小切口加可吸收线缝合治疗闭合性跟腱断裂_临床医学论文.docVIP

小切口加可吸收线缝合治疗闭合性跟腱断裂_临床医学论文 小切口加可吸收线缝合治疗闭合性跟腱断裂_临床医学论文 作者：彭建强，张江，蔡汉周，韩卫东，李中檀，周经颖，邹庆宝 【摘要】 [目的]探讨治疗闭合性跟腱断裂手术新方法，减少术后发生皮肤坏死。[方法]采用小切口加可吸收线(1-0普迪斯)在跟腱近侧断端行Bunnell缝合、远端行腱皮缝合,治疗39例闭合性跟腱断裂患者。[结果]39例中3例发生少许皮肤坏死，其中2例换药后愈合，1例经清创缝合后愈合。随访35例，时间10～36个月，平均时间23个月，按照ArnerLindholm疗效评定标准，优29例 (82.9%)，良4例(11.4%)，优良率达94.3%。[结论]小切口加可吸收线在跟腱近端断端行Bunnell缝合，远端腱皮缝合，对合可靠，创伤小，对皮肤血供影响小，发生皮肤坏死的可能性小，再断裂及感染机会少，功能恢复快，是治疗闭合性跟腱断裂的较好方法。 【关键词】 可吸收线; 跟腱断裂; 闭合损伤; 皮肤坏死 Small incision and absorbable suture for closed Achilles tendon rupture∥ PENG JianI Hanzhou,et al.The Fourth Peoples Hospital of Shenzhen,Shenzhen 518000,China 　　Abstract：[Objective]To investigate new methods of the management of closed rupture of Achilles tendon surgery to reduce postoperative skin necrosis.[Method]Small incisions and absorbable sutures were used to manage 39 cases of closed Achilles tendon rupture,with proximal stump a Bunnelltype suture and remote stump percutaneous repair.[Result]In the 39 cases,three developed slight skin necrosis,of which two healed by changing dressings,the other one healed by debriding and sutureing.Followup of 10 months to 36 months was available for 35 cases.According to ArnerLindholm efficacy evaluation standard,29 cases (82.9%) had excellent result,4(11.4%) had good result,with the good to excellent result of 94.3%.[Conclusion]Small incisions and absorbable sutures used to manage the closed Achilles tendon rupture,with proximal stump a Bunnelltype suture and remote stump percutaneous repair is an effective and reliable methord for closed Achilles tendon repture,with small invasion,less impact on the skin blood supply,less skin necrosis,less rerupture reinfection,and faster recovery. 　　Key words：absorbable suture; Achilles tendon rupture; closed injury; skin necrosis 　闭合性跟腱断裂在临床上并不少见,治疗方法有手术治疗和非手术治疗，目前多主张手术治疗。但术后常出现伤口皮肤坏死感染这一难题。本科从2002年12月-2007年12月间共收治闭合性跟腱断裂39例，采用小切口加可吸收线缝合治疗，取得较好的疗效，现报道如下： 　　1 资料与方法 　　1.1 一般资料 　　本组男30例，女9例;年龄17～62岁，平均31.4岁;左侧28例，右侧11例。经核磁共振检查及手术发现均为完全性跟腱断裂。断端距跟骨结节2～6 cm