[1]明晓锋,王振,冯彦江,等.改良有限切开修复技术治疗急性闭合性跟腱断裂[J].中医正骨,2021,33(01):67-71.
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改良有限切开修复技术治疗急性闭合性跟腱断裂()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年01期
页码:
67-71
栏目:
临床报道
出版日期:
2021-01-20

文章信息/Info

作者:
明晓锋1; 王振1; 冯彦江1; 韩旭东1; 蔡鸿敏1; 马言1; 俞光荣2
(1.河南省洛阳正骨医院/河南省骨科医院,河南 郑州 450016; 2.同济大学附属同济医院,上海 200065)
关键词:
跟腱;  足损伤;  腱损伤;  修复外科手术;  外科手术; 微创性
摘要:
目的:探讨改良有限切开修复技术治疗急性闭合性跟腱断裂的临床疗效和安全性。方法:2016年2月至2018年12月收治32例急性闭合性跟腱断裂患者。男25例,女7例。年龄20～47岁,中位数36岁。左侧20例,右侧12例。超声检查可见跟腱断端的低回声间隙。均为运动伤,受伤至手术时间l～10 d,中位数4 d。均为初次断裂,断裂部位距跟腱止点近端3.0～7.8 cm。均采用改良有限切开修复技术治疗。分别采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足功能评分标准、跟腱断裂总评分(achilles tendon total rupture score,ATRS)评定标准及足踝功能评价(foot and ankle ability measure,FAAM)量表评价治疗效果,并观察记录治疗及随访期间的并发症发生情况。结果:32例患者中14例跟腱断端距离≤2 cm,采用跟腱断端正中横切口; 18例跟腱断端距离>2 cm,采用跟腱断端正中偏内侧纵切口。6例患者在术后2～9个月时失访,其余26例患者均随访12个月以上(12～41个月)。随访12个月以上的26例患者,末次随访时的AOFAS踝与后足功能评分为(96.19±2.38)分; ATRS(94.12±2.55)分; 术后12个月时FAAM日常生活活动功能为(97.21±2.46)%,体育活动功能为(87.96±2.80)%。1例发生浅表皮肤坏死,经换药后延期愈合,未使用抗生素; 3例发生静脉血栓栓塞症,经注射低分子肝素钙及口服阿司匹林后治愈; 均未发生切口裂开或深层感染、腓肠神经损伤、跟腱再断裂。结论:采用改良有限切开修复技术治疗急性闭合性跟腱断裂,并发症少、术后足踝功能恢复好。

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备注/Memo

备注/Memo:
基金项目:河南省中医药科学研究专项课题(2017ZY2124)
通讯作者:俞光荣 E-mail:yuguangrong@tongji.edu.cn
更新日期/Last Update: 2021-01-20