대한족부족관절학회지 (Journal of Korean Foot and Ankle Society)

  • 제16권3호
  • /
  • Pages.181-189
  • /
  • 2012
  • /
  • 1738-3757(pISSN)
  • /
  • 2288-8551(eISSN)
대한족부족관절학회 (Korean Foot & Ankle Society)
권호 표지

아킬레스건 파열의 수술적 치료 비교: 최소 절개 봉합술과 관혈적 봉합술

A Comparative Study of Surgical Treatment in the Ruptured Achilles Tendon: Minimal incision and Open repair

  • 공규민 (인제대학교 의과대학 부산백병원 정형외과학교실) ;
  • 곽희철 (인제대학교 의과대학 부산백병원 정형외과학교실) ;
  • 김전교 (인제대학교 의과대학 부산백병원 정형외과학교실)
  • Kong, Gyu-Min (Department of Orthopedic Surgery, College of Medicine, Inje University, Busan Paik Hospital) ;
  • Gwak, Heui-Chul (Department of Orthopedic Surgery, College of Medicine, Inje University, Busan Paik Hospital) ;
  • Kim, Jeon-Gyo (Department of Orthopedic Surgery, College of Medicine, Inje University, Busan Paik Hospital)
  • 투고 : 2012.07.27
  • 심사 : 2012.08.21
  • 발행 : 2012.09.15
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: The purpose of this study was to compare and analyse the clinical outcomes of minimal incision repair and open repair in ruptured Achilles tendon. Materials and Methods: We retrospectively analyzed the outcomes of 10 patients with minimal incision repair (group 1) and 19 patients with open repair (group 2) from February 2007 to June 2011. The postoperative clinical evaluations were done by Arner-Lindholm scale, AOFAS score, overall patient's satisfaction and cosmetic satisfaction of scar. Results: There was no statistical difference between two groups in Arner-Lindholm scale, AOFAS score, overall patient's satisfaction (p=1.21, 0.87, 1.07). There was statistically high rate of cosmetic satisfaction in group 1(p<0.001). There were no complications in group 1. Complications occurred in three patients (deep infection, rerupture, deep vein thrombosis) of group 2. Conclusion: Treatment of minimal incision repair in Achilles's tendon ruptures showed high rate of cosmetic satisfaction and low rate of complication's, but there were no significant differences with open repair in other clinical outcomes. The minimal incision repair could be recommended as one of the effective treatment for the Achilles's tendon ruptures.

