闭合性跟腱断裂微创腱皮缝合的远期疗效观察.doc

闭合性跟腱断裂微创腱皮缝合的远期疗效观察
作者:商晓军,朱亚平,韦兆祥
【摘要】[目的]通过对长期疗效和可能并发症的观察,介绍并评价微创腱皮缝合术治疗急性闭合性跟腱断裂的临床效果。[方法]自1996年1月~2005年4月间,随机选取跟腱断裂的患者28名,经术前查体和MRI证实,均为新鲜完全性闭合性跟腱断裂。首先微创暴露跟腱断端,清除断端的瘢痕和血凝块,梳理对合两断端,在皮外经跟腱断端以远健康部位做减张缝合。患者常规术后随访,平均随访4年(1~7年)。随访包括常规的临床评价和术后MRI检查,并应用ArnerLindholm疗效评定标准对术后效果进行评定。其中2例未能按时随访。[结果]对所有26例患者,按ArnerLindholm疗效评定标准进行评定,其中优19例,良6例,差1例,优良率为97%,无感染发生,再断裂1例,为长期局部类固醇封闭患者。术后MRI显示,全部患者的跟腱得到了良好的修复,跟腱断端连续性好,疤痕小。[结论]通过长期随访,微创腱皮缝合是一种修复急性闭合性跟腱断裂较好的方法,具有创伤小,有效保护跟腱血运,术后并发症少的优点。
【关键词】跟腱;腱损伤;缝合技术
The long term result of the acute closed rupture of achilles tendon treated by the short incision and tenocutaneous relaxing suture

Abstract:[Objective]To evaluate the long term effect of the short incision and tenocutaneous relaxing suture to treat the acute closed rupture of the Achilles tendon.[Method]28 cases were treated by short incision and tenocutaneous relaxing suture from 1996-2005,The scar tissue and blood blocks between the ends of ruptured Achilles tendon were first pletely,then treated with percutanneous decmpression suture,the duration of follow up ranged from 2 years to 10 treatment e were evaluated by ArnerLindholm evaluation system and the MRI of post cases were lost.[Result]According to the ArnerLindholm evaluation system and the MRI of post operation,the treatment e were excellent in 18,and good in 6,with excellent rate of 92%,plication