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-  2015 

经通道辅助缝合系统微创修复急性闭合跟腱断裂的疗效观察

DOI: doi:10.7507/1002-1892.20150009

Keywords: 急性闭合跟腱断裂, 通道辅助缝合系统, 微创技术

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Abstract:

目的探讨经通道辅助缝合系统(channel-assisted minimally invasive repair,CAMIR)微创修复急性闭合跟腱断裂的疗效。 方法2011年1月-2012年6月,收治30例(30侧)急性闭合跟腱断裂患者。男18例,女12例;年龄22~50岁,平均30.4岁。左侧10例,右侧20例。均为运动损伤。B超检查示跟腱完全断裂;断端距跟骨止点2~8 cm,平均4.4 cm。受伤距手术时间3 h~9 d,中位时间4 d。术中在CAMIR辅助下采用改良Bunnel缝合法修复断裂跟腱。 结果手术时间10~25 min,平均17.0 min;切口长1.5~2.5 cm,平均2.0cm。术后切口均Ⅰ期愈合,无切口感染、下肢深静脉血栓形成、腓肠神经损伤及跟腱再断裂等并发症发生。患者均获随访,随访时间12~24个月,平均16个月。末次随访时患者行走正常,提踵有力,均恢复至跟腱断裂前活动水平。MRI示跟腱愈合、连续;患侧与健侧小腿周径差均小于1 cm,踝关节背伸20~30°、跖屈20~30°。按照Arner Lindholm疗效评定标准,获优28例,良2例,优良率100%。 结论CAMIR辅助微创修复急性闭合跟腱断裂具有对合可靠、创伤小、再断裂及感染率低等优点,最大限度避免了腓肠神经损伤的发生

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