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跟腱再断裂原因临床探讨

Clinical Discussion of Reasons in 16 Cases of Achilles Tendon Re-abruption

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【作者】 冯琼华卢光辉许典雄张勇

【Author】 FENG Qionghua,LU Guanghui,XU Dianxiong,ZHANG YongThe Second Dept.of Orthopaedic Surgery,the People’s Hospital of Daye City,Daye 435100,Hubei,China

【机构】 湖北省大冶市人民医院骨Ⅱ科湖北省大冶市人民医院骨Ⅱ科 湖北大冶435100湖北大冶435100

【摘要】 目的:探讨跟腱再断裂原因及相关防治措施与临床结果。方法:对16例跟腱再断裂患者,分析其断裂原因,再次手术清除断端瘢痕组织,Bennett直接缝合9例;V-Y延长术后,断端直接缝合5例,跟腱附着点再断裂2例,先作跟骨结节骨隧道,再用小钢丝做Bennett抽丝缝合,其周围用丝线缝合加强固定。术后踝关节保持跖屈位,屈膝30°,石膏管型固定6周后,改成短腿石膏外固定4周,再穿高跟矫形鞋2-3月,1年内禁止过量活动。结果:跟腱全部愈合,踝关节功能优12例,良2例,差2例。结论:只要严格手术操作,掌握缝合技巧,术后处理得当,跟腱再断率将明显下降。

【Abstract】 Objective: To discuss reasons of Achilles tendon re-abruption and the way of prevention and treatment,and evaluate the clinical outcomes.Methods: The clinic data of 16 cases of Achilles tendon re-abruption were analyzed.After careful debridement,nine cases were treated by Bennett suture with 10# nesis,and five cases were treated by Achilles tendon V-Y prolongation operation and Bennett suture.In the other two cases,whose Achilles tendons were broken on the insertion,by punching a bone tunnel in calcaneal eminence and with a thin wire,Achilles tendons were sutured through the tunnel and fixed by suturation with 10# nesis around the calcaneal eminence.After the operation,the ankle flextion was maintained by cast plast fixation for eight weeks,then wore an orthotic high-heel shoe for two or three months,and without acute exercise in one year.Results: All the Achilles tendons healed,and ankle function examination showed that 12 cases were excellent,three cases were good,and one case was in ankle function.Conclusion: Proper operation techniques and post-operation treatment could decrease the probability of Achilles tendon re-abruption and enhance the healing.

  • 【文献出处】 武汉大学学报(医学版) ,Medical Journal of Wuhan University , 编辑部邮箱 ,2007年03期
  • 【分类号】R686.1
  • 【被引频次】5
  • 【下载频次】106
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