Study On The Clinical Efficacy Of Minimally Invasive Technique Of Oval Forceps

Background: There is no universal gold standard for surgical treatment of acute Achilles tendon rupture.In recent years,Mini-invasive Surgical Method by Achillion device has been proved to be a safe and reliable minimally invasive surgical method for the treatment of Achilles tendon rupture.But due to its high price,disposable products,domestic products not listed,not covered by medical insurance,and the full amount of patients required Reasons such as self-payment limit the use and promotion in China.At present,the classical open anastomosis technique is the most commonly used in clinic.In Our hospital,we use oval forceps and epidural needle simulating the theory of Achillion device to achieve minimally invasive and reduce the risk of complications.Objective: To investigate the clinical efficacy and feasibility of oval forceps assisted minimally invasive technology in the treatment of acute closed Achilles tendon rupture.Method: A retrospective analysis was made of 43 patients with acute closed rupture of Achilles tendon who underwent surgery in our hospital from January 2013 to June 2019,of which 17 cases were treated with oval forceps assisted minimally invasive technique and 26 cases with open Kessler suture.We collect the general situation of patients before surgery,and compare the time from injury to hospital admission(h),time from injury to surgery(h),Cutting length(cm),operation time(h),intraoperative blood loss(ml),length of hospital stay(d),and postoperative comparison.Whether there is gastrocnemius nerve injury,postoperative wound infection rate,delayed skin healing rate,skin non-healing rate,marginal necrosis rate,and Achilles tendon re-breakage rate.Results: The average incision length in the open group was 8.89 cm,the median operation time was 1.67 h,the intraoperative bleeding volume was 50 ml,the median hospitalization time was 15d;the average incision length in the minimally invasive group was 2.87 cm,the median operation time was 0.7h,the intraoperative bleeding volume was 20 ml,and the median hospitalization time was 10 d.Compared with the open group,the incision length of the minimally invasive group was shortened by 67.7%(P < 0.05),and the operation time,intraoperative hemorrhage and length of hospitalization of the minimally invasive group were reduced by 58%(P < 0.05),60%(P < 0.05)and 33%(P < 0.05),respectively.There were no postoperative complications in the minimally invasive group,but in the open group,there were 3 cases of postoperative wound infection(11.54%),4 cases of delayed wound healing(15.38%),4 cases of skin necrosis(15.38%)and 3 cases of re fracture(11.54%),which were much higher than that in the minimally invasive group.Conclusions: 1.Oval forceps assisted minimally invasive technique is a safe and reliable minimally invasive method for the treatment of acute Achilles tendon rupture.2.Oval forceps assisted minimally invasive technology can reduce the risk of surgical complications,reduce the length of operation,hospital stay,and reduce the social cost.