两种入路手术治疗闭合性跟腱断裂43例临床分析

doi:10.13418/j.issn.1001-165x.2017.03.018

Abstract

Abstract:

Objective　To summarize and analyze the actions of two kinds of approaches and surgical methods on postoperative complications and curative effects of Achilles tendon rupture reparation.　Methods　From2002.1 to2015.12, 43 cases of patients with closed rupture of Achilles tendon underwent surgical treatment, 25 caseswith one long traditional continuous posterior median incision medial 1cm beside Achilles tendon was assigned into the conventional approach group, and 18 cases with 3cm long short oblique incision of S-shape on the posterior ankle and proximal 2 paired small incisions on the edge of proximal Achilles tendon were assigned into the modified approach group.Bunnell method was used in all Achilles tendon suture. The complications of wound dehiscence, cutaneous nerve injury and recurringAchilles tendon rupture and curative effects of 2 kinds of approaches were analyzed. 　Results　All patients were followed up for 9 months to 5 years. In the conventional approach group, the wound dehiscence problem was found in 4 case, and recurring Achilles tendon rupture was found in 1 case, and no cutaneous nerve injury was found. In the modified approach group, sural nerve injury was found in 1 case, no wound healing was found in 4 cases and recurring Achilles tendon rupture was found in 1 case. The incidence of wound dehiscence in the two groups was higher than that in the conventional group (P<0.05). There was no significant difference between the two groups of Achilles tendon rupture and cutaneous nerve injury (P>0.05). According to the Arner-indholm score standard, 6 months after the Achilles tendon repair, the excellent and good rate of the modified approach group was higher (P<0.05). 　Conclusion　In the modified approach, one short S-shape incision obliquely across the Achilles tendon on posterior ankle along the direction of skin folds with pairs of small incision on the edge of proximal Achilles tendon resulted in less postoperative complications and better curative effect.

Key words: Operative approach, 　Achilles tendon rupture, 　Postoperative complications, 　Curative effect

XIONG Hong-tao, ZHUANG Yong-qing, FU Xiao-kuan, FANG Xi-chi, WEI Rui-hong. Clinical analysis of two surgical approaches for treatment of closed rupture of Achilles tendon in 43 cases[J]. Chinese Journal Of Clinical Anatomy, 2017, 35(3): 322-326.

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Clinical analysis of two surgical approaches for treatment of closed rupture of Achilles tendon in 43 cases

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