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山东大学学报 (医学版) ›› 2020, Vol. 58 ›› Issue (6): 92-96.doi: 10.6040/j.issn.1671-7554.0.2019.1306

• • 上一篇    

小切口腓肠肌腱翻瓣术治疗5例陈旧性跟腱断裂

程瑞林,黄政,李正勋,张宁,胡勇,徐文鹏   

  1. 山东大学第二医院手外科/足踝外科, 山东大学足踝外科研究中心, 山东 济南 250033
  • 发布日期:2022-09-27
  • 通讯作者: 徐文鹏. E-mail:chinaowenxu@126.com
  • 基金资助:
    济南市医疗卫生科技创新计划(重点项目)(201805012)

Small incision gastrocnemius tendon turndown flap to treat 5 cases with chronic Achilles tendon rupture

CHENG Ruilin, HUANG Zheng, LI Zhengxun, ZHANG Ning, HU Yong, XU Wenpeng   

  1. Department of Hand Surgery/Foot &
    Ankle Surgery, The Second Hospital of Shandong University;
    Foot &
    Ankle Surgery Center of Shandong University, Jinan 250033, Shandong, China
  • Published:2022-09-27

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摘要： 目的 评价小切口腓肠肌腱翻瓣术治疗陈旧性跟腱断裂的临床疗效。 方法 回顾性分析2017年1月至2019年9月收治的陈旧性跟腱断裂5例,其中男4例,女1例, 28~67岁。左足3例,右足2例。所有患者均行小切口腓肠肌腱翻瓣术治疗。术后予短腿石膏固定踝跖屈20°位,4周后拆除石膏穿跟腱靴行走4周,在此期间逐渐降低足跟高度。术后常规随访。使用美国足踝外科协会(AOFAS)踝-后足功能评分对手术效果进行评价。 结果 5例患者均获得随访6~38个月,平均23个月。AOFAS踝-后足功能评分由术前71.4提高到术后96.4。所有患者手术切口均一期愈合,无再断裂发生。 结论 小切口腓肠肌腱翻瓣术治疗陈旧性跟腱断裂疗效确切。

关键词: 陈旧性跟腱断裂, 小切口腓肠肌腱翻瓣术, 跟腱断裂修复术, 并发症, 断端瘢痕

Abstract: Objective To evaluate the efficacy of small incision gastrocnemius tendon turndown flap in the treatment of the chronic Achilles tendon rupture. Methods The clinical data of 5 cases with chronic Achilles tendon rupture treated in our department during Jan. 2017 and Sep. 2019 were retrospectively analyzed, including 4 males and 1 female, average age 46.5(28-67)years old, with 3 ruptures in the left feet and 2 in the right feet. All cases were treated with small incision gastrocnemius tendon turndown flap. After operation, the patients wore a blow-knee cast to hold the ankle at 20° of plantar flexion for 4 weeks, then partial-weightbearing walked with ankle-foot orthosis for 4 weeks, during which the heel height was reduced gradually. All patients were followed up. The efficacy of operation was evaluated with AOFAS ankle-hind foot function score. Results During the follow-up of 6 to 38(average 23)months, the AOFAS score increased from 71.4 pre-operation to 96.4 post-operation. All patients’ incisions was healed in one stage, and no re-rupture occurred. Conclusion Small incision gastrocnemius tendon turndown flap is effective to treat chronic Achilles tendon rupture.

Key words: Chronic Achilles tendon rupture, Small incision gastrocnemius tendon turndown flap, Reconstruction of the Achilles tendon rupture, Complication, Scar tissue interposed between the tendon stumps

中图分类号: 

