Coated Vicrylplus Antibacterial Suture With Krackow Anastomosis Method To Repair The Closed Rupture Of Achilles Tendon

Objective: With the development of people's health awareness and theSports participation, the incidence of Achilles tendon rupture was significantlyincreased, the incidence of Achilles tendon injury is about0.18‰[1],the maleto female injury ratios range from2.1:1to12:1[2], The Achilles tendon rupturehas been one of the most common sports-related injuries. In the sportsenthusiasts and athletes the closed achilles tendon ruptures were often occurs,and the most of them were complete ones, they typically occur between2to6cm proximal to the calcaneal insertion. At present, the treatments are morediverse,both the advantages and disadvantages were found. In general, theywere often divided into conservative treatment and surgical treatment.Usually,the conservative treatment was used to repair the not complete tuptures,and asimple plaster fixation was usually used. It can maintain the integrity of theachilles tendon tissue,and the postoperative complications such as deepinfection, skin necrosis, skin and achilles tendon adhesions were lessoccurred,but it is easy to make achilles tendon not recover or rerupture. Thepurpose of the surgical treatment of achilles tendon rupture is to restore theintegrity and continuity, to maintain its physiological length and to keep theplantar flexion strength of the triceps muscle of calf,so as to restore the normalfunction of the ankle joint,So, it requires a good technique to repair Achillestendon ruptures and a sequential effective rehabilitation exercises after theoperations. The traditional sutures, such as interrupted suture and mattresssuture have the low tensile strength, so,it can not afford a largeranti-pulltension,make the ends together and the knots were exposed.It couldeasily lead to the ends of the achilles tendon splitting, affect the achilles tendon recovery, and the postoperative adhesions were in a high rate.Up tonow,there is no an idea method to repair the rupture of the achilles tedon, westill need to actively explore a better one. In the past three years,we use the thecoated antibacterial vicrylplus suture with the Krackow anastomosis method torepair the closed rupture of achilles tondon. So we investigate the result of thecoated antibacterial vicrylplus suture with the Krackow anastomosis method torepair the closed rupture of achilles tendon.Methods: A total of12achilles tendon ruptured patients who werereviewed from Jan.2008to Dec.2011were treated with the coatedantibacterial vicrylplus suture with the Krackow anastomosis method. Amongthem,there were8males and4females with a mean age of42.5years(ranged from28to59years),the left side was4and the right was8. Neitherof them had other diseases.After the oeration the posterior leg plaster fixationwas used, and the postoperative rehabilitation exercises under the guidance ofthe doctor should be followed step-by-step.Arner-Lindholm system was usedto evaluate the function.Results: All patients were followed up for4~36months (averaged18months). According to Amer-Lindholm evaluating criteria,10cases gotexcellent therapeutic effect and2cases got good．The satisfactory rate was100%.No complications such as achilles tendon Adhesion or deep infectionwas found during the following period. There was one patient slipped againafter four weeks of the operation, and the achilles tendon ruptured again, thegood function was recoveried after the second surgery repair.Conclusion: The method of the coated vicrylplus suture of Krackowantibacterial suture to repair the closed achilles tendon rupture has theadvantage of stronge strength,low foreign body reaction,low opptunity ofinfection and good rehabilitation.It was a good choice for treating the closedachilles tendon rupture.