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1、小切口治疗急性闭合性跟腱断裂的临床应用研究中文摘要目的:通过对小切口治疗急性闭合性跟腱断裂长期疗效和可能并发症的观察,介绍并评价小切口治疗急性闭合性跟腱断裂的临床效果。方法:自2009年3月到2012年3月间,在所治疗的急性闭合性跟腱断裂的病人中,选取30例,其中愿意接受该手术治疗的患者18例作为A组(观察组),其余的均采用传统的切开Kessler缝合法作为B组(对照组),经术前查体和MRI、超声证实,均为新鲜完全性闭合性跟腱断裂。分别采用小切口及常规切开两种方法,患者常规术后随访,平均随访6-12个月。随访包括常规的临床评价和术后MRI、超声检查,并应用Ar
2、ner-lindholm疗效评定标准对术后效果进行评定,所有病例没有一例丢失,均通过门诊随访或电话随访。结果:对A组及B组的手术时间、出血量、术后疤痕、术后疼痛情况、术后功能等观察指标进行评定,两组有显著区别。结论:通过长期随访,小切口跟腱缝合法是一种修复急性闭合性跟腱断裂较好的方法,具有创伤小,出血量少,术后疼痛小,术后疤痕小,功能恢复好,术后感染率小,术后并发症少的优点,因此更容易被广大患者,尤其是女性患者所接受。关键词:急性闭合跟腱断裂;小切口缝合法;观察指标;术后康复训练1TheClinicalStudyontheApplicationofMinima
3、llyInvasiveSurgeryCuringAcuteClosedAchillesTendonRuptureAbstractObjective:TointroduceandevaluatetheclinicalefficacyofminimallyinvasivesurgerycuringacuteclosedAchillestendonrupturethroughobservingthelong-termefficacyandtheprobablecomplicationofminimallyinvasivesurgerycuringacuteclose
4、dAchillestendonrupture.Methods:Followup30caseswithtreatmentoffreshclosedAchillestendonruptureduringMarch2009toMarch2012.Amongthose30cases,18caseswithminimallyinvasivesurgerytreatmentofacuteclosedAchillestendonrupturearetakenasGroupA(observedgroup),and12caseswithtreatmentoftraditiona
5、lKessler’ssutureasGroupB(controlledgroup).Allthe30casesafteroperationwerefollowedupwithanaverageof6-12monthsbyoutpatientortelephones.Andthepostoperativeefficacyduringthefollow-upwasevaluatedbyroutineclinicalassessment,postoperativeMRIandUltrasonography,andArner-lindholmassessmentcri
6、teria.Results:Throughtheobservationsandevaluations,GroupAisquitedifferentfromGroupBontheobservingindexesofoperationtime,bloodloss,postoperativescarandpain,andpostoperativeAchillestendonfunction.Conclusion:Basedonthelong-termfollow-up,comparedwiththe2traditionalKessler’ssuture,themin
7、imallyinvasivesutureisabetterwayforrestorationofacuteclosedAchillestendonrupture.Ithasthemeritsofsmallwound,littlebloodloss,minimalpostoperativepain,smallpostoperativescar,goodfunctionalrecovery,lowpostoperativeincisioninflectionrate,andminimalcomplications.Therefore,forthepatients,
8、especiallyforthefem