自制器械辅助微创手术治疗陈旧性跟腱断裂的疗效分析  

Curative effect of minimally invasive technique to treat old Achilles tendon rupture with self-made instrument

作　　者：孙强[1] 董新利[1] 鲁圣助 苏云[1] 李沫茵 姜源鑫 王洪勋[1] SUN Qiang;DONG Xin-li;LU Sheng-zhu;SU Yun;LI Mo-yin;JIANG Yuan-xin;WANG Hong-xun(Department of Orthopaedics,Affilioied Zhongshan Hospital of Dalian University,Dalian,Liaoning 116001,China)

机构地区：[1]大连大学附属中山医院骨科,辽宁大连116001 [2]大连大学 [3]奇加复健医院

出　　处：《中国骨与关节损伤杂志》2020年第4期353-355,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的观察应用自制器械辅助微创手术治疗陈旧性跟腱断裂的临床效果。方法回顾性分析自2017-05—2018-12应用自制器械辅助微创手术治疗的9例陈旧性跟腱断裂,术中将自制器械由卵圆孔端置入皮下组织与腱周组织间隙辅助改良Bunnell缝合法完成对跟腱断端缝合操作。末次随访时采用Arner-Lindholm评分标准对踝关节功能进行评价。结果本组手术时间(31.0±5.9)min,切口长度(3.5±0.6)cm。9例均获得随访,随访时间平均14.1(12~18)个月。术后1例出现切口皮缘部分坏死,经换药后愈合并于术后18 d拆线,其余患者切口均一期愈合。所有患者均无排异反应、腓肠神经损伤、下肢深静脉血栓形成等并发症发生。术后12个月随访时采用Arner-Lindholm评分标准评价踝关节功能:优6例,良2例,可1例。结论采用自制器械辅助微创手术治疗陈旧性跟腱断裂具有手术时间短、切口小、术后并发症少、踝关节功能恢复好等优点,临床疗效满意,值得推广应用。Objective To observe the clinical effect of minimally invasive surgical treatment of old rupture of Achilles tendon with self-made instrument.Methods A retrospective analysis was conducted on 9 cases of old Achilles tendon rupture treated with minimally invasive surgery assisted by self-made instrument from May 2017 to December 2018.During the operation,the self-made instrument was inserted into the subcutaneous tissue through the foramen ovidis and the space between the peritendinous tissues to complete the suture of the Achilles tendon rupture with the modified Bunnell suture method.Ankle function was evaluated by Arner-Lindholm score at the last follow-up.Results The operation time was(31.0±5.9)min,and the incision length was(3.5±0.6)cm.All 9 patients were followed up for an average of 14.1(12-18)months.After the operation,partial necrosis occurred in the skin margin of the incision in one patient,which was healed after dressing change and the stitches removal 18 days after the operation.The rest of the patients had primary wound healing.All patients had no complications such as rejection,sural nerve injury,deep venous thrombosis of lower limbs.At the follow-up12 months after the operation,the Arner-Lindholm scoring standard was used to evaluate the ankle joint function:excellent in6 cases,good in 2 cases and fair in 1 case.Conclusion Minimally invasive surgical treatment of old Achilles tendon rupture with self-made instrument has the advantages of shorter operation time,smaller incision,less postoperative complications,and better ankle joint function.The clinical effect is satisfactory,and it is worth popularizing and applying.

关 键 词：陈旧性跟腱断裂 自制器械 微创手术 改良Bunnell缝合法 

分 类 号：R686.1[医药卫生—骨科学]