临床外科杂志 ›› 2026, Vol. 34 ›› Issue (1): 82-85.doi: 10.3969/j.issn.1005-6483.20250068

• 论著 • 上一篇    下一篇

改良Kessler缝合法、早期康复联合富血小板血浆对急性跟腱断裂病人功能康复的影

桂凯红,黄林,阮远,程中华   

  1. 438000 湖北黄冈,黄冈市中心医院骨科
  • 收稿日期:2025-01-17 出版日期:2026-01-20 发布日期:2026-01-20
  • 通讯作者: 程中华,Email:xianliuzouq73@163.com
  • 基金资助:
    湖北省自然科学基金资助项目(S2015010130084)

Effect ofmodified Kessler suture,early rehabilitation combined with platelet rich plasma on functional rehabilitation of patients with acute Achilles tendon rupture

GUI Kaihong,HUANG Lin,RUAN Yuan,CHENG Zhonghua   

  1. Department of Orthopedics,Huanggang Central Hospital,Hubei,Huanggang 438000,〖WTBZ〗China
  • Received:2025-01-17 Online:2026-03-05 Published:2026-01-20

摘要: 目的探讨改良Kessler缝合法、早期康复联合富血小板血浆(PRP)对急性跟腱断裂(AATR)病人功能康复的影响。方法2021年4月~2023年7月收治的AATR病人92例,采用随机数字表法分成对照组(46例)和辅助PRP组(46例)。比较两组疗效、跟腱愈合情况、踝-后足状况、患踝活动度、术后并发症情况。结果辅助PRP组治疗总有效率、跟腱愈合优良率分别为95.35%和100%,对照组分别为79.55%和88.64%,两组比较差异有统计学意义(P<0.05)。辅助PRP组和对照组术后1年AOFAS评分分别为(93.47±3.19)分和(90.45±5.16)分,均高于术后6个月的[(81.21±8.35)分和(76.52±9.06)分,两组比较,差异有统计学意义(P<0.05),患踝背伸分别为(20.78±2.67)°、(18.26±2.33)°,跖屈角度分别为(42.52±5.61)°、(38.73±4.24)°,术后6个月分别为(13.03±2.15)°、(11.16±2.29)°,(32.56±3.35)°、(29.79±3.58)°,两组比较差异有统计学意义(P<0.05)。术后6个月,两组AOFAS评分均高于术前[(44.45±6.79)分、(44.21±8.36)分],患踝背伸[(10.23±1.21)°、(10.20±1.08)°、跖屈角度[(19.56±2.43)°、(20.03±2.58)°、均大于术前(P<0.05),且辅助PRP组术后6个月、1年AOFAS评分高于对照组,患踝背伸、跖屈角度大于对照组,两组比较差异有统计学意义(P<0.05)。辅助PRP组术后并发症总发生率为4.65%,对照组为11.36%,两组比较,差异无统计学意义(P>0.05)。结论对AATR病人应用改良Kessler缝合法、早期康复联合PRP治疗,可明显提高跟腱愈合效果,有效促进踝-后足功能恢复。

关键词: 早期康复, 富血小板血浆, 改良Kessler缝合法, 急性跟腱断裂

Abstract: Objective To investigate the effect of modified Kessler suture,early rehabilitation combined with platelet rich plasma (PRP) on functional rehabilitation of patients with acute Achilles tendon rupture (AATR).Methods From April 2021 to July 2023,92 patients with AATR admitted to our hospital were gathered and using a random number table method,assigned into a control group (n=46) and an auxiliary PRP group (n=46).The efficacy,Achilles tendon healing,ankle-hindfoot condition,ankle mobility,and postoperative complications were compared between the two groups.Results The total effective rate and excellent rate of Achilles tendon healing in the auxiliary PRP group were 95.35% and 100%,respectively,which were higher than the control group's (79.55% and 88.64% )(P<0.05).One year after surgery,the AOFAS scores (93.47±3.19,90.45±5.16) of both groups were higher than that at 6 months after surgery (81.21±8.35,76.52±9.06) (P<0.05).The angles of dorsiflexion [(20.78±2.67) °,(18.26±2.33) °] and plantarflexion [(42.52±5.61) °,(38.73±4.24) °] of the affected ankle were greater than at 6 months after surgery [(13.03±2.15) °,(11.16±2.29) °,(32.56±3.35) °,(29.79±3.58) °] (P<0.05).Six months after the operation,the AOFAS scores of both groups were higher than those before the operation (44.45±6.79,44.21±8.36).The dorsiflexion of the affected ankle [(10.23±1.21)°,(10.20±1.08)°] and the plantar flexion Angle [(19.56±2.43)°,(20.03±2.58)°] were all greater than those before the operation (P<0.05).In addition,the AOFAS scores of the auxiliary PRP group were higher than those of the control group at 6 months and 1 year after surgery (P<0.05),and the angles of dorsiflexion and plantarflexion of the affected ankle were greater than those of the control group (P<0.05).The total incidence of postoperative complications was not greatly different between the auxiliary PRP group (4.65%) and the control group (11.36%) (P>0.05).Conclusion The application of modified Kessler suture and early rehabilitation combined with PRP treatment can greatly improve the efficacy of Achilles tendon and effectively promote the recovery of ankle-hind foot function in AATR patients.

Key words: early rehabilitation, platelet rich plasma, modified Kessler suture, acute Achilles tendon rupture

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