束束缝合联合逐层梳理缝合法治疗急性闭合跟腱断裂  

Bundle suture combined with layer-by-layer combing suture in the treatment of acute closed achilles tendon rupture

作　　者：顾仕林[1] 王成[1] 何冰心 郑有卯[1] GU Shi-lin;WANG Cheng;HE Bing-xin;ZHENG You-mao(Dept of Hand and Foot Surgery,Taizhou Hospital of Zhejiang Province,Linhai,Zhejiang 3317000,China)

机构地区：[1]浙江省台州医院手足外科,浙江临海317000

出　　处：《临床骨科杂志》2022年第6期890-893,共4页Journal of Clinical Orthopaedics

摘　　要：目的 探讨束束缝合联合逐层梳理缝合法治疗急性闭合跟腱断裂的临床疗效。方法 采用束束缝合联合逐层梳理缝合法治疗21例急性闭合跟腱断裂患者。末次随访时采用AOFAS踝关节评分、疼痛VAS评分、膝关节活动度、踝关节活动度评价疗效。结果 患者均获得随访,时间6~23(15.0±4.3)个月。术后切口均甲级愈合,无切口感染、皮肤坏死或感觉麻木以及腓肠神经损伤等症状。末次随访:MRI检查显示跟腱连续性存在,跟腱T_(1)WI中等信号影,PDWI+FS序列呈中等信号影;AOFAS踝关节评分86~98分,其中优15例,良6例;疼痛VAS评分0~2分;膝关节屈曲113°~135°、伸直0°~10°;踝关节背伸20°~30°、跖屈30°~40°。结论 束束缝合联合逐层梳理缝合法治疗急性闭合跟腱断裂有利于术后踝关节功能的恢复,患者可早期功能锻炼,效果满意。Objective To investigate the clinical efficacy of bundle suture combined with layer-by-layer combing suture in the treatment of acute closed achilles tendon rupture.Methods The 21 patients with acute closed achilles tendon ruptures were treated by bundle suture combined with layer-by-layer combing suture.At last follow-up,AOFAS ankle joint score,pain VAS and the ranges of motion of the knee joint and ankle joint were used to evaluate the effect.Results All patients were followed up for 6~23(15.0±4.3)months.All the incisions were obtained primary healing,there was no wound infection,swelling grade skin necrosis,sural nerve injury,skin numbness and other symptoms.At the last follow-up,MRI examination showed continuity of achilles tendon,moderate signal shadow on TWI and PDWI+FS of achilles tendon.AOFAS scores ranged from 86 to 98 points,of which 15 cases were excellent and 6 cases were good.The pain VAS was 0~2 points.Knee flexion was 113°~135°,extension was 0°~10°;ankle dorsiflexion was 20°~30°,plantar flexion was 30°~40°.Conclusions Bundle suture combined with layer-by-layer combing suture in the treatment of acute closed achilles tendon rupture is beneficial to the recovery of ankle function after operation,and the patients can do early functional exercise,with satisfactory results.

关 键 词：跟腱断裂 手术切口 束束缝合 逐层梳理缝合法 

分 类 号：R686.1[医药卫生—骨科学] R687.2[医药卫生—外科学]