[母]长屈肌腱转位联合腓肠肌筋膜瓣逆转治疗陈旧性跟腱断裂的早期临床疗效分析  

Flexor hallucis tendon transfer combined with gastrocnemius fascia flip for chronic achilles tendon rupture

作　　者：段祺辉 刘路平[1] 浦波[1] 陈磊杰[1] 刘洲[1] 张颉 Duan Qihui;Liu Luping;Pu Bo;Chen Leijie;Liu Zhou(Department of orthopedics,the Second Affilisted Hospital of Kunming Medical University,Kunming 650000,China)

机构地区：[1]昆明医科大学第二附属医院骨科,云南昆明650000

出　　处：《足踝外科电子杂志》2022年第2期34-38,共5页Electronic Journal of Foot and Ankle Surgery

基　　金：云南省刘波院士专家工作站(20225AF150009)。

摘　　要：目的分析应用[足母]长屈肌腱转位联合腓肠肌筋膜瓣逆转治疗陈旧性跟腱断裂的早期临床疗效。方法2018年1月至2020年12月,对10例陈旧性跟腱断裂患者行[母]长屈肌腱转位,其中6例联合腓肠肌逆转筋膜术。术后随访记录患者的伤口愈合情况、再断裂情况以及患足提踵试验情况,应用美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足评分对术前、术后的功能恢复情况进行评估。结果10例患者均获得随访,术后随访时间为6~12个月,平均10.5个月。术后,患者均未出现皮肤坏死、伤口感染及神经损伤。Thompson试验均为阴性,2例提踵试验阳性。7例患者活动及静息时均无明显疼痛,3例患者活动时局部有轻微痛感,整体满意度为80%。术前AOFAS评分为(53.6±6.4)分,末次随访时为(91.3±5.5)分,差异有统计学意义(P<0.05),患者获优8例、良1例、可1例。踝关节背伸与跖屈活动度均较术前显著改善,差异有统计学意义(P<0.05)。结论对于陈旧性跟腱断裂,[足母]长屈肌腱转位结合腓肠肌逆转筋膜瓣是一种有效的治疗方案,临床早期疗效可靠。Objective To analyze the early clinical effectiveness of flexor hallucis tendon transfer combined with gastrocnemius fascia flipin the treatment of chronic achilles tendon rupture. Methods From January 2018 to December 2020, 10 patients with chronic achilles tendon rupture were treated with lexor hallucis tendon transfer and 6 cases combined with gastrocnemius fascia flip. The postoperative follow-up recorded the wound healing time, re-ruptures and the calf raises test of the foot. Preoperative and postoperative functional recovery was assessed by the American Orthopedic Foot and Ankle Society(AOFAS) ankle-hindfoot score. Results All 10 patients were followed up for 6 ~ 12 months, with an average of 10.5 months. There was no skin necrosis or wound infection andnerve injury after operation. The Thompson tests were negative, the calf raises test was positive in 2 patients, 7 patients had no obvious pain during activity and rest, and 3 patients had slight pain during activity,and the overall satisfaction was 80%. The preoperative AOFAS scores were(53.6±6.4) points and the last follow-up were(91.3±5.5) points(P < 0.05). The patients were excellent in 8 cases, good in 1 case and fair in 1 case. Ankle dorsiflexion and plantarflexion rangeofmotion were significantly improved when compared with preoperativevalue, and the difference was statistically significant(P < 0.05). Conclusion Flexor hallucis tendon transfer combined with gastrocnemius fascia flip is effective and safe in the treatment of chronic achilles tendon rupture, and the early efficacy is reliable.

关 键 词：陈旧性跟腱断裂 [母]长屈肌腱 肌腱转位 腓肠肌筋膜瓣 

分 类 号：R683.42[医药卫生—骨科学]