摘要
目的:观察Krackow缝合法和改良Kessler缝合法治疗急性闭合性跟腱断裂的效果及对功能恢复的影响。方法:对2016年1月-2021年12月广州市花都区人民医院收治的98例急性闭合性跟腱断裂患者的临床资料进行回顾性分析,根据缝合方法的不同分为观察组(n=46,Krackow缝合法)和对照组(n=52,改良Kessler缝合法)。比较两组围手术期指标、术后并发症,比较两组术前、术后7 d实验室指标,比较两组术后3个月的康复效果,比较两组术前、术后3、6个月的跟腱活动情况。结果:两组手术时间、术中出血量、切口长度和住院时间比较,差异均无统计学意义(P>0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05);术前两组白细胞(WBC)、皮质醇(Cor)及C反应蛋白(CRP)比较,差异均无统计学意义(P>0.05),术后7 d,两组上述指标均较术前升高,观察组均低于对照组(P<0.05);两组术后优良率比较,差异无统计学意义(P>0.05),但观察组优率显著高于对照组(P<0.05);术前两组美国矫形足踝协会踝-后足评分(AOFAS-AH)、跟腱完全断裂评分(ATRS)比较,差异均无统计学意义(P>0.05),术后3、6个月,两组AOFAS-AH和ATRS均较术前升高,且观察组均显著高于对照组(P<0.05)。结论:Krackow缝合法和改良Kessler缝合法应用于急性闭合性跟腱断裂均能取得较好临床疗效,但Krackow缝合炎症应激反应更小,术后跟腱活动恢复更佳。
Objective:To observe the effect of Krackow suture and modified Kessler suture in the treatment of acute closed rupture achilles tendon and its influence on functional recovery.Method:The clinical data of 98patients with acute closed rupture achilles tendon admitted to Huadu District People’s Hospital of Guangzhou from January 2016 to December 2021 were retrospectively analyzed.According to different suture methods,they were divided into the observation group(n=46,Krackow suture)and the control group(n=52,modified Kessler suture).The perioperative indicators and postoperative complications of the two groups were compared.The laboratory indexes before and 7 days after operation were compared between the two groups.The rehabilitation effects of the two groups at 3 months after operation were compared.The activity of achilles tendon before operation and 3,6 months after operation were compared between the two groups.Result:There were no statistical differences in the operation time,intraoperative bleeding volume,incision length and hospital stay between the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).There were no significant differences in white blood cell(WBC),cortisol(Cor)and C reactive protein(CRP)between the two groups before operation(P>0.05),7 days after operation,the above indexes in the two groups were higher than those before operation,and those in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the total excellent and good rate between the two groups(P>0.05),but the excellent rate in the observation group was significantly higher than that in the control group(P<0.05).There were no significant differences in the American orthopaedic foot and ankle society ankle-hind foot score(AOFAS-AH)and achils tcendon total rupture score(ATRS)between the two groups before operation(P>0.05).3 and 6 months after operation,AOFAS-AH and ATRS in two groups were higher than those before operation,and in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:Both Krackow suture and modified Kessler suture can achieve good clinical effects in acute closed rutpure achilles tendon,but Krackow suture has less inflammatory stress response and better recovery of achilles tendon activity after operation.
作者
伍亮
孙丽丽
谷城
WU Liang;SUN Lili;GU Cheng(Huadu District People's Hospital of Guangzhou,Guangzhou 510800,China;不详)
出处
《中国医学创新》
CAS
2023年第5期23-27,共5页
Medical Innovation of China
基金
花都区科技计划项目(20-HDWS-015)。
作者简介
通信作者:伍亮。
