小切口微创治疗新鲜跟腱断裂_临床医学论文.docVIP

小切口微创治疗新鲜跟腱断裂_临床医学论文 小切口微创治疗新鲜跟腱断裂_临床医学论文 作者：张丙磊　余枫　赵东升　李爱民　殷军　赵玉麟　张路 【摘要】 ：［目的］探讨通过小切口应用跟腱缝合引导器微创治疗新鲜跟腱断裂的临床效果。［方法］2006年3月-2008年3月，通过小切口应用跟腱缝合引导器微创治疗连续的26例新鲜跟腱断裂病人，术后早期功能锻练。男24例，女2例。年龄22～58岁，平均37.6岁。24例获得12～36个月（平均21个月）的随访。采用美国足与踝关节协会（AOFAS）踝与后足功能评分标准进行评分，测量双侧小腿最大周径及跟腱断裂平面的周径，询问恢复工作及伤前体育活动的时间。［结果］无跟腱再断裂、切口表浅或深部感染、皮缘坏死等并发症。腓肠神经支配区皮肤感觉正常。AOFAS 平均得分为97分（86～100分）。23例恢复伤前工作与学习，恢复工作时间平均为10周（4～20周）。24例均恢复伤前体育活动，恢复伤前体育活动时间平均为20周（18～24周）。小腿最大周径伤侧较对侧平均减少0.4 cm（0.2～0.8 cm），跟腱断裂平面周径伤侧较对侧平均增粗0.5 cm（0.3～0.7 cm）。［结论］应用跟腱缝合引导器微创修复新鲜跟腱断裂结合早期功能锻练可得到满意的临床效果，可较早恢复伤前状态，有较少的并发症。 【关键词】 跟腱断裂　缝合技术　微创外科 　　Abstract：［Objective］To evaluate the clinical effect of limited incision with an instrument to repair acute achiles tendon ruptures.［Method］Data on 26 consecutive patients who underwent limited incision with an instrument to repair achiles tendon ruptures and on a rehabilitation programme based on early range of motion exercise after surgery during March 2006 March 2008 were reviewed at an average followup of 21 months (range 12-36 months).There were 24 males and 2 females with an average age of 37.6 (22-58)years.The American Orthopaedic Foot and Ankle Society(AOFAS) score was used to evaluate the treatment outcomes.Calf and ankle circumferences of the injured leg and the contralateral side,the return to work and sports activity time were evaluated.［Result］The patients had neither rerupture nor deep or superficial wound infection.Also,no patient had sensory disturbance with the ankle or foot in the sural nerve distribution.The mean AOFAS score at the time of the latest followup was 97 (86-100).Twentythree patients returned to work at an average of 10 weeks (range,4-20 weeks) and to normal sports activities at 20 weeks (range,18-24 weeks).Calf and ankle circumferences decreased by 0.4 cm（0.2～0.8cm）and increased by 0.5cm（0.3～0.7cm）,respectively in the injured leg as compared with the contralateral leg.［Conclusion］The limited incision with an instrument to repair acute achiles tendon rup