跟腱再断裂的手术治疗15例报告

Surgical Therapy for Recurrent Rupture of Achilles Tendon

目的：了解跟腱再断裂的临床表现及再手术的方法与疗效。方法：15例跟腱再断裂的患者在我所进行手术治疗，术中全面观察跟腱再断裂的表现，根据不同的断裂情况选择手术方式。结果：15例患者再断裂部位均为跟骨结节上3～4cm，均为原断裂部位。跟腱断端瘢痕化增粗，粘连明显。其中12例为横行断裂，2例为短马尾状断裂，1例为大部分撕裂。15例患者中9例为闭合性再断裂，6例为开放性再断裂。10例患者坚持随访至少1年，按Amer—Lindholm评分优良率为70％。结论：跟腱再断裂均发生在原断裂部位，断端瘢痕化，粘连明显，多为横行断裂，急诊再手术缝合修补效果满意。

Objective To investigate the clinical feature of and surgical technique for recurrent rupture of Achilles tendon. Methods Fifteen patients suffered from recurrent rupture of Achilles tendon were treated in our institute. The clinical feature was thoroughly observed and different surgical procedures were applied depending on the different circumstances of recurrent ruptures. Results All 15 cases showed that the site of recurrent rupture was localed at 3 - 4 cm above the calcaneus turberosity, Which was the same as the primary rupture site. The ruptured tendon ends were cicatrized, augmented and obviously adhesive. Of the 15, there were horizontal ruptures in 12 cases, horse tailed rupture in 2, partial ruptures in 1. 9 cases had closed rupture and 6 had open. 10 cases were followed - up for more than 1 year after the first surgery, the excellent and good rate of the surgery accounted for 70 % of the total according to Amer - Lindholm score. Conclusion All recurrent ruptures occurred at the primary rupture site, the ruptured tendon ends were cicatrized, and obviously adhesive. Most recurrent rupture were horizontal rupture. Re - repair of Achilles tendon received satisfactory result.