长屈肌腱转移重建慢并性跟腱断裂.pdfVIP

306 Chinese Journal of Reparative and Reconstructive Surgery, March 2009, Vol. 23, No.3 · · 长屈肌腱转移重建慢性跟腱断裂 李作为 徐向阳 刘津浩 朱渊 徐继平 【摘  要】 目的 探讨 长屈肌腱转移联合界面钉固定重建慢性跟腱断裂的效果。  方法 2004 年 10 月－ 2007 年6 月，收治32 例35 足慢性跟腱断裂患者。男21 例22 足，女11例13足；年龄32 ～85 岁。发病至手术时间为4 ～132 d 。 29 例有患足用力蹬地史，3 例无明显诱因。均有走路无力症状，Thompson 试验阳性31 例33 足。美国足踝外科协会踝- 后足疗效评价标准评分为（56.09 ± 7.25 ）分。MRI 示跟腱断裂裂隙为0.5 ～5.0 cm 。术中足内侧小切口联合跟内侧切口 或直接跟内侧切口取 长屈肌腱，所切取近端 长屈肌腱长度超过跟骨结节3 cm，界面钉于跟骨固定肌腱。  结  果 1 例 因伤口张力过大术后1 周裂开，经对症处理后愈合；其余切口均Ⅰ期愈合。32 例均获随访，随访时间 12 ～32 个月，平均 19.4 个月。术后12 个月按照美国足踝外科协会踝- 后足疗效评价标准评分为（94.22 ± 4.63 ）分，与术前比较差异有统计 学意义（P 0.01 ）；优28 例，良3 例，可1 例。无腓肠神经及胫后神经损伤、跖部痛性瘢痕、足底内外侧神经损伤。  结  论 长屈肌腱转移联合界面钉固定重建慢性跟腱断裂具有术后恢复快、肌腱固定强度高、并发症少的优点。 【关键词】 慢性跟腱断裂 长屈肌腱 转移    跟腱重建 中图分类号：R687.2 R686 文献标志码：A RECONSTRUCTION OF CHRONIC ACHILLES TENDON RUPTURE WITH FLEXOR HALLUCIS LONGUS TENDON TRANSFER/LI Zuowei, XU Xiangyang, LIU Jinhao, ZHU Yuan, XU Jiping. Department of Orthpaedics, Ruijin Hospital, Medicine School of Shanghai Jiao Tong University, Shanghai, 200025, P.R.China. Corresponding author: XU Xiangyang, E-mail: xu664531@ 【Abstract 】 Objective To evaluate the effectiveness of interference screw and flexor hallucis longus tendon as augmentation material in repair of chronic Achilles tendon rupture. Methods From October 2004 to June 2007, 32 patients (35 feet) with chronic Achilles tendon rupture were treated, including 21 males (22 feet) and 11 females (13 feet) and aging 32-85 years. The disease course was 4-132 days. There were 29 patients with hooflike movements history and 3 patients without obvious inducement. The result of Thompson test was positive in 31 cases (33 feet). The score was 56.09 ± 7.25 according to the American