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[1]明曉鋒,王振,馮彥江,等.改良有限切開修復(fù)技術(shù)治療急性閉合性跟腱斷裂[J].中醫(yī)正骨,2021,33(01):67-71.
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改良有限切開修復(fù)技術(shù)治療急性閉合性跟腱斷裂()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年01期
頁碼:
67-71
欄目:
臨床報(bào)道
出版日期:
2021-01-20

文章信息/Info

作者:
明曉鋒1王振1馮彥江1韓旭東1蔡鴻敏1馬言1俞光榮2
(1.河南省洛陽正骨醫(yī)院/河南省骨科醫(yī)院,河南 鄭州 450016; 2.同濟(jì)大學(xué)附屬同濟(jì)醫(yī)院,上海 200065)
關(guān)鍵詞:
跟腱 足損傷 腱損傷 修復(fù)外科手術(shù) 外科手術(shù)微創(chuàng)性
摘要:
目的:探討改良有限切開修復(fù)技術(shù)治療急性閉合性跟腱斷裂的臨床療效和安全性。方法:2016年2月至2018年12月收治32例急性閉合性跟腱斷裂患者。男25例,女7例。年齡20~47歲,中位數(shù)36歲。左側(cè)20例,右側(cè)12例。超聲檢查可見跟腱斷端的低回聲間隙。均為運(yùn)動(dòng)傷,受傷至手術(shù)時(shí)間l~10 d,中位數(shù)4 d。均為初次斷裂,斷裂部位距跟腱止點(diǎn)近端3.0~7.8 cm。均采用改良有限切開修復(fù)技術(shù)治療。分別采用美國足踝外科協(xié)會(huì)(American Orthopaedic Foot and Ankle Society,AOFAS)踝與后足功能評(píng)分標(biāo)準(zhǔn)、跟腱斷裂總評(píng)分(achilles tendon total rupture score,ATRS)評(píng)定標(biāo)準(zhǔn)及足踝功能評(píng)價(jià)(foot and ankle ability measure,FAAM)量表評(píng)價(jià)治療效果,并觀察記錄治療及隨訪期間的并發(fā)癥發(fā)生情況。結(jié)果:32例患者中14例跟腱斷端距離≤2 cm,采用跟腱斷端正中橫切口; 18例跟腱斷端距離>2 cm,采用跟腱斷端正中偏內(nèi)側(cè)縱切口。6例患者在術(shù)后2~9個(gè)月時(shí)失訪,其余26例患者均隨訪12個(gè)月以上(12~41個(gè)月)。隨訪12個(gè)月以上的26例患者,末次隨訪時(shí)的AOFAS踝與后足功能評(píng)分為(96.19±2.38)分; ATRS(94.12±2.55)分; 術(shù)后12個(gè)月時(shí)FAAM日常生活活動(dòng)功能為(97.21±2.46)%,體育活動(dòng)功能為(87.96±2.80)%。1例發(fā)生淺表皮膚壞死,經(jīng)換藥后延期愈合,未使用抗生素; 3例發(fā)生靜脈血栓栓塞癥,經(jīng)注射低分子肝素鈣及口服阿司匹林后治愈; 均未發(fā)生切口裂開或深層感染、腓腸神經(jīng)損傷、跟腱再斷裂。結(jié)論:采用改良有限切開修復(fù)技術(shù)治療急性閉合性跟腱斷裂,并發(fā)癥少、術(shù)后足踝功能恢復(fù)好。

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備注/Memo

備注/Memo:
基金項(xiàng)目:河南省中醫(yī)藥科學(xué)研究專項(xiàng)課題(2017ZY2124)
通訊作者:俞光榮 E-mail:yuguangrong@#edu.cn
更新日期/Last Update: 2021-01-20