通道辅助微创与切开跟腱缩短术治疗陈旧性跟腱过长的疗效比较

发布时间：2018-06-17 19:18

本文选题：陈旧性跟腱断裂 + 跟腱过长　；参考：《解放军医学杂志》2017年07期

【摘要】：目的比较通道辅助微创跟腱缩短术与切开跟腱缩短术治疗陈旧性跟腱断裂愈合后跟腱过长的疗效。方法回顾分析2013年12月-2015年12月符合入选标准的19例患者的临床资料,其中8例采用通道辅助微创跟腱缩短术,11例采用切开Krackow跟腱缩短术。两组患者性别、年龄、受伤至手术时间、术前小腿周径、术前美国矫形足踝协会(AOFAS)评分等一般资料差异无统计学意义(P0.05),具有可比性。比较两组的手术时间、手术切口长度、术后住院时间,术后跟腱恢复情况,小腿周径和AOFAS评分。结果微创组手术时间、手术切口长度及术后住院时间均显著少于切开组(P0.05)。术后8周随访时MRI显示两组患者跟腱均恢复连续性。两组末次随访时小腿周径和AOFAS评分均高于术前,差异有统计学意义(P0.05),但两组间比较差异无统计学意义(P0.05)。结论通道辅助微创缩短术治疗陈旧性跟腱断裂愈合后跟腱过长的疗效与切开跟腱缩短术相似,且具有手术时间短、切口小、住院时间短、可避免腓肠神经损伤等优点。
[Abstract]:Objective to compare the therapeutic effects of channel assisted minimally invasive Achilles tendon shortening and incision of Achilles tendon shortening in the treatment of achilles tendon length after the healing of old rupture of Achilles tendon. Methods the clinical data of 19 patients who met the inclusion criteria from December 2013 to December 2015 were retrospectively analyzed. Among them, 8 cases were treated with channel assisted minimally invasive Achilles tendon shortening and 11 cases were treated with Krackow tendon shortening. There were no significant differences between the two groups in gender, age, time from injury to operation, preoperative circumference of calf, preoperative AOFAS-score of the American Orthopaedic ankle Association (AMA) and so on. There was no significant difference between the two groups (P 0.05), and there was no significant difference between the two groups (P 0.05). The operative time, incision length, postoperative hospitalization time, postoperative Achilles tendon recovery, leg circumference and AOFAS score were compared between the two groups. Results the operation time, incision length and postoperative hospital stay in the minimally invasive group were significantly less than that in the incision group (P 0.05). MRI showed continuity of Achilles tendon in both groups at 8 weeks follow-up. At the last follow-up, the leg circumference and AOFAS score in the two groups were higher than those before operation, the difference was statistically significant (P 0.05), but there was no significant difference between the two groups (P 0.05). Conclusion the curative effect of channel assisted minimally invasive shortening is similar to that of incision and shortening of Achilles tendon after the old rupture of Achilles tendon is healed, and it has the advantages of short operation time, small incision, short hospital stay and can avoid the injury of sural nerve.
【作者单位】：解放军总医院骨科;
【基金】：首都临床特色应用研究资助项目(Z161100000516192)~~
【分类号】：R687.2

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