关节镜辅助微创长屈肌腱转位双束重建治疗陈旧性跟腱断裂的疗效分析  

Clinical efficacy of endoscopically-assisted,minimally-invasive transposition reconstruction with a double-bundle flexor hallucis longus for chronic Achilles tendon ruptures

作　　者：李卓 李雪[2] 胡漫欢 何琳 朱永展 Li Zhuo;Li Xue;Hu Manhuan;He Lin;Zhu Yongzhan(The Eighth Clinical School,Guangzhou University of Chinese Medicine,Foshan 528000,China;Foot and Ankle Surgery Center,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China)

机构地区：[1]广州中医药大学第八临床医学院,佛山528000 [2]佛山市中医院足踝外科,佛山528000

出　　处：《中华创伤骨科杂志》2025年第2期150-155,共6页Chinese Journal of Orthopaedic Trauma

基　　金：广东省基础与应用基础研究基金企业联合基金面上项目(2023A1515220193)。

摘　　要：目的探讨关节镜辅助微创长屈肌腱(FHL)转位双束重建治疗陈旧性跟腱断裂的疗效。方法回顾性分析2015年5月至2020年4月于佛山市中医院足踝外科行关节镜辅助微创FHL转位双束重建手术的36例陈旧性跟腱断裂患者资料。男30例,女6例;年龄(42.1±16.5)岁;体重指数为(28.5±4.5)kg/m^(2);跟腱缺损长度为(51.0±15.0)mm;受伤至手术时间为(13.1±10.4)周。记录并比较术前与末次随访时跟腱断裂评分(ATRS)、美国足踝外科协会(AOFAS)踝-后足评分及维多利亚运动评价协会跟腱评分(VISA-A)。记录所有患者术后并发症情况。结果所有患者术后获(41.3±3.5)个月随访。所有患者均无伤口并发症发生。末次随访时患者的ATRS为(90.3±5.6)分,AOFAS踝-后足评分为(91.0±2.0)分,VISA-A为(91.7±2.9)分,均较术前[(24.3±8.2)、(49.7±9.3)、(25.7±7.8)分]显著提高,差异均有统计学意义(P<0.05)。结论关节镜辅助微创FHL转位双束重建治疗陈旧性跟腱断裂疗效确切,并发症少。ObjectiveTo investigate the clinical efficacy of endoscopically-assisted,minimally-invasive transposition reconstruction with a double-bundle flexor hallucis longus(FHL)for chronic Achilles tendon ruptures.MethodsA retrospective study was conducted to analyze the clinical data of 36 patients with chronic Achilles tendon rupture who had been treated by endoscopically-assisted,minimally-invasive transposition reconstruction with a double-bundle FHL at Foot and Ankle Surgery Center,Foshan Hospital of Traditional Chinese Medicine from May 2015 to April 2020.The cohort consisted of 30 males and 6 females with an age of(42.1±16.5)years.Their body mass index was(28.5±4.5)kg/m^(2),their length of Achilles tendon defect(51.0±15.0)mm,and their duration from injury to surgery(13.1±10.4)weeks.The Achilles tendon rupture score(ATRS),American Orthopedic Foot and Ankle Society(AOFAS)ankle-hindfoot score,and Victorian Institute of Sports Assessment-Achilles(VISA-A)score were recorded and compared between pre-surgery and the last follow-up.All postoperative complications were record.ResultsAll patients were followed up for(41.3±3.5)months.No incision complications were noted.At the last follow-up,ATRS was(90.3±5.6)points,AOFAS ankle-hindfoot score(91.0±2.0)points,and VISA-A score(91.7±2.9)points,all significantly higher than the preoperative values[(24.3±8.2)points,(49.7±9.3)points,and(25.7±7.8)points](P<0.05).ConclusionThe clinical efficacy of the endoscopically-assisted,minimally-invasive transposition reconstruction with a double-bundle FHL for chronic Achilles tendon ruptures is definite,leading to a low rate of complications.

关 键 词：关节镜 外科手术 微创性 跟腱 双束重建 长屈肌腱 

分 类 号：R68[医药卫生—骨科学]