新鲜闭合性跟腱断裂的手术治疗

Surgical Treatment for Fresh Closed Achilles Tendon Rupture

目的探讨新鲜闭合性跟腱断裂的手术治疗方法及临床疗效。方法对45例新鲜跟腱断裂采用经跟腱正中旁内侧入路,Krackow法缝合修复跟腱治疗,术后在医生指导下进行循序渐进的康复锻炼。结果 45例随访10个月～3年,平均随访时间15个月,依据Amer-Lindholm评定标准,其中优35例,良10例。随访期内无跟腱再断裂及深部感染等并发症。结论新鲜跟腱断裂需早期诊断,早期治疗。绝大多数新鲜跟腱断裂为完全断裂,需要手术治疗,采用Krackow缝合法修复是跟腱断裂缝合的首选方法,经跟腱正中旁内侧入路为治疗跟腱断裂的最理想的手术入路,术后在专业医生指导下进行循序渐进的康复锻炼是获得小腿及足踝部良好功能的保证。

Objective To study the clinical effect and the method for surgical treatment of fresh closed Achilles tendon rupture. Methods Forty-five patients with fresh closed Achilles tendon rupture were operated.Achilles tendon was repaired with Krackow anastomosis method via mid-lateral approach.Rehabilitatian exercise was performed under doctor＇s guidance.Results All patients were followed-up for 10- 36 months （averaged 15 months）. According to Amer-Lindholm evaluating criteria, 35 cases were excellent,10 cases were good.no complications such as achilles tendon re-breakage or deep infection was found during following period.Conclusion Fresh closed Achilles tendon rupture should be diagnosis and operated early.Krackow anastomosis method is the best method, and mid-lateral approach is the satisfied approach for Achilles tendon reparation.Rehabilitation exercise under doctor＇s direction could obtain good function of lower limb.