自制带孔克氏针卵圆钳辅助微创缝合急性闭合性跟腱断裂的临床研究  

Minimally invasive suture of acute closed achilles tendon rupture assisted by perforated Kirschner wire oval forceps

作　　者：尚林[1] 李琦[1] 马富强[1] 王亚磊[1] 张小龙 孙士强[1] 贾光辉[1] 王翔宇[1] Shang Lin;Li Qi;Ma Fuqiang;Wang Yalei;Zhang Xiaolong;Sun Shiqiang;Jia Guanghui;Wang Xiangyu(Foot and Ankle Surgery,Zhengzhou Orthopaedic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州市骨科医院足踝外科,河南郑州450052

出　　处：《足踝外科电子杂志》2022年第3期18-21,43,共5页Electronic Journal of Foot and Ankle Surgery

基　　金：河南省医学科技攻关计划联合共建项目(2018020711)。

摘　　要：目的探讨利用自制带孔克氏针卵圆钳辅助微创缝合技术治疗急性闭合性跟腱断裂的手术疗效。方法对郑州市骨科医院2019年11月至2021年2月收治的18例行带孔克氏针卵圆钳辅助微创缝合手术的急性闭合性跟腱断裂患者的资料进行回顾性分析,其中男13例、女5例,平均年龄为28.5(18~38)岁;受伤至手术平均时间为1.5(0.4~2.0)d;在跟腱断裂处采取横切口,平均长度为3.5(3~5)cm。术后1年随访时,采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝-后足评分系统、跟腱完全断裂评分系统(achilles tendon total rupture score,ATRS)及Amer-Lindholm评分评价手术疗效,并对比患者两侧的小腿周径。结果所有患者手术切口一期愈合,均未发生神经、血管损伤等并发症。18例患者获得完全随访,随访时间为12~18个月,平均(14.25±4.00)个月。术后1年随访时,患者的AOFAS评分为(95.62±2.05)分;ATRS评分为(82.56±3.71)分;患者小腿周径患侧为(37.72±5.16)cm、健侧为(37.80±2.65)cm,两侧比较差异无统计学意义(P>0.05)。按Amer-Lindholm评分评价,本组疗效优15例、良3例、差0例,优良率为100.00%(18/18)。结论对于急性闭合性跟腱断裂,采用自制带孔克氏针卵圆钳辅助微创缝合,创伤小,并发症少,恢复快,效果确切。Objective To investigate the efficacy of minimally invasive suture assisted by perforated Kirschner wire oval forceps in the treatment of acute closed achilles tendon rupture.Methods The data of 18 cases of acute closed achilles tendon rupture treated in Zhengzhou Orthopaedic Hospital from November 2019 to February 2021 was analyzed retrospectively,including 13 males and 5 females,with an average age of 28.5(18~38)years;The average time from injury to operation was 1.5(0.4~2.0)d.A transverse incision was made at the rupture of achilles tendon,with an average length of 3.5(3~5)cm.1 year follow-up after operation,the American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot score,the achilles tendon complete rupture scoring system(ATRS)and Amer-Lindholm score were used to evaluate the surgical effect,the peripheral diameters of both legs were compared.Results The surgical incision healed in one stage in all patients,and there was no complications such as nerve and vascular injury.18patients were fully followed up for 12~18 months,with an average of(14.25±4.00)months.At 1 year postoperatively,the AOFAS score was(95.62±2.05)points,the ATRs score was(82.56±3.71)points,the circumference of the patient’s lower leg was(37.72±5.16)cm on the affected side and(37.80±2.65)cm on the healthy side,and there was no significant difference between the two sides(P>0.05).According to Amer-Lindholm score,the curative effect of this group was excellent in 15 cases,good in 3 cases and poor in 0cases,the excellent and good rate was 100%(18/18).Conclusion For acute closed achilles tendon rupture,the use of oval forceps with hole Kirschner wire transverse incision assisted minimally invasive suture has the advantages of less trauma,less complications,rapid healing and definite effect.

关 键 词：跟腱断裂 跟腱修复 微创 

分 类 号：R687.2[医药卫生—骨科学]