Comparison Of Effects Of The Surgical Treatment Achilles Tendon Rupture Between The Evolutionary "ã„£" Incision And The Conventional Incision

Objective:The Achilles tendon is the thickest and strongest tendon in thehuman body. Achilles tendon rupture is a common disease in department oforthopedics. Achilles tendon ruptures occur most commonly in males in theirthird and fourth decades who play sport intermittently. The prevalence isthought to be rising these years, possibly as a result of the increasing ofparticipation in sports by people. Most of these injuries occur during sportingactivities, particularly those involving jumping or twisting motions such assoccer, tennis and badminton. Management of acute ruptures of the Achillestendon is still controversial. It can be divide into conservative approach andoperative management. The conservative approach, usually preferred for olderlow demand patients, should be weighed against the relatively high risk ofre-rupture and long time to return to pre-injury activities offered by surgery.Managements including two types of surgical repair, open, or minimallyinvasive procedures. Minimally invasive procedures runs the risk of suralnerve injury. This complication is hard to avoid. Open surgery provides goodstrength to the repair and low re-rupture rates and better quality of patients’life. However, major complications such as delayed wound healing, woundinfection, adhesions, keloid and wound necrosis may occur.This study aimedto compare the efficacy of the evolutionary “ㄣ” incision with theconventional incision.Methods:Patients of Achilles tendon ruptures from Jun.2011to Aug.2013in the Third Hospital of Hebei Medical University. Patients wereincluded in this analysis based on the following criteria:1)10﹤age﹤60;2)the injuries occurred during sports activity. Patients were excluded out of thisanalysis based on the following criteria:1) with history of trauma on the ipsilateral Achilles tendon;2) with history of pain on the ipsilateral Achillestendon before injured;3) mentally disturbed. We invited19patients toparticipate in the study. Group A (n=9patients) was treated with theevolutionary “ㄣ” incision and Group B (n=10patients) were treated with theconventional incision. The mean age in Group A was35.1years (from14to51years) and in Group B,39.7years (from27to50years). Patients in GroupA were7males and2females and in Group B,9males and only1female.There were7patients injured the left leg and2patients injured the right leg inGroup A. There were5patients injured the left leg and5patients injured theright leg in Group B. The time patients treated in Group A range from1day to4months after they were injured and in Group B, range from1day to2weeksafter they were injured. The observation period in Group A was range from6-32months and in Group B, range from13-30months. Patients in both groupaccepted the same post-operative techniques of fixation. Primary outcomemeasures were the healing period and the number of important surgicalcomplications, including infections, adhesions, Achilles tendon re-ruptures,and sural nerve lesions. And the Arner-Lindholm clinical outcome score wasused in this study. Statistics analysis were made by SPSS16．0.Results:The observation period in Group A was range from6-32monthsand in Group B, range from13-30months. There was no surgicalcomplication took place in Group A. There were3cases of infections,1casesof Achilles tendon re-ruptures and2cases of wound necrosis in Group B. Themain healing period in Group A was12days and in Group B,16.2days (from12to30days). There was no sural nerve lesion took place in either group. TheArner-Lindholm clinical outcome score of Group A included8excellent and1good. The score of Group B included7excellent,2good and1poor.Conclusion:In this study, the evolutionary “ㄣ” incision can reduce thedestruction of blood circulation around the incision. And it can reduce thetension of the incision. The evolutionary “ㄣ” incision can contribute excellenteffects to avoid surgical complications.