首页|Krackow锁定缝合法联合改良Kessler缝合法治疗急性闭合性跟腱体部断裂

Krackow锁定缝合法联合改良Kessler缝合法治疗急性闭合性跟腱体部断裂

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目的 探讨Krackow锁定缝合法联合改良Kessler缝合法治疗急性闭合性跟腱体部断裂的疗效。方法 2020年1 月~2022 年1 月我科对162 例急性闭合性跟腱体部断裂采用Krackow锁定缝合法联合改良Kessler缝合法手术治疗,术后采用相同的康复计划。采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝-后足评分和跟腱完全断裂评分(Achilles Tendon Total Rupture Score,ATRS)进行功能评价。结果 手术时间24~40 min[(31。9±4。6)min]。切口均为一期愈合,无感染、腓肠神经损伤。2 例并发症:下肢深静脉血栓 1 例,意外导致跟腱再断裂 1 例。踝关节屈伸活动度恢复时间为4~12 周[(7。6±1。9)周],患侧单足提踵恢复时间为10~18 周[(13。3±1。8)周],快走或慢跑恢复时间为14~26 周[(19。1±1。8)周]。162 例随访14~25 个月,平均19。0 月。AOFAS踝-后足评分由术前(54。4±4。4)分提高到末次随访(98。0±4。0)分(t =-104。402,P = 0。000);ATRS 评分由术前(52。0±8。3)分提高到末次随访(91。2±2。4)分(t =-62。823,P =0。000)。结论 对于急性闭合性跟腱体部断裂的中青年患者,Krackow锁定缝合法联合改良Kessler缝合法可使患者获得更佳的临床结局,早期进行功能锻炼以回归工作与生活。
Krackow Locking Loop Technique Combined With the Modified Kessler Suture Technique for the Treatment of Acute Closed Achilles Tendon Rupture
Objective To explore the efficacy of Krackow locking loop technique combined with the modified Kessler suture technique in the treatment of acute closed Achilles tendon rupture.Methods From January 2020 to January 2022,162 cases of acute closed Achilles tendon rupture were treated with Krackow locking loop technique combined with the modified Kessler suture technique.The patients were treated with the same postoperative rehabilitation plans.The American Orthopaedic Foot and Ankle Society(AOFAS)hindfoot score and Achilles Tendon Total Rupture Score(ATRS)were collected to evaluate the functions.Results The operation time was 24-40 min(mean,31.9±4.6 min).All incisions healed in one stage without infection or sural nerve injury.Complications occurred in 2 patients,including 1 case of deep venous thrombosis and 1 case of trauma-related re-rupture.The recovery time of ankle flexion and extension motion was4-12 weeks(mean,7.6±1.9 weeks),the recovery time of single-legged heel rise height on the affected side was 10-18 weeks(mean,13.3±1.8 weeks),and the recovery time of fast walking or jogging was 14-26 weeks(mean,19.1±1.8 weeks).The 162 patients was followed up for 14-25 months(mean,19.0 months).The AOFAS hindfoot score increased from(54.4±4.4)points preoperatively to(98.0±4.0)points at the last follow-up(t =-104.402,P =0.000).The ATRS score increased from(52.0±8.3)points preoperatively to(91.2±2.4)points at the last follow-up(t =-62.823,P = 0.000).Conclusions For young and middle-aged patients with acute closed Achilles tendon rupture,Krackow locking loop technique combined with the modified Kessler suture technique can achieve good clinical outcomes.Early functional exercise is required to return to work and life.

Achilles tendon ruptureKrackow locking loop techniqueModified Kessler suture technique

曹源、崔增桢、符玉亮、白梁宇、吕扬、周方

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北京大学第三医院骨科 骨与关节精准医学教育部工程研究中心,北京 100191

跟腱体部断裂 Krackow锁定缝合法 Kessler缝合法

首都卫生发展科研专项

2022-2-4096

2024

中国微创外科杂志
北京大学

中国微创外科杂志

CSTPCD北大核心
影响因子:2.21
ISSN:1009-6604
年,卷(期):2024.24(3)
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