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A comparative study of percutaneous minimally invasive suture versus open suture in the treatment of acute closed Achilles tendon rupture in flying personnel

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Author:
No author available
Journal Title:
Chinese Journal of Aerospace Medicine
Issue:
3
DOI:
10.3760/cma.j.cn113854-20220307-00026
Key Word:
跟腱;外科手术,微创性;缝合技术;回顾性研究;飞行人员;Achilles tendon;Surgical procedures, minimally invasive;Suture techniques;Retrospective study;Flying personnel

Abstract: Objective:To compare the clinical effect of percutaneous minimally invasive suture and open suture in the treatment of acute closed Achilles tendon rupture in flying personnel.Methods:A retrospective study was performed on the flying personnel with acute closed Achilles tendon rupture admitted to Air Force Medical Center from January of 2010 to January of 2020. They were divided into percutaneous minimally invasive suture group and open suture group according to the surgical method. Incision length, operative time, intraoperative blood loss, postoperative wound infection, sural nerve injury, average hospitalization duration and ankle-hind foot score assessed by American Orthopaedic Foot and Ankle Society (AOFAS) were recorded and compared between 2 groups.Results:A total of 27 flying personnel with acute closed Achilles tendon rupture were enrolled, including 12 cases in the percutaneous minimally invasive suture group and 15 cases in the open suture group. The rupture of Achilles tendon was evaluated by local ultrasound and ankle MRI scanning before surgery. All flying personnel were followed up with an average time of (18.3±7.3) months. The incision length of the percutaneous minimally invasive suture group (2.5±0.5) cm was significantly smaller than that of the open suture group (12.2±1.7) cm. The operation time of the percutaneous minimally invasive suture group (34.1±4.6) min was significantly shorter than that of open suture group (75.1±8.7) min, and the intraoperative blood loss (4.6±1.4) ml was significantly lower than that of open suture group (23.0±5.4) ml. The differences were statistically significant ( t=15.45, 11.79, 9.27, P=0.004, <0.001, <0.001). The incisions of all cases were completely healed without infection and no sural nerve injury occurred during operation. The average hospitalization duration in percutaneous minimally invasive suture group (5.0±0.8)d was less than that in open suture group (6.5±0.9)d, and the difference was statistically significant ( t=3.55, P=0.003). The AOFAS scores in the percutaneous minimally invasive suture group were higher than that of the open suture group ( t=2.28, P=0.041) 3 months after the operation; but the AOFAS scores of 2 groups were excellent and with no statistical significance ( P>0.05) 6 months after the operation. Flying personnel in the percutaneous minimally invasive suture group returned to duty 3 months after surgery, comparing to those in the open suture group took 6 months. Conclusions:In the treatment of acute closed Achilles tendon rupture in flying personnel, percutaneous minimally invasive suture is superior to open suture in incision length, operation time, intraoperative blood loss, average hospitalization duration and postoperative functi onal recovery.

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