以疝修补材料“包裹法”加强修复断裂损伤的跟腱

背景：常规的跟腱断裂修复术后愈合慢、粘连、二次断裂等并发症发生率最高可达73%，严重影响了患者踝关节功能。目的：为减少跟腱断裂修复术后的并发症，分析疝修补材料在跟腱断裂修复中的作用。方法：选择跟腱断裂患者11例，其中男8例，女3例；年龄26-58岁，平均42岁；4例为开放性损失（镰刀伤），7例为闭合性损伤（运动性损伤）；左侧3例，右侧8例。在常规跟腱修复手术完成后，取疝修补材料修剪后，采用“包裹”法加强修复跟腱断裂吻合端。术后观察跟腱局部外观及功能恢复情况，采用Arner Lindholm标准进行疗效评价。结果与结论：2例失访，9例获得随访，随访时间6-45个月，Arner Lindholm标准评价显示优7例（78%），良2例（22%）；术后跟腱局部外观及功能恢复良好，无伤口感染、二次断裂等并发症发生。说明在常规跟腱断裂修复手术完成后，应用疝修补材料“包裹”法加强修复跟腱断裂吻合端临床疗效肯定，跟腱功能恢复良好，可防止再次断裂、局部粘连及感染等问题。

Ruptured Achilles tendon repaired with hernia repair materials using a wrap method

BACKGROUND：The incidence of complications folowing conventional repairing for the ruptured tendon is up to 73%, such as delayed healing, adhesion, secondary rupture. These complications severely affect ankle joint function of the patients. OBJECTIVE：To reduce the complications folowing the repair and investigate the role of hernia repair materials in the repairing of ruptured Achiles tendon. METHODS：Eleven patients who underwent repair of ruptured Achiles tendon were retrospectively studied. Among them there were eight males and three females with the mean age of 42 years （26-58 years）. Three cases were injured in left side and eight cases were in right side; four cases were open injury by sickle-induced damage and seven cases were closed injury by exercise-induced damage. The hernia repair materials after pruning was applied with a “wrap” method to strengthen the anastomosis repair of Achiles tendon after the conventional repair surgery had been completed. At the time of folow-up, al patients were observed for postoperative local appearance and function recovery, and assessed with Arner Lindholm standards. RESULTS AND CONCLUSION：The folow-up interval was 6-45 months （average 24.5 months）. Two cases were lost to folow-up. According to the Arner Lindholm standards, the effects were excelent in seven cases （78%） and good in two cases （22%）. Local appearance and function recovered wel postoperatively, and no complications occurred such as wound infection, secondary rupture and so on. A “wrap” method with hernia repair materials is suggested to strengthen the anastomosis repair of ruptured Achiles tendon after the conventional repair surgery is completed, it can significantly promote the healing of Achiles tendon ruptured end anastomosis, prevent Achiles tendon recurrent ruptures, local adhesion and infection.