OBJECTIVE:To investigate the effectiveness of modified percutaneous suture in repairing acute closed Achilles tendon rupture by comparing with conventional open suture.METHODS:Between January 2006 and October 2009, 50 patients with acute closed Achilles tendon rupture were treated with modified percutaneous suture by making 5 small incisions at both sides of Achilles tendon and zigzag suture (improved group, n=22) and with Kessler suture (conventional group, n=28), respectively. No significant difference was found in gender, age, time from injury to operation between 2 groups (P > 0.05).RESULTS:In improved group, the patients achieved healing of incisions by first intention after operation and no complication occurred; however, incision infection occurred in 1 case, Achilles tendon re-rupture in 1 case, and incision scar contracture in 2 cases in conventional group. The operation time of improved group [(38.7 +/- 6.6) minutes] was significantly shorter (t=-12.29, P=0.00) than that of conventional group [(52.3 +/- 6.9) minutes]; the blood loss of improved group [(4.9 +/- 2.0) mL] was significantly less (t=-25.20, P=0.00) than that of conventional group [(40.7 +/- 7.1) mL]. The patients were followed up 2-3 years (mean, 29.9 months). The American Orthopaedic Foot and Ankle Society (AOFAS) score was 99.6 +/- 1.0 in improved group and was 98.4 +/- 3.0 in conventional group, showing no significant difference between 2 groups (t=1.66, P=0.10).CONCLUSION:Comparison with conventional open suture, modified percutaneous suture has some advantages, such as easy operation, less complications, rapid recovery of limb function, and so on. Modified percutaneous suture is one of the best choices for the treatment of acute closed Achilles tendon rupture.
膝关节僵硬是下肢骨折的常见并发症,临床上下肢骨折术后由于长期限制活动可引起膝关节的粘连、挛缩、僵硬等并发症.CPM为临床提供了一个良好的被动功能锻炼的器械.我院自2001年来,通过对96例下肢骨折术后患者施行无痛性连续被动活动,其功能恢复效果满意.现将体会报告如下:
Halo-Vest又称头环脊柱固定背心,是通过前后各2根支撑连接杆将固定于胸廓前后的背心夹与固定于头颅的头环相连接而起到固定作用.而头环固定本身可用于连接前的牵引复位.适用于不稳定型上颈椎损伤的固定、牵引复位、复位手术后固定以及一些陈旧性上颈椎损伤病的术前准备,现已广泛应用于颈椎外科,是急性上颈椎损伤安全有效和实用易行的治疗方法.我科从2002年1月～2005年7月,已将Halo-Vest用于治疗不稳定型上颈椎损伤病共计22例,取得良好的治疗效果,报告如下.
