单切口[母]长屈肌腱转位修复跟腱缺损的疗效观察  

Effect of single incision transposition of hallux flexor tendon to repair Achilles tendon defect

作　　者：汤浩 吴信举 佟磊 朱自强 TANG Hao;WU Xinju;TONG Lei(Department of Orthopedics,Second Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu,221009,China)

机构地区：[1]徐州医科大学第二附属医院骨科,江苏徐州221009

出　　处：《实用手外科杂志》2024年第1期25-28,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨单切口[母]长屈肌腱转位修复跟腱缺损的临床效果。方法报道2019年9月-2021年12月接受单切口[母]长屈肌腱转位治疗的跟腱缺损患者14例。其中慢性跟腱断裂5例,慢性跟腱炎9例。临床观察指标:⑴术后2周内伤口愈合情况;⑵比较术后1年与术前的VAS评分,AOFAS踝及后足评分,跟腱(Victorian institute of sports assessment achilles questionnaire,VISA-A)评分及AOFAS[母]趾评分。结果14例均顺利完成手术,手术时间55~110 min,平均(87.14±14.89)min。伤口均一期愈合,14例均获随访,随访时间14~37个月,平均22.17个月。术后1年AOFAS踝及后足功能评分及跟腱VIAS-A评分分别为(92.29±6.44)分和(88.93±9.03)分,明显高于术前的(53.71±14.35)分及(47.64±7.59)分(P<0.001);VAS评分为(0.36±0.63)分,明显低于术前的(5.36±1.45)分(P<0.001);AOFAS[母]趾评分为(87.93±4.92)分,与术前的(89.29±5.35)分相比差别无统计学意义(P>0.05)。结论单切口[母]长屈肌腱转位修复跟腱缺损,能重建跟腱连续性,改善足踝部功能,提高患者生活质量。Objective To investigate the clinical effect of single incision transposition of hallux flexor tendon in the repair of Achilles tendon defect.Methods A series of case reports,patients with Achilles tendon defect who received single-incision rotatation of hallux long flexor tendon in our department from September 2019 to December 2021 were included.There were 5 cases of chronic Achilles tendon rupture and 9 cases of chronic Achilles tendinitis.The patients ranged in age from 25 to 64,with an average age of 44.There were 8 males and 6 females.Outcome indexes:⑴wound healing within 2 weeks after surgery.⑵VAS score,AOFAS ankle and posterior foot score,VISA-A score of Achilles tendon and AOFAS thumb score of affected side were compared 1 year after surgery and before surgery to evaluate the surgical effect.Results All 14 patients successfully completed the operation,the operation time was 55-110min,87.14±14.89min on average.The wounds of all patients healed in one stage.All 14 patients were followed up for 14~37 months(mean 22.17 months).AOFAS ankle and hind foot scores and Achilles tendon VIAS-A scores were 92.29±6.44 and 88.93±9.03,respectively,significantly higher than those before surgery(53.71±14.35,47.64±7.59)(P<0.001).VAS score of 0.36±0.63 was significantly lower than that of 5.36±1.45 compared with preoperative(P<0.001).The AOFAS thumb score was 87.93±4.92 one year after operation,which was not statistically significant compared with 89.29±5.35 before operation(P>0.05).Conclusion Single-incision transposition of hallux flexor tendon can repair Achilles tendon defect,rebuild Achilles tendon continuity,improve foot and ankle function,and improve patients'quality of life.

关 键 词：单切口 [母]长屈肌腱 跟腱缺损 

分 类 号：R687.3[医药卫生—骨科学]