改良跟腱内侧J形切口结合阔筋膜移植修复KuwadaⅡ和Ⅲ型跟腱缺损
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祁义民 QI Yi-min 南京医科大学附属南京医院南京市第一医院骨科, 江苏 南京 210006 Department of Orthopedic, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu, China  
杨蓊勃 YANG Weng-bo 南京医科大学附属南京医院南京市第一医院骨科, 江苏 南京 210006 Department of Orthopedic, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu, China  
蒋纯志 JIANG Chun-zhi 南京医科大学附属南京医院南京市第一医院骨科, 江苏 南京 210006 Department of Orthopedic, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu, China  
曾逸文 ZENG Yi-wen 南京医科大学附属南京医院南京市第一医院骨科, 江苏 南京 210006 Department of Orthopedic, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu, China  
吴磊 and WU Lei 南京医科大学附属南京医院南京市第一医院骨科, 江苏 南京 210006 Department of Orthopedic, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu, China 541977490@qq.com 
期刊信息:《中国骨伤》2022年,第35卷,第1期,第11-14页
DOI:10.12200/j.issn.1003-0034.2022.01.003
基金项目:
中文摘要:

目的:探讨改良跟腱内侧“J”形切口结合阔筋膜移植在治疗Kuwada Ⅱ和Ⅲ型跟腱缺损中的临床疗效。

方法:回顾性分析2016年1月至2018年8月采用改良跟腱内侧“J”形切口结合I期阔筋膜移植治疗的15例KuwadaⅡ和Ⅲ型跟腱缺损患者的临床资料,其中男14例,女1例;年龄24~43岁,平均31.7岁;Kuwada Ⅱ型9例,Ⅲ型6例。观察切口并发症情况,末次随访时采用Arner-Lindholm评分标准评价患足功能。

结果:15例均获得随访,时间3~16个月,平均9.2个月。术后无切口皮肤坏死及感染发生,无跟腱再断裂发生。根据Arner-Lindholm评分标准评定,优13例,良2例。

结论:采用改良跟腱内侧“J”形切口结合Ⅰ期阔筋膜移植治疗Kuwada Ⅱ和Ⅲ型跟腱缺损可避免术后切口并发症,可以双重加固跟腱强度,使患者可以早期康复功能锻炼,临床疗效满意。
【关键词】跟腱  阔筋膜  手术切口  手术后并发症
 
Repair of KuwadaⅡand Ⅲ Achilles tendon defects through modified medial J-shaped approach with autologous fascia lata transplantation
ABSTRACT  

Objective: To investigate the clinical effect of modified medial J-shaped incision of Achilles tendon combined with fascia lata transplantation in the treatment of Kuwada typeⅡand Ⅲ Achilles tendon defects.

Methods: From January 2016 to August 2018,the clinical data of 15 patients with KuwadaⅡand Ⅲ Achilles tendon defects treated with modified J-shaped approach with autologous fascia lata transplantation were retrospectively analyzed,including 14 males and 1 female,with an average age of 31.7 years old ranging from 24 to 43. There were 9 cases of KuwadaⅡdefect and 6 cases of KuwadaⅢ defect. Postoperative observations were made for incision complications,and the Arner-Lindholm scoring standard was used to evaluate the function of the affected foot at the last follow-up.

Results: All 15 cases were followed up from 3 to 16 months with an average of 9.2 months. No skin necrosis or infection occurred after operation,and no Achilles tendon rupture occurred again. According to the Arner-Lindholm scoring standard,13 cases were excellent,2 cases were good.

Conclusion: Modified medial J-shaped incision is a satisfactory approach for repairing Achilles tendon defects. It is helpful to prevent postoperative incision complications,which double-strengthen the Achilles tendon strength,so that patients can perform early rehabilitation and functional exercises with satisfactory clinical results.
KEY WORDS  Achilles tendon  Fascia lata  Surgical incision  Postoperative complications
 
引用本文,请按以下格式著录参考文献:
中文格式:祁义民,杨蓊勃,蒋纯志,曾逸文,吴磊.改良跟腱内侧J形切口结合阔筋膜移植修复KuwadaⅡ和Ⅲ型跟腱缺损[J].中国骨伤,2022,35(1):11~14
英文格式:QI Yi-min,YANG Weng-bo,JIANG Chun-zhi,ZENG Yi-wen,and WU Lei.Repair of KuwadaⅡand Ⅲ Achilles tendon defects through modified medial J-shaped approach with autologous fascia lata transplantation[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(1):11~14
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