长屈肌腱转位修复陈旧性跟腱断裂对趾运动的影响分析  

Effect of flexor hallucis longus tendon transposition on toe-tracing movement in repairing old achilles tendon rupture

作　　者：王玺喆 张杰 张华[1] 韩小平[1] WANG Xizhe;ZHANG Jie;ZHANG Hua;HAN Xiaoping(Department of Orthopedics,Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi,830000,China)

机构地区：[1]新疆医科大学第五附属医院骨一科

出　　处：《足踝外科电子杂志》2019年第4期18-21,26,共5页Electronic Journal of Foot and Ankle Surgery

基　　金：新疆维吾尔自治区自然科学基金资助项目(2018D01C311)

摘　　要：目的探讨长屈肌腱转位修复陈旧性跟腱断裂对趾运动的影响。方法回顾性分析2015年10月—2018年1月新疆医科大学第五附属医院骨一科收治的12例采用长屈肌腱转位修复的陈旧性跟腱断裂患者的相关资料。其中男9例,女3例;年龄27~45岁,平均(38.08±5.18)岁。观察术前及末次随访时趾运动(跖屈与背伸)的活动范围、肌力大小,并采用不同的趾观察指标评价结果。结果术后患者均获得12~18个月随访,平均(15.25±2.70)个月,手术切口均甲级愈合;至末次随访时患者对手术效果均表示满意,2例患者偶感抓地不适,1例患者出现高处落地时自觉不稳。末次随访时第一跖趾关节活动范围、疼痛、活动及力线指标与术前相比,差异无统计学意义(P>0.05);跖趾关节跖屈肌力对鞋的要求与术前相比,差异具有统计学意义(P<0.05);所有患者趾跖趾关节均显示跖屈无力,但均未发现日常生活期间趾功能衰弱。结论长屈肌腱转位修复陈旧性跟腱断裂能够恢复跟腱功能;屈力量虽有损失,但未给患者主观上带来明显不适,对趾运动影响较小;具有术后并发症少、疗效满意等优点,是一种安全又可靠的方法。Objective To investigate the effect of flexor hallucis longus tendon transposition on toe-tracing movement in repairing old achilles tendon rupture.Methods The data of 12 patients with chronic Achilles tendon rupture repaired by flexor hallucis longus tendon transposition from October 2015 to January 2018 were retrospectively analyzed,including 9 males and 3 females,aged 27-45 years with an average age of(38.08±5.18).The range of motion and muscle strength of toe hallux movement(plantar curvature and dorsal extension)were observed before and during the last follow-up,and the evaluation results were evaluated by different toe-placing observation indicators.Results All the patients were followed up for 12 to 18 months,with an average of(15.25±2.70)months.All incisions healed in grade A.At the last follow-up,all patients were satisfied with the results of the operation.Two patients occasionally felt uncomfortable grasping,and one patient was consciously unstable when landing at a high position.At the last followup,the first metatarsophalangeal joint range of motion,pain,movement and force line index were not significantly different from those before operation(P>0.05);the requirements of flexor plantaris muscle strength and shoes were significantly different from those before operation(P<0.05).All patients showed flexion weakness in the metatarsophalangeal joint,but no weakness of toe braking function was found during daily life.Conclusion Flexor longus tendon transposition can restore the function of Achilles tendon after repairing chronic rupture of Achilles tendon.We found that the loss of flexion strength did not bring obvious discomfort to patients subjectively,and it had little influence on toe movement.It has the advantages of less complications and satisfactory curative effect after operation.It is a safe and reliable method.

关 键 词：跟腱断裂 长屈肌腱 腱转移术 趾 

分 类 号：R683.42[医药卫生—骨科学]