MEDLINE/PubMed Journal Browser Search

Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

Title: [Curative analysis of individual surgery for chronic Achilles tendon rupture].
Author: Hu Y, Li Q, Fu W, Chen G, Mao Y, Li J, Tang X.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2017 Apr 15; 31(4):432-436. PubMed ID: 29798608.
Abstract:
OBJECTIVE: To investigate the effectiveness of individual surgery for chronic Achilles tendon rupture. METHODS: A retrospective analysis was made on the clinical data of 25 patients (26 Achilles tendons) with chronic Achilles tendon rupture between September 2009 and March 2016, including 22 males and 3 females with a mean age of 38 years (range,18-59 years). The median disease duration was 12 weeks (range, 4 weeks to 12 years). The repairing method depended on the defect size, injury site, and tissue condition of the involved Achilles tendon: 9 Achilles tendons were repaired by end-to-end anastomosis, 8 by a gastrocnemius turndown flap, and 9 by auto free tendon (4 ipsilateral hamstring tendon and 5 ipsilateral 2/3 peroneus longus tendon). The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot score, heel lifting of the affected leg, active ankle range of motion (plantar flexion and dorsiflexion), maximum calf circumference, and complications were applied to assess the effectiveness. RESULTS: Hypersensitivity occurred in 1 incision, and stage I healing was obtained in the other incisions. No complication of re-rupture, infection, nerve injury, or deep venous thrombosis occurred. All the patients were followed up 8-85 months (mean, 34 months). The AOFAS ankle-hind foot score was significantly improved to 95.81±5.34 at last follow-up from preoperative 50.54±5.52 ( t=-34.844, P=0.000); the excellent and good rate was 100% (excellent in 21 cases and good in 4 cases). The active dorsiflexion of the operated side [(13.9±2.4)°] was significantly lower than that of normal side [(16.7±2.0)°] ( t=-9.099, P=0.000), but the active plantar flexion showed no significant difference between affected side [(39.8± 3.2)°] and normal side [(40.6±2.6°)] ( t=-1.917, P=0.068). The maximum calf circumference of the operated side [(379.4±18.8) mm] was significantly lower than that of normal side [(387.1±16.6) cm] ( t=-5.053, P=0.000). The other patients could finish heel lifting of the affected leg without limitation except for 1 patient. All patients returned to normal work and activity, and 12 patients returned to normal sports. CONCLUSION: Individual surgery depending on the defect, injury site, and tissue condition of the involved Achilles tendon can repair all kinds of chronic Achilles tendon rupture with a low rate of complications. 目的: 探讨个体化手术治疗陈旧性跟腱断裂的临床疗效。. 方法: 2009 年 9 月—2016 年 3 月，收治 25 例（26 侧）陈旧性跟腱断裂患者。其中男 22 例，女 3 例；年龄 18～59 岁，平均 38 岁。病程 4 周～12 年，中位病程 12 周。根据跟腱缺损大小，结合损伤部位及跟腱组织情况行个体化手术治疗。其中 9 侧跟腱行端端缝合术，8 侧行腓肠肌腱瓣翻转术，9 侧行自体游离肌腱跟腱重建术（4 侧取同侧腘绳肌腱，5 侧取同侧 2/3 腓骨长肌腱）。术后随访观察伤口等并发症情况，术前和末次随访时采用美国矫形足踝协会（AOFAS）踝-后足评分评价功能恢复情况，末次随访时观测患侧单足提踵活动、双侧踝关节主动屈伸活动度及双侧小腿最大周径等指标。. 结果: 术后 1 侧切口发生缝线异物反应，余 25 侧切口均Ⅰ期愈合。均无跟腱再断裂、伤口感染、神经损伤或静脉血栓形成等并发症发生。25 例患者均获随访，随访时间 8～85 个月，平均 34 个月。AOFAS 踝-后足评分由术前（50.54±5.52）分提高至末次随访时的（95.81±5.34）分，差异有统计学意义（ t=–34.844， P=0.000）；达优 21 例、良 4 例，优良率 100%。末次随访时患侧和健侧踝关节主动背伸分别为（13.9±2.4）°和（16.7±2.0）°，差异有统计学意义（ t=–9.099， P=0.000）；踝关节主动跖屈分别为（39.8±3.2）°和（40.6±2.6）°，差异无统计学意义（ t=–1.917， P=0.068）。末次随访时患侧和健侧小腿最大周径分别为（379.4±18.8）mm 和（387.1±16.6）mm，差异有统计学意义（ t=–5.053， P=0.000）。除 1 例患者因疼痛仅能完成部分单足提踵活动外，其余患者均能不受限完成单足提踵活动。所有患者均恢复受伤前生活和工作能力，12 例恢复伤前运动。. 结论: 根据跟腱缺损大小，结合损伤部位及跟腱组织情况行个体化手术方式，可有效修复各类型陈旧性跟腱断裂，操作简便，并发症发生率低。.

[Abstract] [Full Text] [Related] [New Search]