小切口辅助经皮缝合系统修复急性闭合跟腱断裂并发症

目的：分析小切口辅助经皮修复急性跟腱断裂术后并发症的原因、处置及预防对策。方法 ：回顾性研究2008年8月至2019年11月采用小切口辅助经皮跟腱缝合系统（micro incision percutaneous Achilles tendon suture system,MIPAS）治疗的急性闭合性跟腱断裂患者279例，其中男269例，女10例；右侧96例，左侧183例；年龄18～64(36.9±11.4)岁；伤后至手术时间0.5～7(2.7±0.9) d。收集记录术后18个月内切口相关情况、再断裂、腓肠神经损伤、静脉血栓、跟腱粘连、局部疼痛和踝关节僵硬，以及相应处置措施和并发症转归，总结分析原因和预防策略。结果：所有患者未出现切口浅表及深部感染，未出现症状性跟腱粘连和踝关节僵硬。发生迟发性线结反应2例（0.7%），再断裂5例（1.8%），腓肠神经损伤3例（1.1%），穿刺点皮肤内陷21例（7.5%），症状性静脉血栓2例（0.7%），一过性内踝后方疼痛45例（16.1%）。经个体化处理，功能良好，美国足踝外科协会（American Orthopaedic Foot&Ankle ...

Complications in repairing acute closed Achilles tendon rupture with micro-incision percutaneous Achilles tendon suture system

Objective To analyze the causes,management and prevention of complications after micro-incision percutaneous repair of acute Achilles tendon rupture.Methods A retrospective study indentyfied 279 patients with acute Achilles tendon rupture who underwent a mini-invasive procedure using the micro-incision percutaneous Achilles tendon suture system (MIPAS) from August 2008 to November 2019,including 269 males and 10 female;96 cases on the right side and 183 cases on the left side;aged from 18 to 64 years old with an average of (36.9±11.4) years old.Surgery was performed 0.5 to 7 days with an average of (2.7±0.9) days after injury.The incision-related complications,re-rupture,sural nerve injury,deep vein thrombosis,Achilles tendon adhesion,local pain,and ankle stiffness within 18 months after surgery were recorded,as well as the corresponding management and outcome,the causes and prevention measures were analyzed.Results No superficial or deep infection was found in all patients,symptomatic Achilles tendon adhesion and ankle stiffness were not observed,delayed suture foreign-body reactions occurred in 2 cases (0.7%),re-rupture in 5 cases (1.8%),sural nerve injury in 3 cases (1.1%),21 cases (7.5%) with skin invagination at puncture site,2 cases (0.7%) with symptomatic vein thrombosis,and 45 cases (16.1%) of transient posterior medial malleolus pain.After individualized treatment,the function was good.American Orthopeadic Foot&Ankle Sciety (AOFAS) score was 93 to 100 with an average of (98.9±5.4) scores.Conclusion Despite the occurrence of unique complications with MIPAS,it shows low functionally-related complications rates,such as incision-related complications,re-rupture,sural nerve injury,deep vein thrombosis and ankle stiffness.