长度、住院时间、观察术后伤口感染、跟腱再次断裂等并发症,通过跟腱完全断裂评分表(ATRS)评估跟腱功能。结果两组患者临床基线比较差异均无统计学意义(P>0.05),具有可比性。随访18个月。微创组的手术时间(40.0min)、切口长度(3.0cm)、住院时间(5d)均小于切开组(42.5min、10.0cm、6d),差异有统计学意义(P<0.05);两组均未术后发生腓肠神经损伤,微创组和开放组术后伤口感染或不愈合率分别为0和8.6%,再次断裂率分别为3.1%和2.9%,末次随访时ATRS评分分别为98.0分和98.5分,差异均无统计学意义(P>0.05)。结论与切开缝合比较,Dresden微创缝合技术治疗急性跟腱断裂的手术时间短、手术切口长度小、住院时间短,术后跟腱功能恢复良好,有降低伤口感染的趋势。Objective To compare the outcomes of Dresden technique versus open surgery for acute Achilles tendon ruptures. Methods From January 2013 to June 2017, 67 patients were operatively treated for acute Achilles tendon rupture at Department of Orthopaedics, China Japan Friendship Hospital.Of them, Dresden technique was used in 32 (minimally invasive group) and open surgery in 35 (open surgery group).The 2 groups were compared in terms of baseline characteristics, operation time, operative incision length, hospital stay, postoperative complications like incision infection and tendon re-rupture and the Achilles Tendon Total Rupture Score (ATRS). Results The 2 groups were compatible due to insignificant differences in the baseline characteristics (P>0.05).They were followed up for 18 months.The minimally invasive group had significant shorter operation time (40.0 min), incision length (3.0 cm) and hospital stay (5 d) than the open surgery group (42.5 min, 10.0 cm and 6 d)(P<0.05).No sural nerve lesion was observed in either group. The rate of wound complications was 0%for the minimally invasive group and 8.6% for the open surgery group;the rate of re-rupture was 3.1 % for the former and 2.9% for the latter;the ATRS at the final follow-up was 98.0 for the former and 98.5 for the latter.There were no significant differences between the 2 groups in the above comparisons (P>0.05). Conclusions Percutaneous suture of the Achilles tendon with the Dresden instruments is a safe, fast and standardized surgical procedure for acute Achilles tendon ruptures, leading to shorter operation time, incision length and hospital stay, better functional recovery and a tendency of decreased wound complications than the open surgery.

关 键 词：跟腱 腱损伤 外科手术 微创性 

分 类 号：R687.2[医药卫生—骨科学]