跟腱断裂:有限切口修复

IF 0.1 Q4 ORTHOPEDICS
Elisabeth Schauer, M. Assal
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引用次数: 0

摘要

跟腱断裂是一种常见的损伤,自20世纪中叶以来,其发病率稳步上升。保守治疗是公认的治疗方法,但与手术治疗相比,保守治疗有较高的肌腱再破裂风险。然而,标准的开放手术可能导致并发症,如伤口并发症和手术部位感染。因此,人们一直在努力开发替代手术技术,以降低并发症的风险。在20世纪70年代,Ma和Griffith引入了经皮肌腱修复术,将切口限制在6个刺伤。随后,开放和经皮入路合并为有限切口手术,其中包括两者的优点:视觉控制和更小的切口。最初的有限切口入路是使用扭曲克氏针作为缝合引导。它们被特定的引导器械取代,如Achillon和经皮跟腱修复系统(PARS)装置,这使得有限切口手术更安全,更标准化。器械由4个臂组成:外臂便于针头通过预定的孔引入,内臂允许缝线完全在肌腱鞘下通过。微创手术可以减少并发症的发生率,特别是在伤口愈合和感染方面。有限切口技术也可减少腓肠神经损伤。证据等级:诊断级v -专家意见。有关证据水平的完整描述,请参见作者说明。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Achilles Tendon Ruptures: Limited Incision Repair
Achilles tendon ruptures are a common injury, and a steadily rising incidence has been noted since the middle of the 20th century. Conservative management is a recognized treatment method, but it bears a higher risk of tendon rerupture compared with surgical treatment. Standard open surgery, however, can lead to complications, such as wound complications and surgical site infection. Hence, efforts have been put into the development of alternative surgical techniques to lower the risk of complications. In the 1970s, Ma and Griffith introduced percutaneous tendon repair by limiting the incision to 6 stab wounds. Subsequently, the open and percutaneous approaches have been merged into limited incision procedures, which include the advantages of both: visual control as well as smaller incisions. The primary limited incision approach consisted in using twisted Kirschner wires as suture guides. They were replaced by specific guiding instruments, such as the Achillon and Percutaneous Achilles Repair System (PARS) device, which rendered the limited incision procedure safer and more standardized. The instruments consist of 4 arms: The outer arms facilitate needle introduction by predetermined holes, the inner arms allow for suture passage exclusively underneath the tendon sheath. The minimally invasive procedures may reduce complication rates, especially regarding wound healing and infection. Limited incision techniques also may reduce sural nerve injury. Level of Evidence: Diagnostic Level V—expert opinion. See Instructions for Authors for a complete description of levels of evidence.
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来源期刊
CiteScore
0.40
自引率
0.00%
发文量
18
期刊介绍: Techniques in Foot & Ankle Surgery offers a unique opportunity to master the most innovative and successful surgical techniques for correction of foot and ankle disorders. Featuring contributions from the world"s foremost orthopaedic surgeons and podiatrists, this quarterly journal supplies step-by-step details on these techniques. The contributors explain the rationale, indications, and contraindications for each procedure, identify the pitfalls and potential complications, and provide invaluable tips for improving results. The journal is illustrated cover to cover with intraoperative photographs and drawings, including several in full color.
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