키워드

참고문헌

  1. Leppilahti J, Puranen J, Orava S. Incidence of Achilles tendon rupture. Acta Orthop Scand. 1996;67:277-279. https://doi.org/10.3109/17453679608994688
  2. Maffulli N. Rupture of the Achilles tendon. J Bone Joint Surg Am. 1999;81-A:1019-1036.
  3. Bradley JP, Tibone JE. Percutaneous and open surgical repairs of Achilles tendon ruptures. A comparative study. Am J Sports Med. 1990;18:188-195. https://doi.org/10.1177/036354659001800213
  4. Inglis AE, Scott WN, Sculco TP, Patterson AH. Ruptures of the Tendo Achilles. An objective assessment of surgical and non-surgical treatment. J Bone Joint Surg Am. 1976;58- A:990-993.
  5. Mukundan C, El Husseiny M, Rayan F, Salim J, Budgen A. "Mini-open" repair of acute tendo Achilles ruptures--the solution? Foot Ankle Surg. 2010;16:122-125. https://doi.org/10.1016/j.fas.2009.07.005
  6. Fortis AP, Dimas A, Lamprakis AA. Repair of achilles tendon rupture under endoscopic control. Arthroscopy. 2008;24:683-688. https://doi.org/10.1016/j.arthro.2008.02.018
  7. Tang KL, Thermann H, Dai G, Chen GX, Guo L, Yang L. Arthroscopically assisted percutaneous repair of fresh closed achilles tendon rupture by Kessler's suture. Am J Sports Med. 2007;35:589-596. https://doi.org/10.1177/0363546506295080
  8. Nistor L. Surgical and non-surgical treatment of Achilles Tendon rupture. A prospective randomized study. J Bone Joint Surg Am. 1981;63:394-399. https://doi.org/10.2106/00004623-198163030-00012
  9. Ljungqvist R. Subcutaneous partial rupture of the Achilles tendon. Acta Orthop Scand. 1967;Suppl113:1+.
  10. Cretnik A, Kosanovic M,Smrkolj V. Percutaneous versus open repair of the ruptured Achilles tendon: a comparative study. Am J Sports Med. 2005;33:1369-1379. https://doi.org/10.1177/0363546504271501
  11. CretnikA, Zlajpah L, Smrkolj V, Kosanovic M. The strength of percutaneous methods of repair of the Achilles tendon: a biomechanical study. Med Sci Sports Exerc. 2000;32:16-20.
  12. Rebeccato A, Santini S, Salmaso G, Nogarin L. Repair of the Achilles tendon rupture: a functional comparison of three surgical techniques. J Foot Ankle Surg. 2001;40:188-194. https://doi.org/10.1016/S1067-2516(01)80018-1
  13. Rippstein P, Jung M, Assal M. Surgical repair of acute Achilles tendon rupture using a "mini-open" technique. Foot Ankle Clin N Am. 2002;7:611-619. https://doi.org/10.1016/S1083-7515(02)00040-2
  14. Krackow KA, Thomas SC, Jones LC. A new stitch for ligament-tendon fixation. Brief note. J Bone Joint Surg Am. 1986;68-A:764-766.
  15. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994;15:349-353. https://doi.org/10.1177/107110079401500701
  16. Arner O, Lindholm A. Subcutaneous rupture of the Achilles tendon; a study of 92 cases. Acta Chir Scand Suppl. 1959;116(Supp 239):1-51.
  17. Saxena A, Maffulli N,Nguyen A, Li A. Wound complications from surgeries pertaining to the Achilles tendon: an analysis of 219 surgeries. J Am Podiatr Med Assoc. 2008;98:95-101. https://doi.org/10.7547/0980095
  18. Cetti R, Christensen SE, Ejsted R, Jensen NM, Jorgensen U. Operativeversus nonoperative treatment of Achilles tendon rupture. A prospective randomized study and review of the literature. Am J Sports Med. 1993;21:791-799. https://doi.org/10.1177/036354659302100606
  19. Ma GW, Griffith TG. Percutaneous repair of acute closed ruptured Achilles tendon: a new technique. Clin Orthop. 1977;128:247-255.
  20. Sutherland A, Maffulli N. A modified technique of percutaneous repair of ruptured Achilles tendon. Oper Orthop Traumat. 1999;7:288-295.
  21. Winter E, Weise K, Weller S, Ambacher T. Surgical repair of Achilles tendon rupture. Comparison of surgical versus nonsurgical treatment. Clin Orthop. 1986;207:156-163.
  22. Aracil J, Pina A, Lozano JA, Torro V, Escriba I. Percutaneous suture of Achilles tendon ruptures. Foot and Ankle. 1992;13:350-351. https://doi.org/10.1177/107110079201300610
  23. Kakiuchi M. A combined open and percutaneous technique for repair of tendo Achilles. Comparison with open repair. J Bone Joint Surg Am. 1995;77-B:60-63. https://doi.org/10.1302/0301-620X.77B1.7822398
  24. Assal M, Jung M, Stern R, Rippstein P, Delmi M, Hoffmeyer P. Limited open repair of Achilles tendon ruptures: a technique with a new instrument and findings of a prospective multicenter study. J Bone Joint Surg Am. 2002;84-A:161-170.
  25. Jung HG, Paik HD. Surgical Repair of Achilles Tendon Rupture by Minimal Incision Technique. J Korean Foot Ankle Soc. 2005;9:173-178.
  26. Lee KB, Park YB, Kim BS, Choi J, Jung ST. Limited Open Repair Technique of Achilles Tendon Ruptures - Operative Technique and Early Results - J Korean Foot Ankle Soc. 2006;10:37-41.