CAJ | 학술논문

目的分析小切口内应用0-0可吸收普迪思圈套线(PDS-Ⅱ线)双津下缝合法修复急性跟腱断裂的临床疗效. 方法本组34例患者均为急性闭合性跟腱断裂,其中男25例,女9例；年龄20 ～45岁,平均32岁.致伤原因:运动损伤27例,摔伤6例,重物击伤1例.受伤至手术时间1 ～6d,平均3d.所有患者均行微创小切口,应用PDS-Ⅱ线双津下缝合法修复.术后于踝跖屈30°位短腿石膏固定,6周后拆除石膏开始功能锻炼,8 ～10周后可完全负重,3～4个月后逐渐恢复运动. 结果术后发生切口愈合不良1例,反射性交感神经营养不良1例,其余患者切口均Ⅰ期愈合,无皮肤粘连.术后无感染、下肢深静脉血栓形成、腓肠神经损伤等并发症发生.所有患者均获随访,随访时间12～24个月,平均15个月.随访期间均未发生跟腱再次断裂等并发症.根据Termann跟腱损伤的临床评价标准,本组评分平均为92分(76～ 96分).其中优28例,良5例,可1例,优良率为97％. 结论采用小切口内双津下缝合法修复急性跟腱断裂,并发症发生率低,临床疗效满意,是一种理想的跟腱手术方法.
목적 분석소절구내응용0-0가흡수보적사권투선(PDS-Ⅱ선)쌍진하봉합법수복급성근건단렬적림상료효. 방법 본조34례환자균위급성폐합성근건단렬,기중남25례,녀9례；년령20 ～45세,평균32세.치상원인:운동손상27례,솔상6례,중물격상1례.수상지수술시간1 ～6d,평균3d.소유환자균행미창소절구,응용PDS-Ⅱ선쌍진하봉합법수복.술후우과척굴30°위단퇴석고고정,6주후탁제석고개시공능단련,8 ～10주후가완전부중,3～4개월후축점회복운동. 결과 술후발생절구유합불량1례,반사성교감신경영양불량1례,기여환자절구균Ⅰ기유합,무피부점련.술후무감염、하지심정맥혈전형성、비장신경손상등병발증발생.소유환자균획수방,수방시간12～24개월,평균15개월.수방기간균미발생근건재차단렬등병발증.근거Termann근건손상적림상평개표준,본조평분평균위92분(76～ 96분).기중우28례,량5례,가1례,우량솔위97％. 결론 채용소절구내쌍진하봉합법수복급성근건단렬,병발증발생솔저,림상료효만의,시일충이상적근건수술방법.
Objective To evaluate the efficacy of mini-incisional double-tsuge suture method with 0-0 absorbable polydioxanone-cord (PDS-Ⅱ) in repair of acute achilles tendon rupture.Methods A total of 34 patients were subjected to acute closed achilles tendon ruptures,including 25 males and 9 females at a mean age of 32 years ( range,20-45 years).Injury causes included sports injuries in 27 patients,falling injuries in six and heavy object impingement injury in one.The time from injury to operation was average 3 days (range,1-6 days).All patients underwent minimally invasive repair with double-tsuge suture method by using PDS-Ⅱ.The ankle joint was fixed with short leg plaster cast at 30° plantar flexion position and the cast was removed six weeks later to take functional exercise.The patients could walk with full weight-bearing 8-10 weeks later and could gradually return to activity 3-4 months later.Results There was one patient with poor incision healing and one patient with reflex sympathetic dystrophy postoperatively.The rest patients had stage Ⅰ incision healing without skin adhesions.No complications such as infection,lower extremity deep venous thrombosis or sural nerve injury occurred postoperatively.All the patients received follow-up of 12-24 months (average 15 months),which showed no complications like tendon rerupture occurred.According to clinical evaluation criterion of Termann,the average score was 92 points (range,76-96 points).The result was excellent in 28 patients,good in five and fair in one,with excellence rate of 97％.Conclusions Small incisional double-tsuge suture method achieves low rate of complications and good outcomes for repairing acute achilles tendon rupture and is an ideal tendon surgery approach.