跟腱断裂手术治疗后的并发症及其预防

The complications and their prevention in patients after Achille's tendon ruptureoperation

目的分析跟腱断裂术后并发症,并提出相应的预防措施。方法回顾分析我院1999-2007年65例跟腱断裂患者术后并发症的发生情况。结果本组65例,发生并发症者12例,急性跟腱断裂10例,陈旧性跟腱断裂2例。其中跟腱再断裂3例,均给予再次手术治疗,术式为端端吻合+跖肌腱加强,术后恢复良好;伤口感染不愈合3例,给予再次彻底清创及换药处理或皮瓣转移后伤口愈合;皮肤坏死2例,行换药处理或局部旋转皮瓣修复后治愈;术后跟腱粘连及踝关节僵硬4例,通过加强功能锻炼,术后6～12个月恢复正常。结论伤后治疗的延误、术中操作不当及跟腱本身因素等是导致跟腱断裂术后并发症的原因。跟腱伤后尽早手术治疗、术中微创操作及术后有效的预防措施可以减少跟腱断裂术后并发症的发生。

Objective To analyze the complications of Achille＇s tendon rupture operation and bring forward corre- sponding preventable steps. Method Twelve cases with complications after Achilles tendon rupture operation were systematicaUy analyzed. Result The delay of treatment after injury,incorrect operation approach and status of Achille＇s tendon were causes of complications after Achille＇s tendon rupture operation. Conclusion Early operation after injury,minimize invasive procedures during operation and effective postoperative measures can decrease the complications postoper- atively.