带线铆钉经皮微创治疗跟腱断裂25例.docVIP

精品论文 参考文献 带线铆钉经皮微创治疗跟腱断裂25例 王昆 丁亮华（通信作者) 何双华 　　（苏州大学附属第三医院骨三科 213000） 　　【摘要】目的 探讨采用经皮带线铆钉治疗急性闭合性跟腱断裂的临床疗效。方法 25例急性闭合性跟腱断裂病例，采用经皮带线铆钉治疗，术后随访伤口愈合、足跟疼痛、跟腱再断裂及患侧踝关节功能恢复情况，采用Arner Lindholm疗效评定标准评估手术前后踝关节功能。结果 手术顺利，术中未发生重要血管、神经等组织结构的损伤，所有患者均得到随访，按Arner Lindholm评分标准，本组优21例，良4例，优良率100%。结论 经皮带线铆钉治疗急性闭合性跟腱断裂效果良好，可降低跟腱再断裂等并发症的发生率，是治疗急性闭合性跟腱断裂的理想方法。 　　【关键词】跟腱断裂 带线铆钉 经皮治疗 　　【中图分类号】R687 【文献标识码】A 【文章编号】2095-1752（2014）13-0109-02 　　 Percutaneous treatment of acute closed Achilles tendon ruptures with the rivet with thread. 　　WANG Kun，DING Liang-hua*，HE Shuang-hua 　　【Abstract】Objective To investigate the clinical effects of the percutaneous treatment of acute closed Achilles tendon ruptures with the rivet with thread. Method The data of twenty-five patients of the acute closed Achilles tendon ruptures receiving percutaneous treatment with the rivet with thread were reviewed, including the healing of skin incision, improvement of heal pain, re-ruptures after operations. The plantar flexion angle was compared before and after operation. Arner Lindholm system was used to evaluate the functional recovery of the sick ankle joint. Results The process of the operation was smooth going without the injury of major vessel and nerve . All patients were followed up. According to Arner Lindholm system the treatment outcome was excellent in twenty-one cases and good in three., with excellence rate of 100%. Conclusions The clinical effects were valid because of its lesser incidence rate of complication such as re-ruptures, lesser invasive treatment，convenient for clinical application. 　　【Keywords】Achilles tendon ruptures rivet with thread percutaneous treatment 　　跟腱断裂为临床常见，对闭合性跟腱断裂的最佳治疗方法一直存有争议，近年来，对闭合性跟腱断裂越来越倾向于手术治疗[1]，而手术方式选择不当会引起较多的并发症，影响跟腱功能的恢复。本科室自2009年10月至2012年10月期间在经皮微创下采用带线铆钉治疗急性闭合性跟腱断裂25例，随访效果良好。现报道如下： 　　资料和方法 　　1.1一般资料 　　A 本组病例25例。男21例，女4例；左侧19例，右侧6例；年龄18-50岁，平均(33.2plusmn;0.3)；全部患者均可以扪及跟腱断端的间隙，Thomson征均为阳性，MRI提示跟腱