腓肠肌腱膜瓣翻转联合阔筋膜移植治疗跟腱再断裂  

Turning over rough surface of aponeurosis of gastrocnemius with fascia lata graft for Achilles tendon rerupture

作　　者：冒海军[1] 许光跃[1] MAO Hai-jun;XU Guang-yue(Department of Orthopaedics,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu,China)

机构地区：[1]南京大学医学院附属南京鼓楼医院骨科

出　　处：《中国骨伤》2019年第8期717-720,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨腓肠肌腱膜瓣翻转联合阔筋膜移植修复跟腱再断裂的临床疗效。方法:自2013年7月至2017年4月,对11例跟腱术后再断裂患者采用腓肠肌腱膜瓣翻转联合阔筋膜移植重建治疗,男10例,女1例;年龄25~48岁。所有患者术前患足跖屈力量减弱、单足提踵试验阳性。观察术后并发症,并于术后6个月采用美国足踝外科学会踝-后足功能评分(AOFAS)进行功能评价。结果:本组11例患者获得随访,时间6~11个月。所有患者手术切口均Ⅰ期愈合,无皮肤坏死、切口感染、深静脉血栓、再断裂等并发症。跟腱缺损长度4~7 cm。患者完全恢复负重时间8~11周。术后6个月AOFAS评分79~100分,其中优9例,良2例。结论:腓肠肌腱膜翻转联合阔筋膜移植修复跟腱再断裂,具有跟腱修复可靠,并发症少,跟腱功能恢复良好的优点,是一种有效的临床治疗方法。Objective:To explore clinical effects of turning over rough surface of aponeurosis of gastrocnemius with fascia graft for Achilles tendon rerupture.Methods:From July 2013 to April 2017,11 patients with Achilles tendon reruptures were repaired by turning over rough surface of aponeurosis of gastrocnemius with fascia graft,including 10 males and 1 female aged from 25 to 48 years old.The patients were all manifested weakness of plantar flexion strength injured foot,and positive of single heel rise test before operation.Postoperative complications was observed,and AOFAS score at 6 months after operation was applied to evaluate clinical efficacy.Results:All patients were followed up for 6 to 11 months.All wound were healed at stageⅠwithout skin necrosis,wound infection,deep vein thrombosis and rerupture.The length of tendon defect ranged from 4 to 7 cm,the full weight-bearing time ranged from 8 to 11 weeks.Postoperative AOFAS score at 6 months was for 79 to 100,and 9 patients got excellent results,and 2 good.Conclusion:For patients with recurrent ruptures of Achilles tendon,turning over rough surface of aponeurosis of gastrocnemius with fascia graft has advantages of stable repair,less complications and good recovery of function.

关 键 词：肌 骨骼 阔筋膜 跟腱 

分 类 号：R686[医药卫生—骨科学]