天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (9): 1105-1108.doi: 10.11958/20160022

• 临床研究 • 上一篇    下一篇

带线锚钉修复急性闭合性跟腱止点断裂的临床效果评估

任志鹏1,辛景义1,王贵忻1,梁军2   

  1. 天津市天津医院创伤骨科（邮编 300211）
  • 收稿日期:2016-01-21 修回日期:2016-06-05 出版日期:2016-09-15 发布日期:2016-09-28
  • 通讯作者: 辛景义 E-mail:jingyixin123@126.com
  • 作者简介:任志鹏（1986）， 男， 住院医师， 硕士， 主要从事骨、关节、软组织运动损伤研究
  • 基金资助:
    天津市天津医院科技基金（TJYY1508）

Curative effect of suture anchor tenodesis in repair of acute closed distal Achilles tendon injuries

REN Zhipeng， XIN Jingyi△， WANG Guixin， LIANG Jun   

  1. Department of Orthopedic Trauma, Tianjin Hospital, Tianjin 300211, China
  • Received:2016-01-21 Revised:2016-06-05 Published:2016-09-15 Online:2016-09-28
  • Contact: XIN Jingyi E-mail:jingyixin123@126.com

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摘要： 目的 探讨应用带线锚钉修复急性闭合性跟腱止点断裂的临床疗效。 方法 回顾性分析 2012 年 10 月— 2014 年 1 月天津市天津医院创伤骨科应用带线锚钉修复急性闭合性跟腱止点断裂 25 例患者的临床资料， 采用标准手术入路， 带线锚钉重建跟腱止点， Krachow 缝合法编织缝合跟腱末端。 术后随访 19～ 35 个月 。 观察患者治疗效果， 包括术后切口愈合、足跟部疼痛及跟腱再断裂等情况， 并于术后 1 年比较患侧与健侧踝关节活动范围， 应用跟腱完全断裂评分标准（ATRS）及美国足踝外科学会踝-后足评分系统（AOFAS）等评价踝关节功能。 结果 本组患者手术均顺利完成， 手术时间 25～ 35 min， 平均（30.4±4.8）min。 术中未发生重要血管、神经等组织结构的损伤。 患者均得到随访， 切口愈合良好， 未见感染及皮肤坏死， 无足跟部疼痛和跟腱再断裂发生。 术后 1 年跖屈患侧与健侧双侧踝关节活动范围差异无统计学意义（44.36°±3.33° vs. 46.40°±4.53°， P＞ 0.05）， 而背屈患侧活动范围小于健侧（16.88°± 4.10° vs. 20.12°±3.21°， P＜ 0.05）。 ATRS 评分 79～ 97 分， 平均（88.7±6.1）分；AOFAS 评分 76～ 100 分， 平均（92.4±5.6）分。 优 20 例， 良 5 例。 结论 带线锚钉修复急性闭合性跟腱止点处断裂短期效果满意。

关键词: 跟腱, 骨折, 闭合性, 修复外科手术, 止点断裂, 带线锚钉

Abstract: Objective To evaluate the effectiveness of the suture anchor in the treatment of acute closed distal achilles tendon rupture. Methods A retrospective review of clinical data in 25 patients with acute achilles tendon rupture was performed in the department of orthopedic trauma of Tianjin Hospital between October 2012 to January 2014. The operation was performed by standard approach, with the suture anchors to reconstruct the achilles tendon insertion, and the Krachow technique was used to suture the achilles tendon． All patients were followed up for 19～ 35 months. The situation of the wound healing, heel pain, and achilles tendon re-rupture were observed and analyzed. According to the passive range of motion of the bilateral ankle joint, the achilles tendon total rupture score (ATRS), the American orthopaedic foot and ankle society (AOFAS) score and functional recovery were assessed one year after operation. Results The operation was successfully completed in this group. The operation time was 25-35 min, the average time was (30.4 ±4.8) min. No major vascular and nerve injury occurred in the operation. All patients were followed up. The wound healed well. No infection and skin necrosis, no heel pain and achilles tendon re-rupture were found during follow-up. There was no significant difference in mean passive plantar flexion between injured ankles and uninjured ankles one year after operation (44.36°± 3.33° vs. 46.40°±4.53°, P＞ 0.05). But mean passive dorsiflexion was lower in injured ankles than that of uninjured ankles (16.88°± 4.10° vs. 20.12°±3.21°， P < 0.05). The mean ATRS score was 88.7±6.1 (range 79-97), and the mean AOFAS score was 92.4± 5.6 (range 76-100) at first postoperative year. According to the AOFAS scale, the results were excellent in 20 cases and good in 5 cases. Conclusion It was successful to repair the acute closed distal achilles tendon injuries with the suture anchors.

Key words: achilles tendon, fractures, closed, reconstructive surgical procedures, distal end rupture, suture anchor