Supine position and spoon-shaped medial incision and reverse traction overlapping suture for closed Achilles tendon rupture
10.3760/cma.j.cn115530-20241211-00477
- VernacularTitle:仰卧位内侧弧形切口反向牵拉重叠缝合法治疗闭合性跟腱断裂的疗效分析
- Author:
Shuncheng JIAO
1
;
Yun SU
;
Haochun ZHANG
;
Xiaobo WANG
Author Information
1. 北京市顺义区医院骨外一科，北京 101300
- Publication Type:Journal Article
- Keywords:
Achilles tendon rupture;
Surgical treatment;
Complications;
Spoon-shaped medial Incision;
Supine position
- From:
Chinese Journal of Orthopaedic Trauma
2025;27(7):586-592
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy of supine position and spoon-shaped medial incision and reverse traction overlapping suture versus that of prone position and percutaneous minimally invasive suture for acute closed Achilles tendon rupture.Methods:A retrospective study was conducted to analyze the clinic data of 43 patients with acute closed Achilles tendon rupture who had undergone surgical treatment at Department of Orthopedics, Zhongshan Hospital Affiliated to Dalian University from October 2019 to December 2022. There were 40 males and 4 females with an age of (82.5±10.9) kg. The patients were divided into 2 groups according to their different treatment methods: group A of 20 cases treated by supine position and spoon-shaped medial incision and reverse traction overlapping suture, and group B of 23 cases treated by prone position and percutaneous minimally invasive suture. The 2 groups were compared in terms of operation time, intraoperative blood loss, incision length, postoperative hospital stay, complications, and ankle-hindfoot score of American Orthopedic Foot and Ankle Society (AOFAS) and Achilles tendon total rupture score (ATRS) at 3 and 6 months after operation.Results:There was no significant difference in the preoperative general data between the 2 groups, showing they were comparable ( P>0.05). The operation time in group A [(36.8±3.7) min] was significantly shorter than that in group B [(43.3±5.2) min], the intraoperative blood loss in group A [(26.1±4.5) mL] significantly more than that in group B [(15.7±2.2) mL], the incision length in group A [(7.5±0.8) cm] significantly longer than that in group B [(3.8±0.8) cm], and the AOFAS ankle-hindfoot score [(85.6±3.7) points] and ATRS [(80.3±0.7) points] in group A at 3 months after operation were significantly higher than that in group B [(81.6±3.5) points and (74.4±2.4) points] (all P<0.05). There were no significant differences between groups A and B in postoperative hospital stay [4 (3, 4) d versus 3 (3, 4) d], AOFAS ankle-hindfoot score [(93.3±1.8) points versus (92.2±1.5) points], or ATRS at 6 months after operation [(93.3±1.1) points versus (93.0±0.5) points] ( P>0.05). The AOFAS ankle-hindfoot score and ATRS were significantly improved at 6 months after operation in all patients ( P < 0.05). In group A, of the 12 patients under general anesthesia, laryngeal discomfort occurred in 1 case. In group B, of the 16 patients under general anesthesia, laryngeal discomfort occurred in 4 cases, chest tenderness in 1 case, and shoulder numbness in 1 case. In group A, there was 1 case of superficial redness and swelling at the incision. In group B, there were 2 cases of superficial redness and swelling at the incision, 1 case of sural nerve injury, and 1 case of Achilles tendon re-rupture. There was significant difference in anesthetic complications or postoperative complications between the 2 groups ( P<0.05). Conclusion:In the treatment of acute closed Achilles tendon rupture, compared with prone position and percutaneous minimally invasive suture, supine position and spoon-shaped medial incision and reverse traction overlapping suture can reduce the incidence of anesthesia and postoperative complications, and promote early functional recovery. Therefore, it can be used as a suitable choice.
