跟腱牵引治疗陈旧性跟腱断裂.doc

1 跟腱牵引治疗陈旧性跟腱断裂作者:黄炯锋,谢冠豪,黎应森,黄炳生,张杰英,廖文益,廖乐粤,陈立安【摘要】目的介绍跟腱牵引治疗陈旧性跟腱断裂的方法。方法对 13 例陈旧性跟腱断裂患者首先进行跟腱牵引,待跟腱延长下行后再行跟腱断端直接吻合。结果经过6 个月~ 2 年的随访,按 Arner 拟 dindholm 疗效评定标准, 其中优 9例,良4例。结论本方法具有操作简单, 创伤少, 术后肌力及功能恢复良好,但存在牵引早期局部疼痛较剧, 须加强镇静止痛治疗。【关键词】跟腱断裂陈旧性牵引治疗 Achilles Tendon Traction in treatment of Old Tendon Disinsertion Abstract : Objective To introduce the method of Achilles Tendon Traction in treatment of old tendon 2 Achilles tendon traction was first adopted to 13 patients with old tendon anastomotic operation was later given to the downward extended tendon and the broken After six months ’ to two years ’ follow 拟 up visit , curative results of9 cases were excellent and 4 cases were good according to Arner 拟 dindholm assessment The method is simple with little and its function restored satisfactorily after opertation. However , strong topalgia occurs at early stage of treament of seldation and odynolysis is needed. Key words : tendon disinsertion ; old ; traction ; treatment 跟腱断裂是一种常见创伤,但由于有约 20 %~ % 不等误诊率[1], 故陈旧性跟腱断裂也较为常见, 因踝关节功能受影响, 故常需手术治疗。手术方法较多, 但都存在切口长、吻合口增粗、或蹬力缺失等缺点。自 2000 年~ 200 6 年我院收治陈旧性跟腱断裂 13 例,采用先进行跟腱牵引, 再行跟腱断端直接吻合的手术方法, 疗效满意, 现报告如下。 1 临床资料 3 一般资料本组 13 例,男 10 例,女 3 例,年龄 21~ 46 岁,受伤原因: 开放性损伤 4例, 闭合性损伤 9例, 切割伤 4例, 体育运动伤 8 例,车祸伤 1 例,病程最短 27 天,最长 63 天, 开放性损伤 4 例首诊