中国骨伤
中國骨傷
중국골상
CHINA JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY
2015年
5期
450-453
,共4页
跟腱%腱损伤%腱转移术%修复外科手术
跟腱%腱損傷%腱轉移術%脩複外科手術
근건%건손상%건전이술%수복외과수술
Achilles tendon%Tendon injuries%Tendon transfer%Reconstructive surgical procedures
目的：探讨拇长屈肌腱转位后应用挤压螺钉重建陈旧性KuwadaⅣ型跟腱断裂的临床效果。方法：回顾性分析2010年9月至2012年6月，拇长屈肌腱转位后采用挤压螺钉固定重建26例陈旧性跟腱断裂患者的临床资料，其中男18例，女8例；年龄20～66岁，平均44.2岁。所有患者为单侧损伤。MRI显示跟腱断端距离为6.0～9.0 cm。观察术后并发症情况，并采用美国足踝外科协会（American Orthopaedic Foot and Ankle Society，AOFAS）踝与后足评分及Leppilahti跟腱修复评分进行评价疗效。结果：26例获得随访，时间18～68个月，平均30.4个月。术后无神经损伤及切口感染，所有患者切口Ⅰ期愈合。术后踝关节外形及功能恢复良好，AOFAS踝与后足评分由术前52.27±12.30提高至术后90.92±6.36（t=-18.26，P<0.05）。Leppilahti跟腱修复评分术前34.23±12.86提高至术后90.00±5.10分（t=-22.67， P<0.05）。结论：拇长屈肌腱转位后应用挤压螺钉固定来重建陈旧性KuwadaⅣ型跟腱断裂具有操作简单，术后恢复快、肌腱固定牢靠、并发症少的优点。
目的：探討拇長屈肌腱轉位後應用擠壓螺釘重建陳舊性KuwadaⅣ型跟腱斷裂的臨床效果。方法：迴顧性分析2010年9月至2012年6月，拇長屈肌腱轉位後採用擠壓螺釘固定重建26例陳舊性跟腱斷裂患者的臨床資料，其中男18例，女8例；年齡20～66歲，平均44.2歲。所有患者為單側損傷。MRI顯示跟腱斷耑距離為6.0～9.0 cm。觀察術後併髮癥情況，併採用美國足踝外科協會（American Orthopaedic Foot and Ankle Society，AOFAS）踝與後足評分及Leppilahti跟腱脩複評分進行評價療效。結果：26例穫得隨訪，時間18～68箇月，平均30.4箇月。術後無神經損傷及切口感染，所有患者切口Ⅰ期愈閤。術後踝關節外形及功能恢複良好，AOFAS踝與後足評分由術前52.27±12.30提高至術後90.92±6.36（t=-18.26，P<0.05）。Leppilahti跟腱脩複評分術前34.23±12.86提高至術後90.00±5.10分（t=-22.67， P<0.05）。結論：拇長屈肌腱轉位後應用擠壓螺釘固定來重建陳舊性KuwadaⅣ型跟腱斷裂具有操作簡單，術後恢複快、肌腱固定牢靠、併髮癥少的優點。
목적：탐토무장굴기건전위후응용제압라정중건진구성KuwadaⅣ형근건단렬적림상효과。방법：회고성분석2010년9월지2012년6월，무장굴기건전위후채용제압라정고정중건26례진구성근건단렬환자적림상자료，기중남18례，녀8례；년령20～66세，평균44.2세。소유환자위단측손상。MRI현시근건단단거리위6.0～9.0 cm。관찰술후병발증정황，병채용미국족과외과협회（American Orthopaedic Foot and Ankle Society，AOFAS）과여후족평분급Leppilahti근건수복평분진행평개료효。결과：26례획득수방，시간18～68개월，평균30.4개월。술후무신경손상급절구감염，소유환자절구Ⅰ기유합。술후과관절외형급공능회복량호，AOFAS과여후족평분유술전52.27±12.30제고지술후90.92±6.36（t=-18.26，P<0.05）。Leppilahti근건수복평분술전34.23±12.86제고지술후90.00±5.10분（t=-22.67， P<0.05）。결론：무장굴기건전위후응용제압라정고정래중건진구성KuwadaⅣ형근건단렬구유조작간단，술후회복쾌、기건고정뢰고、병발증소적우점。
Objective:To explore the clinical effect of interference screw and flexor hallucis longus tendon as augmenta?tion material in repair of chronic Achilles tendon rupture. Methods:From September 2010 to June 2012,26 patients with chronic Achilles tendon rupture were treated,including 18 males and 8 females with an average age of 44.2 years old(20 to 66 years old). All patients were unilateral damage. MRI showed the Achilles tendon ends' distance was 6.0 to 9.0 cm. The postoperative complications were observed. The curative effect was assessed by American Orthopedic Foot and Ankle Society and Leppilahti score. Results:All the 26 patients were followed up for 18 to 68 months(means 30.4 months). No neurological injury and infection of incision occurred,all patients were stage I incision healing. The shape and function of the ankle were re?covered well. The average AOFAS score increased from 52.27±12.30 preoperatively to 90.92±6.36 postoperatively. Leppilahti Achilles Tendon Repair score increased from 34.23 ± 12.86 preoperatively to 90.00 ± 5.10 postoperatively. Conclusion:The flexor hallucis tendon transfer with an interference screw technique for repairing the chronic Achilles tendon rupture of type IV of Kuwada had advantages of simple operation,quick recovery,firm tendon fixation,and less complications.
