Clinical Analysis Of Mini-incision With Double-Tsuge Operation Method In Repairing Achilles Tendon Ruptures

The acute closed Achilles tendon rupture epidemiology morbidity is about 6 per 100 thousand- 37 per 100 thousand. 75% of Achilles tendon ruptures related to exercise and was located in 2-6 cm above attachment with a growing trend year by year. It has a strong impact on people’s life and work. Treatments of acute closed Achilles tendon ruptures remain highly controversial. By observing and analyzing clinical effectiveness of traditional minimally invasive small incision double-tsuge surgical treatments in repairing acute closed Achilles tendon ruptures, this paper provided a scientific basis for selecting proper treatment of acute closed Achilles tendon ruptures clinically.Methods:This study investigated 53 patients with acute closed Achilles tendon ruptures treated in the fourth ward of the department of orthopedics of the First Affiliated Hospital of Dalian Medical University and carried out research and analysis on them. In combination with literature, anatomies of Achilles tendon, characteristics,mechanisms, postoperative complications and functional exercise of closed Achilles tendon ruptures as well as merits of minimally invasive small incision double-tsuge surgical treatment etc. were analyzed. It objectively evaluated that minimally invasive small incision double-tsuge surgical treatment was an ideal surgical treatment against acute closed Achilles tendon ruptures. Based on postoperative recovery of local incision, healing of Achilles tendon, shank myodynamia, shank circumference,functional recovery of ankles, complications and patients’ satisfaction, these treatments were scored according to Arner-Lindholm efficacy evaluation standard and evaluation standard of American Orthopaedic Foot and Ankle Society(AOFAS).Results: Among 53 patients with acute closed Achilles tendon ruptures, lengths of incision were 4.47cm±0.70 cm and hospital stays were 7.40 days±2.17 days. After surgery, there was 1 case of delayed union. After symptomatic treatments, they recovered well. According to Arner-Lindholm efficacy evaluation standard, 37 cases were evaluated as excellent, 15 cases were evaluated as good and 1 case was evaluated as poor in group B with an excellent and good rate of 98.1%. According to evaluation standard of American Orthopaedic Foot and Ankle Society(AOFAS), the score was97.2±2.1.Conclusions: minimally invasive small incision double-tsuge surgical treatments against acute closed Achilles tendon ruptures, the lengths of incision and hospital stays of minimally invasive small incision double-tsuge surgical treatment reduced significantly, and its incidence of postoperative complications dropped remarkably as well. In addition, minimally invasive small incision double-tsuge surgical treatment did not need any special instrument or expensive consumables which lighten the financial burden of patients. Thus, it was an ideal treatment against acute closed Achilles tendon ruptures. It is noted that the application of 4-0 absorbable sutures is important for it is helpful for flatting aponeurosis repair which will cover an Achilles tendon rupture smoothly and avoid occurrence of postoperative Achilles tendon adhesion. After surgery, a short-leg Achilles tendon boot was used to fix the ankle on 20° of plantar flexion which was close to natural plantar flexion. It was more convenient and flexible than plaster fixation and allowed patients to have functional exercise earlier so that limb functions of patients could be recovered quicker.