【摘要】 目的 本研究旨在探讨一种小切口跖肌腱加固手术技术治疗急性闭合性跟腱断裂的临床效果。方法 回顾性队列研究纳入了北京大学第三医院2017年3月至2021年1月收治的63例急性闭合性跟腱断裂患者，其中21例患者接受微创小切口跖肌腱加固术，为微创组。基于患者人口学特征及损伤位置，通过2∶1匹配纳入42例接受传统切开翻瓣术的患者，为传统组。记录患者的手术时长、切口长度及住院时长。在术前及临床随访时比较患者的美国足踝外科协会（American Orthopaedic Foot and Ankle Society,AOFAS）踝-后足评分、Arner-Lindholm评分，以评价临床效果。结果 相较于传统组，微创组的平均手术时长、住院天数及切口长度均显著更短（P<0.05）。两组患者在末次随访时的AOFAS评分相较术前均显著改善（P<0.05）；在末次随访时微创组的AOFAS评分显著高于传统组（P<0.05），而两组在术后恢复非负重下地时间及重返运动时间方面均无显著差异。结论 相较于传统技术，微创小切口跖肌腱加固术可以显著减少手术时间，获得更好的中期疗效，且助力患者在术后更早开始负重练习，可成为急性跟腱断裂外科治疗更好的选择。更多还原

【Abstract】 Objective This study aimed to investigate the clinical efficacy of a minimally invasive plantaris tendon reinforcement surgical technique in the treatment of acute closed achilles tendon rupture. Methods A retrospective cohort study enrolled 63 patients with acute closed achilles tendon rupture admitted to Peking University Third Hospital from March 2017 to January 2021, among whom 21 patients underwent minimally invasive plantaris tendon reinforcement and were assigned to the minimally invasive group. Based on demographic characteristics and injury location,42 patients who received traditional open flap surgery were included in the traditional group at a 2 ∶ 1 matching ratio. The operative time, incision length and hospital stay were recorded for all patients. The American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot score and Arner-Lindholm score were compared between the two groups before surgery and during clinical follow-up to evaluate the clinical efficacy. Results Compared with the traditional group, the minimally invasive group had significantly shorter mean operative time, hospital stay and incision length(P<0.05). The AOFAS scores of both groups at the final follow-up were significantly improved compared with those before surgery(P<0.05); the minimally invasive group had a significantly higher AOFAS score than the traditional group at the final follow-up(P<0.05), while there were no significant differences between the two groups in the time to non-weight-bearing ambulation and return to sports after surgery. Conclusion In comparison with the traditional surgical technique, minimally invasive plantaris tendon reinforcement can significantly reduce operative time and achieve better mid-term clinical outcomes, and it also facilitates an earlier start of weight-bearing exercises for patients postoperatively. Therefore, it can serve as a superior option for the surgical treatment of acute achilles tendon rupture.更多还原