急性跟腱断裂修复术后跟腱疼痛的内镜手术治疗

Endoscopic management of heel cord pain after repair of acute Achilles tendon rupture

跟腱断裂缝合或者其他修复术后的疼痛,其临床表现类似于慢性跟腱腱病。主要症状是踝部运动引起的疼痛,而局部异响或者肿胀可能不明显。专科查体可以使局部疼痛被诱发重现,并且也可以确定疼痛累及的范围。采用内镜手术处理跟腱断裂修复术后的疼痛,在国际上属于探索性手术,由于手术创伤小,术后康复快,越来越多的足踝医师或者运动医学专业的医师开始尝试该技术。术前判断疼痛的原因和定位病变的部位是内镜下粘连松解术的关键。

The clinical presentation post-repair Achilles tendon pain is similar to that of chronic Achilles paratendinopathy. Exercise-induced pain is the main symptom,whereas crepitation and swelling may well diminish. The patient can experience both deep heel cord pain during propulsion and post-static dyskinesia. ＂Wave＂test,＂pinch ＂ test and the ＂side tensioning ＂ test can reproduce the symptoms and identify the extent of involvement. This is important for surgical planning and design of the portals for endoscopic adhesiolysis of the Achilles tendon.