小切口微创手术治疗新鲜跟腱断裂的临床价值

目的：探讨小切口微创手术治疗新鲜跟腱断裂的一晦床价值。方法：选取我院新鲜闭合性跟腱断裂患者50例，随机分为实验组和对照组各25例。实验组行小切口手术，对照组行常规切口手术。术后对患者进行随访，采用美国足踝协会（AOFAS）推荐的评分标准对患者术后功能恢复情况进行评价，观察并记录完全恢复患者例数、完全恢复时间、小腿最大周长差和术后并发症发生情况。结果：实验组AOFAS评分为（98．6±9．7）分，痊愈率96．00％，痊愈时间（20．2±3．2）周，两侧小腿最大周长差为（0．79＋0．68）cm，共有1例患者出现并发症，并发症发生率8％；而对照组的AOFAS评分为（91．4±11．5）分，痊愈率92．00％，痊愈时间（22．4±3．8）周，两侧小腿最大周长差为（0．91~0．76）cm；共有6例患者出现并发症，并发症的发生率为24％。两组患者的痊愈率、两侧小腿最大周长差比较差异无统计学意义（痊愈率：x2=-0．355，P=0．552；侧小腿最大周长差：t=O．588，P=0．559）；而与对照组比较，实验组AOFAS评分明显升高，完全恢复时间明显缩短，术后并发症的发生率显著降低，差异均有统计学意义（AOFAS评：t=2．393，P=0．021；恢复时间：t=2．150，P=0．037；并发症发生率：xⅫ．153，P=0．042）。结论：小切口手术与常规切口手术治疗新鲜跟腱断裂的疗效相当，但小切口手术术后恢童时间曼短．并发症更少．临床价值相对更高．

Clinical Efficacy of Minimally Invasive Surgical in the Treatment of Fresh Achilles Tendon Rupture

Objective： To evaluate the clinical efficacy of minimally invasive surgical in the treatment of fresh Achilles tendon rupture. Methods： 50 patients with fresh closed Achilles tendon rupture were selected and randomly divided into the experimental group and the control group （25 cases in each group）. The experimental group was treated with minimally invasive surgical. The control group was treated with conventional surgical. Postoperative recovery fimction were evaluated and compared according to the standard recom- mended by the United States and ankle society （AOFAS）. Fully recovered patients number, time for returned to normal sports, the calf circumference difference and postoperative complications were observed and recorded during the follow-up period. Results： In the exper- imental group, the mean AOFAS score was （98.6＋ 9.7） point, the cure rate was 96.00%, the mean time for returned to normal sports was （20.2i 3.2） weeks, the calf circumference difference was （0.79＋ 0.68） cm and postoperative complications occurred in 1 patients, the in- cidence rate of postoperative complications was 8%. Meanwhile, in the control group, the mean AOFAS score was （91.4＋ 11.5） point, the cure rate was 92.00%, the mean time for returned to normal sports was （22.4＋ 3.8） weeks, the calf circumference difference was （0.91 ~ 0.76） cm and postoperative complications occurred in 6 patients, the incidence rate of postoperative complications was 24%. No significant difference of the cure rate and calf circumference was found between two groups （cure rate： x-2=0.355, P=0.552; calf circum- ference difference： t=-0.588,P=0.559）. Compared with the control group, in the experimental group, the AOFAS score was higher, the mean time for returned to normal sports was shorter and the incidence rate of postoperative complications was lower. The differences were statistically significant （AOFAS scores： t=2.393 ,P=0.021; time for returned to normal sports： t=2.150, P=0.037; incidence rate of postoperative complications： x~--4.153, P=0.042）. Conclusion： There was no significant difference of the clinical efficacy between the minimally invasive surgical and conventional surgical in the treatment of fresh Achilles tendon rupture. However, the minimally invasive surgical had a higher clinical value with shorter recovery time and less incidence rate of postoperative complications.