| OBJECTIVE: Acute Achilles tendon rupture is a common injury in the foot and ankle.The incidence of acute Achilles tendon rupture in foreign countries is about 18/100000 per year,most of whom are men aged 30-40 years old.The age of onset of the disease is44%-83% Patients caused by sports injuries.Acute Achilles tendon rupture controversy exists mainly in the treatment,can be divided into conservative treatment and surgical treatment.To compare the prognosis of two minimally invasive surgical approaches with Achillon and Mini-incision repair with double-Tsuge loop suture,a retrospective controlled study was conducted to provide clinicians with a surgical reference.Methods: A retrospective study was conducted on patients with acutely closed Achilles tendon rupture from 2012.5 to 2017.5 in the Affiliated First Hospital of Dalian Medical University.A total of 140 patients were eligible.According to the surgical methods,the patients were divided into Tsuge group and Achillon group.Double-Tsuge loop suture group: 92 males and 9 females;aged 24 to 65 years,an average of 37.1 ± 8.6;left 56 cases,right 45 cases;patients were injured to surgery for 0to 25 days,an average of 4.1 ± 1.8 days.Cause of injury: sports injury and non-sports injuries than about 4: 1.Achillon group: 35 males and 4 females;aged 27 to 46 years,with an average of 35.7 ±6.0 years;25 cases on the left and 14 cases on the right;patients were injured to surgery for 2 to 9 days with an average of 4.1 ± 3.9 days.Cause of injury: The proportion of sports injuries and non-sports injuries is about 3: 1.After 6 months,1 year and 3 years,the patient's postoperative efficacy and patient satisfaction were recorded.Postoperative outcomes and patient satisfaction were observed in two groups: surgical time,complications,incision infection,and sensory conditions in the sural nerve innervation area.and using AOFAS ankle-hind foot curative effect evaluation and ATRS Achilles tendon Fracture score assessment of postoperative efficacy.Results: 139 patients were followed up from 6 months to 3 years.According to the statistical results,the operation time and hospitalization days of patients in the double-Tsuge loop suture group were shorter than those of the patients in the Achillon group(P < 0.05).The difference was statistically significant.The overall incidence of complications was 10% in Achillon group,including 1 case of sural nerve injury 2%,incision infection 1 case 2%,1 case of adhesion with achilles tendon 2%,followed by a patient with Achilles tendon and skin Adhesion occurred.One patient died of pulmonary embolism one and a half months after surgery.The overall complication rate in patients in the double-Tsuge loop suture group was 1%,and 1 case had 1% of fractures.There were no complications such as infection,sural nerve injury,and skin adhesion.According to the statistical results,the scores of the double-Tsuge loop suture group were higher than those of the Achillon group at the 6th month after operation and1 st year after the operation(P < 0.05).At the third year after the operation,the double-Tsuge loop suture group score and the Achillon group score.The difference was not statistically significant.The overall ATRS and AOFAS scores in both groups increased with time,and scores at different times were statistically significant(P <0.05).Conclusion: Both double-Tsuge loop suture and Achillon surgery are minimally invasive surgery,with a small incision,healing,and fewer complications.Compared with the surgery with Achilon,double-Tsuge loop suture method has a good early effect,and patients can perform early functional exercise. |
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