基于跟腱断裂Kuwade分型采用三种自体肌腱移植重建方法的临床疗效分析  

Achilles tendon rupture sutured by three type of autologous tendon in woven based on classification Kuwade

作　　者：卜晗[1] 张梅刃[1] 蒋际钊[1] 陈利新[1] 马少云[1] 

机构地区：[1]广东省中医院珠海医院骨伤一科,珠海519015

出　　处：《中华移植杂志（电子版）》2014年第2期25-28,45,共5页Chinese Journal of Transplantation(Electronic Edition)

摘　　要：目的探讨基于跟腱断裂Kuwade分型，使用3种自体肌腱移植重建的手术方法治疗跟腱断裂，分析其临床疗效。方法2010年1月至2013年11月，广东省中医院珠海医院骨伤一科共收治跟腱断裂患者41例，共有23例纳入研究。按照Kuwade分型，分别采用自体跖肌腱编织缝合（16例）、V—Y肌腱瓣修复＋自体跖肌腱编织缝合（2例）及自体半腱肌和股薄肌移植重建治疗（5例）。结果23例跟腱断裂患者手术顺利，术后均未发生感染及伤口不愈合。截至2013年月，术后随访5—51个月。无皮缘坏死、伤口感染、再次断裂和神经损伤并发症。按照Arner—Lindholm疗效评定标准，14例优，9例良，优良率为100％。结论按照Kuwade分型选择不同方式的自体肌腱移植治疗方法，均能够取得满意的临床疗效，是跟腱断裂较为合理的治疗思路。Objective To explore surgical methods and clinical effect sutured by three type of autologous tendon in woven based on Kuwade classification of achilles tendon rupture. Methods Between January 2010 and November 2013, we used the sutured way of autologous plantaris tendon in woven, V-Y tendon flap suture with autologous plantaris tendon in woven, autologous semitendinosus and gracilis graft reconstructed on 23 patients of completed achilles tendon rupture based on classification Kuwade. Results As of April 2013, postoperative followed-up of 23 patients were 5-51 months （average of 23.1 months）, without any complications of skin edge necrosis, wound infection, achilles tendon rerupture, nerve injury. According to standard of Arner-Lindholm efficacy evaluation, 14 of 23 cases reached excellent result, while the other 9 cases achieved good result. Conclusion It could achieved satisfied clinical effect and was a reasonable ideas used different ways of autologous tendon graft reconstructed for achilles tendon rupture based on classification Kuwade.

关 键 词：跟腱断裂 Kuwade分型 自体移植 

分 类 号：R687.2[医药卫生—骨科学]