Objective: To evaluate the effectiveness and feasibility of a transverse small incision intrathecal "loop" minimally invasive suture for acute Achilles tendon rupture.
Methods: The clinical data of 30 patients with acute Achilles tendon rupture treated with transverse small incision intrathecal "loop" minimally invasive suture between January 2022 and October 2023 was retrospectively analyzed. The patients were all male, aged from 29 to 51 years, with an average of 39.8 years. The cause of injury was acute sports injury, and the time from injury to operation was 1-14 days, with an average of 3.4 days. The operation time, incision length, intraoperative blood loss, intraoperative complications, wound healing, and hospital stay were recorded. Postoperative appearance and function of ankle were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Vancouver Scar Scale (VSS) score, and Arner-Lindholm score.
Results: The operation time ranged from 30 to 90 minutes, with an average of 54.2 minutes; the incision length ranged from 1.3 to 3.5 cm, with an average of 2.2 cm; the intraoperative blood loss ranged from 5 to 70 mL, with an average of 22.3 mL; and the hospital stay ranged from 2 to 6 days, with an average of 3.7 days. All incisions healed by first intention, and there was no incision infection, poor healing, and deep venous thrombosis. All patients were followed up 5.3-22.0 months (mean, 14.7 months). During the follow-up, all the 30 patients had returned to exercise, and there was no complication such as Achilles tendon re-rupture, postoperative infection, and gastrocnemius muscle injury. At last follow-up, the AOFAS ankle-hindfoot score was 82-100, with an average of 95.1; the VSS score was 1-4, with an average of 2.1; according to the Arner-Lindholm score, 24 cases were rated as excellent and 6 cases as good.
Conclusion: Transverse small incision intrathecal "loop" minimally invasive suture for the treatment of acute Achilles tendon rupture has the advantages of simple instrument, convenient operation, small trauma, quick recovery, and satisfactory effectiveness.
目的: 探讨横形小切口鞘内“回”型微创缝合法治疗急性跟腱断裂的可行性和临床疗效。.
方法: 回顾分析2022年1月—2023年10月采用横形小切口鞘内“回”型微创缝合法治疗的30例急性跟腱断裂患者临床资料。患者均为男性；年龄29～51岁，平均39.8岁。致伤原因均为急性运动损伤；受伤至手术时间1～14 d，平均3.4 d。记录手术时间、切口长度、术中出血量、术中并发症、切口愈合情况、住院时间等；术后采用美国矫形足踝协会（AOFAS）踝-后足评分、温哥华瘢痕量表（VSS）评分、Arner-Lindholm评分评估踝关节外观及功能。.
结果: 手术时间30～90 min，平均54.2 min；切口长度1.3～3.5 cm，平均2.2 cm；术中出血量5～70 mL，平均22.3 mL；住院时间2～6 d，平均3.7 d。患者切口均Ⅰ期愈合，无切口感染、愈合不良、下肢深静脉血栓形成发生。30例患者均获随访，随访时间5.3～22.0个月，平均14.7个月。随访期间30例患者均已重返运动，未出现跟腱再断裂、术后感染、腓肠肌损伤等并发症。末次随访时，AOFAS踝-后足评分为82～100分，平均95.1分；VSS评分1～4分，平均2.1分；根据Arner-Lindholm评分评定疗效，获优24例、良6例。.
结论: 横形小切口鞘内“回”型微创缝合法治疗急性跟腱断裂器械简单、操作方便、创伤小、恢复快，可获得满意疗效。.
Keywords: Acute Achilles tendon rupture; minimally invasive suture; oval forceps assisted; transverse small incision.