新型跟腱微创缝合器械修复新鲜闭合性跟腱断裂的临床研究  

Clinical study on a novel minimally invasive Achilles tendon suture instrument for treating fresh closed Achilles tendon rupture

作　　者：鲁圣助 谈美娟 孙强[3] 匡延顺 LU Shengzhu;TAN Meijuan;SUN Qiang;KUANG Yanshun(Department of Orthopaedics,Wuchang Hospital Affiliated to Wuhan University of Science and Technology,Wuhan Hubei,430063,P.R.China;Department of Oncology,Wuchang Hospital Affiliated to Wuhan University of Science and Technology,Wuhan Hubei,430063,P.R.China;Department of Orthopaedics,Zhongshan Hospital of Dalian University,Dalian Liaoning,116001,P.R.China)

机构地区：[1]武汉科技大学附属武昌医院骨科,武汉430063 [2]武汉科技大学附属武昌医院肿瘤科,武汉430063 [3]大连大学附属中山医院创伤骨科,辽宁大连116001

出　　处：《中国修复重建外科杂志》2023年第9期1062-1067,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的 介绍一种新型跟腱微创缝合器械,观察其用于修复新鲜闭合性跟腱断裂的临床疗效。方法 回顾分析2017年9月—2022年5月150例符合选择标准的新鲜闭合性跟腱断裂患者临床资料,其中80例采用新型跟腱微创缝合器械修复跟腱(微创组),70例采用传统切开缝合手术(开放组)。两组患者性别、年龄、损伤侧别、致伤原因、受伤至手术时间及断端与跟骨结节距离等基线资料比较,差异均无统计学意义(P>0.05)。记录并比较两组患者手术时间、术中出血量、切口长度、住院时间、住院费用及并发症发生情况。术后1年采用美国矫形足踝协会(AOFAS)踝-后足评分评价踝关节功能。结果 微创组手术时间、切口长度、术中出血量少于开放组(P<0.05),但两组住院时间及住院费用差异无统计学意义(P>0.05)。两组患者均获随访,随访时间12~24个月,平均15.5个月。开放组6例发生切口坏死、7例跟腱粘连,而微创组切口均Ⅰ期愈合,无跟腱粘连发生;两组上述并发症发生率差异均有统计学意义(P<0.05)。术后1年微创组AOFAS踝-后足评分高于开放组,差异有统计学意义(P<0.05)。结论 与传统切开缝合手术比较,采用新型跟腱微创缝合器械治疗新鲜闭合性跟腱断裂符合微创理念,具有切口小、并发症少、术后功能恢复好的优点,且治疗费用无增加。Objective To assess the effectiveness of a novel minimally invasive Achilles tendon suture instrument in the treatment of fresh closed Achilles tendon rupture.Methods A retrospective study was conducted on 150 patients who underwent surgical intervention for fresh closed Achilles tendon rupture.Eighty patients were treated with the novel minimally invasive Achilles tendon suture instrument(minimally invasive group)and 70 patients with traditional open surgery(traditional group).The two groups were comparable in terms of gender,age,injured side,cause of injury,the interval between injury and operation,and the distance from the fracture end to the calcaneal tuberosity(P>0.05).The operation time,intraoperative blood loss,incision length,hospital stays,hospitalization expenses,and complications were recorded and compared.At 1 year after operation,the ankle joint function was evaluated by the American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot score.Results The minimally invasive group demonstrated significantly shorter operation time,smaller incision length,and lower intraoperative blood loss when compared with the traditional group(P<0.05).However,there was no significant difference in terms of hospital stays and hospitalization expenses between the two groups(P>0.05).All patients were followed up 12-24 months after operation(mean,15.5 months).In the traditional group,6 cases of incision necrosis and 7 cases of Achilles tendon adhesion occurred,while in the minimally invasive group,all incisions healed at first intention and no Achilles tendon adhesion occurred.The differences in the incidences of the two complications between the two groups were significant(P<0.05).At 1 year after operation,the AOFAS ankle-hindfoot score in the minimally invasive group was superior to that of the traditional group(P<0.05).Conclusion In comparison with traditional open surgery,the use of self-designed novel minimally invasive Achilles tendon suture instrument proves to be an ideal technique for treating fresh closed Ach

关 键 词：新型跟腱微创缝合器械 跟腱断裂 闭合性损伤 微创技术 跟腱修复 

分 类 号：R687.2[医药卫生—骨科学]