跟腱断裂手术修复及制动方式改进的临床研究

目的改进闭合性跟腱断裂的手术和制动方法,减少并发症。方法跟腱内侧小切口,显露并对合断端,使用克氏针、钢丝自制矩形框架,远离断端经皮固定,稀疏、平顺缝合断端,术后踝关节休息位有限制动。结果获得随访的39例,采用Amer-Lindholm评定标准,优34例（占87.18%）,良5例（12.82%）。未发生术后再断裂、皮肤及肌腱坏死、深部感染等并发症。结论使用矩形框架,小切口修复闭合性跟腱断裂,术后踝关节休息位制动是一种较好的闭合性跟腱断裂治疗方法。

Clinical study of the improvement of surgical techniques for closed Achilles tendon ruptures and modes of restraints on ankle joint motion

Objective To improve the surgical techniques of closed Achilles tendon ruptures and mode of activity restraint and to reduce the incidence of complications.Methods A small incision was made medial to Achilles tendon so as to reveal and rearrange the ruptured ends for end-to-end anastomosis.Kirschner wire and steel-wire were used to make steel-wire rectangular framework with percutaneous fixation away from the distal ruptured ends,which were sutured with sparsity and smoothness.Postoperative activity restraint of the ankle joint was prescribed with rest position.Results Postoperative follow-ups of a total of 39 patients showed 34 patients（87.18%） were rated as excellent and 5 patients（12.82%） were rated as good,according to Arner-Lindholm rating system.There were no complications such as re-rupture,skin or tendon necrosis or deep wound infection.Conclusion A good treatment for closed Achilles tendon ruptures is exemplified by the use of rectangular frame with minor incisions and activity limitation of the ankle joint with rest position after operation.