摘要
目的比较跟骨骨隧道线扣与带线锚钉技术修复跟腱止点或近止点断裂的临床效果。方法回顾性分析2012年8月至2022年8月手术治疗的104例跟腱止点或近止点断裂患者的临床资料,按手术方式分为骨隧道线扣组和锚钉固定组,各52例,分别采用经跟骨骨隧道线扣技术和带线锚钉技术修复跟腱损伤。比较两组围手术期指标、术后并发症、踝-后足评分(AOFAS评分)及跟腱功能(ARTS评分)。结果两组比较,骨隧道线扣组手术时间显著长于锚钉固定组,术中出血量、住院时间及费用均明显低于锚钉固定组,均有统计学差异(均P<0.001)。术后均随访12个月。3例患者出现切口表浅红肿,其中锚钉固定组2例,骨隧道线扣组1例。两组术后患侧踝关节背屈角度、跖屈角度均较术前显著改善(P<0.001);组间比较,两组手术前后患侧背屈、跖屈角度均无统计学差异(P>0.05)。两组术后3、6、12个月各时点AOFAS踝-后足评分、ATRS评分均较术前显著改善(P<0.001);末次随访(术后12个月)骨隧道线扣组AOFAS评分优于锚钉固定组(P<0.001)。结论经跟骨骨隧道线扣技术与带线锚钉技术修复跟腱止点或近止点断裂均可有效恢复足踝功能,术后并发症少,但跟骨骨隧道线扣技术创伤更小,患者恢复更快,术后12个月踝-后足功能恢复更好,费用更低,是一种安全、有效且经济方法,值得临床推广。
Objective To compare the efficacy of the transcalcaneal tunnel suture-button technique and the suture anchor technique for the repair of insertional and proximal Achilles tendon ruptures.Methods A retrospective analysis was performed on 104 patients with insertional or proximal Achilles tendon ruptures who underwent surgical treatment between August 2012 and August 2022.Based on the surgical technique,the patients were divided into the transcalcaneal suture-button group and the suture anchor group,with 52 patients in each,and treated with the transcalcaneal tunnel suture-button technique and the suture anchor technique,respectively.Perioperative outcomes,postoperative complications,American Orthopaedic Foot&Ankle Society(AOFAS)ankle-hindfoot scores and Achilles Tendon Total Rupture Score(ATRS)were compared between the two groups.Results Compared with the suture anchor group,the operation time was longer,but the intraoperative blood loss,hospital stay and medical costs were significantly less in the transcalcaneal suture-button group(all P<0.001).All patients were followed up for 12 months.Superficial incision redness and swelling was observed in 3 cases,including 2 cases in the suture anchor group and 1 case in the transcalcaneal suture-button group.The dorsal flexion angle and plantar flexion angle of the involved ankle joint were significantly improved compared with those before operation in both groups(P<0.001);however,no significant differences were found between the two groups in these angles before or after surgery(P>0.05).The AOFAS ankle-hindfoot score and ATRS score at 3,6,and 12 months postoperatively were significantly improved compared with preoperative scores in both groups(P<0.001).At the final follow-up(12 months postoperatively),the AOFAS score was found to be significantly higher in the transcalcaneal suture-button group than in the suture anchor group(P<0.001).Conclusions Both the transcalcaneal tunnel suture-button technique and the suture anchor technique are effective for the repair of insertional and proximal Achilles tendon ruptures,and result in low rates of postoperative complica-tions and effective restoration of ankle function.However,the transcalcaneal suture-button technique is associated with less surgical trauma,faster patient recovery,superior ankle-hindfoot function at 12 months postoperatively,and lower overall costs,rendering it a safe,effective,and economical method worthy of broader clinical adoption.
作者
贾杰
王阳
车凯薇
高俊峰
王聪
李泽阳
梁虎
JIA Jie;WANG Yang;CHE Kaiwei;GAO Junfeng;WANG Cong;LI Zeyang;LIANG Hu(Department of Hand&Foot Surgery,the Fourth People's Hospital of Hengshui,Hengshui 053000,Hebei,China;Department of Child Health,the Fourth People's Hospital of Hengshui,Hengshui 053000,Hebei,China)
出处
《中国现代手术学杂志》
2025年第3期216-222,共7页
Chinese Journal of Modern Operative Surgery
基金
衡水市科技计划项目(2021014057Z)。
关键词
跟腱断裂
经跟骨骨隧道线扣技术
带线锚钉技术
Achilles tendon rupture
transcalcaneal tunnel suture-button technique
suture anchor technique