  • R686.7
[1] Maffulli N, Via AG, Oliva F. Chronic Achilles Tendon Rupture [J]. Open Orthop J, 2017, 11(Suppl-4): 660-669.
[2] 陈凯, 于涛, 李兵, 等. 陈旧性跟腱断裂的手术治疗[J]. 足踝外科电子杂志, 2018, 5(1): 23-26. CHEN Kai, YU Tao, LI Bing, et al. Surgical treatment of the neglected achilles tendon rupture [J]. Electronic Journal of Foot and Ankle Surgery, 2018, 5(1): 23-26.
[3] Wegrzyn J, Luciani JF, Philippot R, et al. Chronic Achilles tendon rupture reconstruction using a modified flexor hallucis longus transfer [J]. Int Orthop, 2010, 34(8): 1187-1192.
[4] Yasuda T, Shima H, Mori K, et al. Direct repair of chronic achilles tendon ruptures using scar tissue located between the tendon stumps [J]. J Bone Joint Surg Am, 2016, 98(14): 1168-1175.
[5] Schweitzer KM Jr, Dekker TJ, Adams SB. Chronic achilles ruptures: reconstructive options [J]. J Am Acad Orthop Surg, 2018, 26(21): 753-763.
[6] Lin YJ, Yang L, Yin L, et al. Surgical strategy for the chronic achilles tendon rupture [J]. Biomed Res Int, 2016, 2016: 1416971-1416978. doi:10.1155/2016/1416971.
[7] 徐杨博, 魏代清, 邓勇, 等. 拇长屈肌腱转位治疗陈旧性跟腱断裂[J]. 中华创伤骨科杂志, 2019, 21(4): 284-289. XU Yangbo, WEI Daiqing, DENG Yong, et al. Transfer of flexor hallucis longus tendon for obsolete Achilles tendon rupture [J]. Chinese Journal of Orthopaedic Trauma, 2019, 21(4): 284-289.
[8] Vega J, Vilá J, Batista J, et al. Endoscopic flexor hallucis longus transfer for chronic noninsertional achilles tendon rupture [J]. Foot Ankle Int, 2018, 39(12): 1464-1472.
[9] Malagelada F, Clark C, Dega R. Management of chronic Achilles tendon ruptures - A review [J]. Foot(Edinb), 2016, 28: 54-60. doi: 10.1016/j.foot.2016.05.001.
[10] Maffulli N, Oliva F, Maffulli GD, et al. Surgical management of chronic Achilles tendon ruptures using less invasive techniques [J]. Foot Ankle Surg, 2018, 24(2): 164-170.
[11] Kraeutler MJ, Purcell JM, Hunt KJ. Chronic achilles tendon ruptures [J]. Foot Ankle Int, 2017, 38(8): 921-929.
[12] Mann RA, Holmes GB Jr, Seale KS, et al. Chronic rupture of the Achilles tendon: a new technique of repair [J]. J Bone Joint Surg Am, 1991, 73(2): 214-219.
[13] Maffulli N, Oliva F, Costa V, et al. The management of chronic rupture of the Achilles tendon: minimally invasive peroneus brevis tendon transfer [J]. Bone Joint J, 2015, 97-B(3): 353-357.
[14] Abraham E, Pankovich AM. Neglected rupture of the Achilles tendon. Treatment by V-Y tendinous flap [J]. J Bone Joint Surg Am, 1975, 57(2): 253-255.
[15] Lin YJ, Duan XJ, Yang L. V-Y Tendon Plasty for Reconstruction of Chronic Achilles Tendon Rupture: A Medium-term and Long-term Follow-up [J]. Orthop Surg, 2019, 11(1): 1-8.
[16] Esenyel CZ, Tekin C, Cakar M, et al. Surgical treatment of the neglected achilles tendon rupture with Hyalonect [J]. J Am Podiatr Med Assoc, 2014, 104(5): 434-443.
[17] Dumbre Patil SS, Dumbre Patil VS, Basa VR, et al. Semitendinosus tendon autograft for reconstruction of large defects in chronic achilles tendon ruptures [J]. Foot Ankle Int, 2014, 35(7): 699-705.
[18] El Shazly O, Abou El Soud MM, El Mikkawy DM, et al. Endoscopic-assisted achilles tendon reconstruction with free hamstring tendon autograft for chronic rupture of achilles tendon: clinical and isokinetic evaluation [J]. Arthroscopy, 2014, 30(5): 622-628.
[19] Maffulli N, Leadbetter WB. Free gracilis tendon graft in neglected tears of the achilles tendon [J]. Clin J Sport Med, 2005, 15(2): 56-61.
[20] Park YS, Sung KS. Surgical reconstruction of chronic achilles tendon ruptures using various methods [J]. Orthopedics, 2012, 35(2): 213-218.
[21] Parsons JR, Weiss AB, Schenk RS, et al. Long-term follow-up of achilles tendon repair with an absorbable polymer carbon fiber composite [J]. Foot Ankle, 1989, 9(4): 179-184.
[22] Shoaib A, Mishra V. Surgical repair of symptomatic chronic achilles tendon rupture using synthetic graft augmentation [J]. Foot Ankle Surg, 2017, 23(3): 179-182.
[23] Badalihan A, Aihemaiti A, Shawutali N, et al. Outcome of a one-stage tensile stress surgical technique and early postoperative rehabilitation in the treatment of neglected achilles tendon rupture [J]. J Foot Ankle Surg, 2015, 54(2): 153-159.
[24] 王晓宁, 黄鑫, 姜钰, 等. 腱周膜下通道技术治疗Myerson Ⅱ型陈旧性跟腱断裂[J]. 中华创伤骨科杂志, 2019, 21(4): 279-283. WANG Xiaoning, HUANG Xin, JIANG Yu, et al. Management of chronic Achilles tendon rupture of Myerson type Ⅱ using a tunnel beneath paratenon [J]. Chinese Journal of Orthopaedic Trauma, 2019, 21(4): 279-283.
[25] 于涛, 俞光荣. 陈旧性跟腱断裂的临床研究现状[J]. 同济大学学报(医学版), 2016, 37(3): 144-148. YU Tao, YU Guangrong. The clinical research status of neglected achilles tendon rupture [J]. Journal of Tongji University(Medical Science), 2016, 37(3): 144-148.
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