| 趾长屈肌腱和长屈肌腱移位修复陈旧性跟腱断裂 |
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Received:July 26, 2007
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| 作者 | Author | 单位 | Unit | E-Mail |
| 曲家富 |
QU Jia-fu |
唐山市第二医院足外科，河北 唐山 063000 |
Department of Foot & Ankle Surgery,the Second Hospital of Tangshan,Tangshan 063000,Hebei,China |
qujiafu2008@sina.com |
| 曹立海 |
CAO Li-hai |
唐山市第二医院足外科，河北 唐山 063000 |
Department of Foot & Ankle Surgery,the Second Hospital of Tangshan,Tangshan 063000,Hebei,China |
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| 赵洪波 |
ZHAO Hong-bo |
唐山市第二医院足外科，河北 唐山 063000 |
Department of Foot & Ankle Surgery,the Second Hospital of Tangshan,Tangshan 063000,Hebei,China |
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| 高建华 |
GAO Jian-hua |
唐山市第二医院足外科，河北 唐山 063000 |
Department of Foot & Ankle Surgery,the Second Hospital of Tangshan,Tangshan 063000,Hebei,China |
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| 李绍光 |
LI Shao-guang |
唐山市第二医院足外科，河北 唐山 063000 |
Department of Foot & Ankle Surgery,the Second Hospital of Tangshan,Tangshan 063000,Hebei,China |
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| 杜晓健 |
DU Xiao-jian |
唐山市第二医院足外科，河北 唐山 063000 |
Department of Foot & Ankle Surgery,the Second Hospital of Tangshan,Tangshan 063000,Hebei,China |
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| 孙洋 |
SUN Yang |
唐山市第二医院足外科，河北 唐山 063000 |
Department of Foot & Ankle Surgery,the Second Hospital of Tangshan,Tangshan 063000,Hebei,China |
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| 彭义 |
PENG Yi |
唐山市第二医院足外科，河北 唐山 063000 |
Department of Foot & Ankle Surgery,the Second Hospital of Tangshan,Tangshan 063000,Hebei,China |
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| 王良 |
WANG Liang |
唐山市第二医院足外科，河北 唐山 063000 |
Department of Foot & Ankle Surgery,the Second Hospital of Tangshan,Tangshan 063000,Hebei,China |
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| 期刊信息：《中国骨伤》2008年21卷，第4期，第297-299页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：探讨趾长屈肌腱、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11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(长屈肌腱移位修复6例，趾长屈肌腱移位修复3例),良3例(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、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 |
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| Flexor digitorum(hallucis)longus muscle tendon transfer in the repair of old rupture of the Achilles tendon |
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Abstract:
Objective: To explore the operative technique of repair and its curative effect of old rupture of the Achilles tendon with flexor digitorum(hallucis)longus tendon transfer.
Methods: From Nov 2001 to May 2005,13 patients who 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. All patients had the history of closed injury 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 digitorum(hallucis)longus tendon was cut down alternatively. The distal end of flexor digitorum longus tendon should be sutured to flexor hallucis longus tendon if the flexor digitorum longus tendon was cut. The distal end of flexor hallucis longus tendon should be sutured to flexor digitorum longus tendon if the flexor hallucis longus tendon was cut. The proximal end of tendon to be cut down was sew up a suture line and pulled out from the incision to reveal the Achilles tendon. A transverse hole was drilled through the anterior aspect of the insertion of the tendon of the calcareous,and then drilled upward perpendicularly. The two holes were cross-connected by towel clamp. The flexor digitorum(hallucis)longus tendon to be transferred was pulled through the first hole from wall outward and upward,and then pulled through superior extremity of the second hole. The end of tendon was sutured firmly with the Achilles tendon.
Results: All patients have no infection or re-rupture during follow-up (average 24 months;range 11 to 54 months). There was no subsequent hammer-toe deformity. Dorsiflexion at least to neutral and normal plantar flexion were obtained in all patients. According to Arner-Lindholm standard,the final results were excellent in 9 patients(6 cases were used flexor hallucis longus tendon,and 3 cases were used flexor digitorum longus tendon),good in 3 patients(2 cases were used flexor hallucis longus tendon and 1 case was used flexor digitorum longus tendon) and poor in 1 patie- nt used with flexor digitorum longus tendon.
Conclusion: The repair of old rupture of the Achilles tendon with flexor digitorum(hallucis) longus tendon transfer is an ideal and effective method. Furthermore,the use of flexor hallucis longus muscle tendon tends to be more reasonable. |
| KEYWORDS:Achilles tendon Revision,surgical Tendon transfer Wounds and injuries |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 曲家富,曹立海,赵洪波,高建华,李绍光,杜晓健,孙洋,彭义,王良.趾长屈肌腱和长屈肌腱移位修复陈旧性跟腱断裂[J].中国骨伤,2008,21(4):297~299 |
| 英文格式: | QU Jia-fu,CAO Li-hai,ZHAO Hong-bo,GAO Jian-hua,LI Shao-guang,DU Xiao-jian,SUN Yang,PENG Yi,WANG Liang.Flexor digitorum(hallucis)longus muscle tendon transfer in the repair of old rupture of the Achilles tendon[J].zhongguo gu shang / China J Orthop Trauma ,2008,21(4):297~299 |
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