趾长屈肌腱和[足母]长屈肌腱移位修复陈旧性跟腱断裂.pdfVIP

中国骨伤2008年4月第21卷第4期 China J Orthop＆Trauma，Apr．2008，Vo1．21，No．4 · 297· · 经 验 趾长屈肌腱和 长屈肌腱移位修复陈旧性 跟腱断裂 曲家富，曹立海，赵洪波，高建华，李绍光，杜晓健，孙洋，彭义，王良 (唐山市第二医院足外科，河北 唐山 063000) 【摘要】 目的：探讨趾长屈肌腱、蹲长屈肌腱移位修复陈旧性跟腱断裂的手术方法和疗效。方法：13例陈旧性跟 腱断裂患者，男9例，女4例；年龄32-69岁，平均41岁；左侧8例，右5例；受伤至手术时间3-8个月，平均4．5个月。 13例患者均有明确外伤史，均为闭合性损伤跟腱断裂。采用趾长屈肌腱移位修复陈旧性跟腱断裂5例，行蹲长屈肌腱 移位修复陈旧性跟腱断裂8例。结果：13例随访时间l1个月-4．5年，平均2年，伤口无感染，跟腱无再断裂，踝关节活 动基本正常，足背屈跖屈功能良好，未发生锤状趾畸形。按Arner-Lindholm疗效评定标准评定，优9例(蹲长屈肌腱移 位修复6例，趾长屈肌腱移位修复3例)，良3例(蹲长屈肌腱移位修复2例，趾长屈肌腱移位修复1例)，差1例(趾长 屈肌腱移位修复)。结论：采用趾长屈肌腱、蹲长屈肌腱移位修复陈旧性跟腱断裂的手术方法，可获得良好的疗效，是较 理想的治疗方法。而采用蹲长屈肌腱移位修复陈旧性跟腱断裂更趋近于合理。 【关键词】 跟腱； 修补手术，外科； 腱转移术； 创伤和损伤 Flexordigitorum (hallucis)longusmuscletendontransferinthe repairofold ruptureoftheAchilles~ndon QU 丘，CA0 Li一^ ，ZHA0 Hong-bo，GA0 Jian—hua，LIShao—guang，DUXi~-j ，SUN Yang，PENG Yi，WANG Liang．Depart— ment ofFootAnkle Surgery，the SecondHospitalofTangshan。Tangshan 063000，Hebei，China ABSTRACT Objective：To explore the operative technique of repair and its curative effect of old rupture of the Achilles tendonwithflexordigitorum(hallueis)longustendontransfer．Methods：FromNov 2001 toMay 2005，13 patientswho had old rupture of the Achilles tendon were treated with this operative technique．Five of them were treated with flexor digitorum longus tendon transfer and 8 with flexor hallucis longus tendon．A1l patients had the history of closed iniury of Achilles tendon(9 male and 4 female．8 left feet and 5 right feet)．The age ranged from 32 to 69 years(mean 41 years)．Operative technique：flexor dig- itorum(hallucis)longus tendon was cut down alternatively．The distal end of flexor digitorum longus tendon should be sutured to flexor hallueis longus tendon if the flexor digitorum longus tendon was cut．The distal end of flexor hallueis longus tendon should be sutured to flexor digitorum longus tendon