改良跟腱内侧J形切口结合阔筋膜移植修复KuwadaⅡ和Ⅲ型跟腱缺损  

Repair of KuwadaⅡandⅢAchilles tendon defects through modified medial J-shaped approach with autologous fascia lata transplantation

作　　者：祁义民 杨蓊勃[1] 蒋纯志[1] 曾逸文[1] 吴磊[1] QI Yi-min;YANG Weng-bo;JIANG Chun-zhi;ZENG Yi-wen;WU Lei(Department of Orthopedic,Nanjing First Hospital,Nanjing Medical University,Nanjing210006,Jiangsu,China)

机构地区：[1]南京医科大学附属南京医院南京市第一医院骨科,江苏南京210006

出　　处：《中国骨伤》2022年第1期11-14,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨改良跟腱内侧“J”形切口结合阔筋膜移植在治疗KuwadaⅡ和Ⅲ型跟腱缺损中的临床疗效。方法:回顾性分析2016年1月至2018年8月采用改良跟腱内侧“J”形切口结合I期阔筋膜移植治疗的15例KuwadaⅡ和Ⅲ型跟腱缺损患者的临床资料,其中男14例,女1例;年龄24~43岁,平均31.7岁;KuwadaⅡ型9例,Ⅲ型6例。观察切口并发症情况,末次随访时采用Arner-Lindholm评分标准评价患足功能。结果:15例均获得随访,时间3~16个月,平均9.2个月。术后无切口皮肤坏死及感染发生,无跟腱再断裂发生。根据Arner-Lindholm评分标准评定,优13例,良2例。结论:采用改良跟腱内侧“J”形切口结合Ⅰ期阔筋膜移植治疗KuwadaⅡ和Ⅲ型跟腱缺损可避免术后切口并发症,可以双重加固跟腱强度,使患者可以早期康复功能锻炼,临床疗效满意。Objective:To investigate the clinical effect of modified medial J-shaped incision of Achilles tendon combined with fascia lata transplantation in the treatment of Kuwada typeⅡandⅢAchilles tendon defects.Methods:From January 2016 to August 2018,the clinical data of 15 patients with KuwadaⅡandⅢAchilles tendon defects treated with modified J-shaped approach with autologous fascia lata transplantation were retrospectively analyzed,including 14 males and 1 female,with an average age of 31.7 years old ranging from 24 to 43.There were 9 cases of KuwadaⅡdefect and 6 cases of KuwadaⅢdefect.Postoperative observations were made for incision complications,and the Arner-Lindholm scoring standard was used to evaluate the function of the affected foot at the last follow-up.Results:All 15 cases were followed up from 3 to 16 months with an average of 9.2 months.No skin necrosis or infection occurred after operation,and no Achilles tendon rupture occurred again.According to the Arner-Lindholm scoring standard,13 cases were excellent,2 cases were good.Conclusion:Modified medial J-shaped incision is a satisfactory approach for repairing Achilles tendon defects.It is helpful to prevent postoperative incision complications,which double-strengthen the Achilles tendon strength,so that patients can perform early rehabilitation and functional exercises with satisfactory clinical results.

关 键 词：跟腱 阔筋膜 手术切口 手术后并发症 

分 类 号：R686.1[医药卫生—骨科学]