踇长屈肌腱转位联合挤压螺钉固定修复陈旧闭合性跟腱断裂  

Hallux flexor hallucis longus tendon translocation in combination with extruding bolt fix repair olden closed achilles tendon rupture

作　　者：唐志斌[1] 李春[1] 邓焱[2] 陈志伟[1] 

机构地区：[1]南华大学附属第一医院骨科,湖南衡阳421001 [2]娄底市中心医院骨科,湖南娄底417118

出　　处：《中国现代医学杂志》2015年第4期68-71,共4页China Journal of Modern Medicine

摘　　要：目的 探讨踇长屈肌腱修复陈旧闭合性跟腱断裂的手术方法和疗效。方法 2008年1月-2012年5月收治连续性的12例选用踇长屈肌腱转位修复陈旧性跟腱断裂的患者。术前体查见小腿三头肌萎缩,损伤处可见凹陷,触及跟腱连续性中断,Thompson试验阳性10例、可疑2例。术前及术后末次随访通过Arn-er-Lindholm疗效评定标准及美国矫形外科足部与踝关节学会（AOFAS）评分标准评估踝关节功能改善情况。结果 该组术后患者均获随访,随访时间12∽49个月,平均随访20.4个月;患者住院时间18∽24 d,平均20.6 d。术后切口均Ⅰ期愈合,随访期内无跟腱再发断裂、深部切口感染、皮肤坏死及周围神经损伤等并发症发生。按Arner-Lindholm疗效评定标准本组病例：优8例（66.7%）,良4例（33.3%）,优良率100%。按AOFAS评分标准踝关节功能评分为（88.33±2.99）。均较术前明显提高,比较差异有统计学意义（=10.780,=0.000）。结论 踇长屈肌腱转位联合挤压螺钉固定修复陈旧闭合性跟腱断裂疗效满意,能恢复跟腱的功能,具有疗效确切、并发症少等优点。[Objective] To explore the operative method and curative effect of olden closed achilles tendon rup- ture repaired by Hallux flexor hallucis longus tendon. [ Methods ] Twelve patients with olden closed achilles tendon rupture repaired by Hallux flexor hallucis longus tendon from 2008.1 to 2012.5 were investigated. Physical examina- tion before operation showed deeps surae muscle amyotrophy, hollow damage, and discontinued achilles tendon. There were 10 case-positive and 2 case-questionable in Thompson test. The improvement of ankle joint was evalu- ated by Arner-Lindholm curative effect evaluation criteria and AOFAS before and after operation. [ Results ] All pa- tients accepted follow up from 12 to 49 months, and the mean time was 20.4 months. The length of patient stay was 18-24 days, and the mean length was 20.6 days. All postoperative cut was healed at I stage. There were no achilles tendon reappeared rupture, deep part cut infection, skin necrosis and peripheral nerve damage within the follow up. According to arner-Lindholm curative effect evaluation criteria, all patients included 8 case-good and 4 case-better. Ankle joint functional score was （88.33±2.99） according to AOFAS, which was significantly higher than that before operation （t =10.780, P =0.000）. [ Conclusion] The repair of olden closed achilles tendon rupture by hallux flexor hallucis longus tendon translocation in combination with extruding bolt fix can obtain better curative effect, restore achilles tendon function and reduce complications.

关 键 词：踇长屈肌腱 跟腱 挤压螺钉 

分 类 号：R686.1[医药卫生—骨科学]