治疗闭合性跟腱断裂两种术式的临床疗效分析

发布时间：2018-06-19 06:27

本文选题：跟腱断裂 + Krackow方法　；参考：《延边大学》2015年硕士论文

【摘要】：目的；治疗闭合性跟腱断裂两种术式的临床疗效分析,为以后治疗闭合性跟腱断裂,在修补术式上提供资料参考。方法；对我院住院治疗(2011年10月—2014年6月)的124例,其中符合纳入标准的109例闭合性跟腱断裂患者进行回顾性分析。根据入院患者手术的具体术式不同分为两组,分别为Krackow缝合术式组、改良Kessler缝合术式组。对术后两组患者采取常规石膏固定,屈膝、踝关节跖屈位。术后24h后进行患侧足趾及股四头肌功能锻炼,根据切口愈合情况约术后两周切口拆线,其中长腿石膏固定4周、小腿石膏固定2周(并将踝关节置于中立位),开始进行无负重练习,术后6周,拆除固定石膏,行轻度循序渐进负重练习,术后6个月,完全负重,可进行平走及慢跑功能练习。109例患者平均随访时间12个月,于术后6、12个月按照美国足踝评分系统(AOFAS)和Arner-Lindholm标准进行记录,术后康复锻炼情况、术后并发症情况。结果；术后109例患者均获得随访,随访时间6个月到18个月,平均随访时间为12个月。其中Krackow缝合术式组,15例患者发生切口感染、二次断裂9例,改良Kessler缝合术式组,4例发生切口感染,二次断裂3例,经对症处置后,切口痊愈出院。术前两组患者一般资料性别及年龄、分型、无统计学意义(P0.05),术后6、12个月足踝评分系统(AOFAS)和Arner-Lindholm标准有统计学意义(P0.05),术后感染率及二次断裂有统计学意义(P0.05)。结论；两种缝合闭合性跟腱断裂的术式均可以达到治疗跟腱的目的,但术后的切口皮肤感染率、二次跟腱断裂发生率及足踝评分系统(AOFAS)和Arner-Lindholm标准,改良Kessler缝合组取得很好的临床效果。
[Abstract]:Objective: to analyze the clinical curative effect of two operative methods for closed Achilles tendon rupture, and to provide reference for the treatment of closed Achilles tendon rupture. Methods: a retrospective analysis was performed on 124 patients with closed Achilles tendon rupture in our hospital from October 2011 to June 2014. The patients were divided into two groups: Krackow suture group and modified Kessler suture group. Routine plaster fixation, knee flexion and ankle metatarsal flexion were used in both groups. 24 hours after operation, functional exercise of the affected toe and quadriceps femoris was performed. According to the healing condition of the incision, the thread was removed about two weeks after the operation, and the long leg was fixed with plaster for 4 weeks. Leg plaster fixation for 2 weeks (and ankle joint placed in neutral position, start to do weightless exercises, 6 weeks after surgery, remove the plaster fixation, do a mild progressive load exercise, 6 months after the operation, complete load, The average follow-up time of 109 patients with walking and jogging function was 12 months. After 6 and 12 months, the patients were recorded according to the American ankle and foot scoring system (AOFASS) and Arner-Lindholm standard. The postoperative rehabilitation exercise and postoperative complications were recorded. Results: 109 patients were followed up for 6 to 18 months, with an average follow-up time of 12 months. In the Krackow suture group, incision infection occurred in 15 cases, secondary rupture in 9 cases, incision infection in 4 cases in modified Kessler suture group, and secondary rupture in 3 cases. The incision was cured and discharged after symptomatic treatment. There was no significant difference in sex, age and classification between the two groups before operation, but there was no significant difference between the two groups (P 0.05). There was a significant difference between AOFASS and Arner-Lindholm criteria in ankle and foot scoring system at 6 and 12 months after operation. The postoperative infection rate and secondary rupture were significantly higher than those in the control group (P 0.05). Conclusion: both methods of suturing closed rupture of Achilles tendon can achieve the purpose of treating Achilles tendon, but the infection rate of incision skin, the incidence of secondary rupture of Achilles tendon, and the ankle scoring system AOFASand Arner-Lindholm standard were observed. The modified Kessler suture group had good clinical effect.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.2

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