本文選題：跟腱斷裂 + Krackow方法��； 參考：《延邊大學(xué)》2015年碩士論文

【摘要】：目的；治療閉合性跟腱斷裂兩種術(shù)式的臨床療效分析,為以后治療閉合性跟腱斷裂,在修補(bǔ)術(shù)式上提供資料參考。方法；對(duì)我院住院治療(2011年10月—2014年6月)的124例,其中符合納入標(biāo)準(zhǔn)的109例閉合性跟腱斷裂患者進(jìn)行回顧性分析。根據(jù)入院患者手術(shù)的具體術(shù)式不同分為兩組,分別為Krackow縫合術(shù)式組、改良Kessler縫合術(shù)式組。對(duì)術(shù)后兩組患者采取常規(guī)石膏固定,屈膝、踝關(guān)節(jié)跖屈位。術(shù)后24h后進(jìn)行患側(cè)足趾及股四頭肌功能鍛煉,根據(jù)切口愈合情況約術(shù)后兩周切口拆線,其中長(zhǎng)腿石膏固定4周、小腿石膏固定2周(并將踝關(guān)節(jié)置于中立位),開(kāi)始進(jìn)行無(wú)負(fù)重練習(xí),術(shù)后6周,拆除固定石膏,行輕度循序漸進(jìn)負(fù)重練習(xí),術(shù)后6個(gè)月,完全負(fù)重,可進(jìn)行平走及慢跑功能練習(xí)。109例患者平均隨訪時(shí)間12個(gè)月,于術(shù)后6、12個(gè)月按照美國(guó)足踝評(píng)分系統(tǒng)(AOFAS)和Arner-Lindholm標(biāo)準(zhǔn)進(jìn)行記錄,術(shù)后康復(fù)鍛煉情況、術(shù)后并發(fā)癥情況。結(jié)果；術(shù)后109例患者均獲得隨訪,隨訪時(shí)間6個(gè)月到18個(gè)月,平均隨訪時(shí)間為12個(gè)月。其中Krackow縫合術(shù)式組,15例患者發(fā)生切口感染、二次斷裂9例,改良Kessler縫合術(shù)式組,4例發(fā)生切口感染,二次斷裂3例,經(jīng)對(duì)癥處置后,切口痊愈出院。術(shù)前兩組患者一般資料性別及年齡、分型、無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后6、12個(gè)月足踝評(píng)分系統(tǒng)(AOFAS)和Arner-Lindholm標(biāo)準(zhǔn)有統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后感染率及二次斷裂有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論；兩種縫合閉合性跟腱斷裂的術(shù)式均可以達(dá)到治療跟腱的目的,但術(shù)后的切口皮膚感染率、二次跟腱斷裂發(fā)生率及足踝評(píng)分系統(tǒng)(AOFAS)和Arner-Lindholm標(biāo)準(zhǔn),改良Kessler縫合組取得很好的臨床效果。
[Abstract]:Objective: to analyze the clinical curative effect of two operative methods for closed Achilles tendon rupture, and to provide reference for the treatment of closed Achilles tendon rupture. Methods: a retrospective analysis was performed on 124 patients with closed Achilles tendon rupture in our hospital from October 2011 to June 2014. The patients were divided into two groups: Krackow suture group and modified Kessler suture group. Routine plaster fixation, knee flexion and ankle metatarsal flexion were used in both groups. 24 hours after operation, functional exercise of the affected toe and quadriceps femoris was performed. According to the healing condition of the incision, the thread was removed about two weeks after the operation, and the long leg was fixed with plaster for 4 weeks. Leg plaster fixation for 2 weeks (and ankle joint placed in neutral position, start to do weightless exercises, 6 weeks after surgery, remove the plaster fixation, do a mild progressive load exercise, 6 months after the operation, complete load, The average follow-up time of 109 patients with walking and jogging function was 12 months. After 6 and 12 months, the patients were recorded according to the American ankle and foot scoring system (AOFASS) and Arner-Lindholm standard. The postoperative rehabilitation exercise and postoperative complications were recorded. Results: 109 patients were followed up for 6 to 18 months, with an average follow-up time of 12 months. In the Krackow suture group, incision infection occurred in 15 cases, secondary rupture in 9 cases, incision infection in 4 cases in modified Kessler suture group, and secondary rupture in 3 cases. The incision was cured and discharged after symptomatic treatment. There was no significant difference in sex, age and classification between the two groups before operation, but there was no significant difference between the two groups (P 0.05). There was a significant difference between AOFASS and Arner-Lindholm criteria in ankle and foot scoring system at 6 and 12 months after operation. The postoperative infection rate and secondary rupture were significantly higher than those in the control group (P 0.05). Conclusion: both methods of suturing closed rupture of Achilles tendon can achieve the purpose of treating Achilles tendon, but the infection rate of incision skin, the incidence of secondary rupture of Achilles tendon, and the ankle scoring system AOFASand Arner-Lindholm standard were observed. The modified Kessler suture group had good clinical effect.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R687.2

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