腓骨长肌及胫骨后肌联合修复陈旧性跟腱断裂伴缺损

Fibularis Longus and Tibialis Posterior Transfer for the Treatment of Old Achilles Tendon Rupture with Defect

作者自行设计使用腓骨长肌及胫骨后肌联合修复陈旧性跟腱断裂伴缺损48例,获得完整随访资料43例。跟腱缺损长度为8～10cm,自身已无修复条件。手术方法的优点:联合转移的肌腱弥补了长距离跟腱缺损,保持了原有肌肉的动力,弥补了小腿三头肌的挛缩无力。保持了足内、外翻的肌力平衡,足外形正常。肌肉的血循环不受干扰,增加了修复跟腱后愈合的机会。手术后6周都能逐渐下地行走,肌力一般都能达到Ⅳ级～V级,功能恢复良好,未发生因愈合不良再次发生断裂。

The authors designed a new method with fibularis longus and tibialis posterior transfer for the treatment of old Achilles tendon ruptuer with defect. A total of 48 cases were operated upon with this method, and 43 cases were followed up. The defect of Achilles tendon was 8 to 10cm, to repair it. The Achilles tendon itself could not be conducted. This defect was filled with the transfered tendens at operation.The weaked triceps surae was enforced by the two transfered muscles. Inversion and eversion force of the foot was equilibrated and normal apearance of the foot was maitained.Uninjured circulation of the transfered muscles enhanced healing of the repaired tendon. All patients could walk 6 weeks afer operation. Generally, IV-V grade force could be achieved.The function of the ankles were good.No tendon rupture ocurred because of poor healing.