拇长屈肌腱转位治疗顽固性跟腱止点病

Flexor hallucis longus tendon augmentation for treatment of intractable insertional achilles tendinopathy

目的探讨拇长屈肌腱转位治疗顽固性跟腱止点病的临床疗效。方法对30例顽固性跟腱止点病患者采用跟腱清创、拇长屈肌腱转位的术式进行跟腱重建。采用VISA-A评分评价疗效。结果患者均获得随访,时间25～43个月。VISA-A评分:术前为37. 50分±2. 70分,末次随访时为80. 80分±3. 10分,差异有统计学意义(P <0. 01)。1例因切口愈合不良行清创后重新缝合,其余患者无并发症发生。结论跟腱止点病的手术治疗不仅要去除跟腱腱体的病变,还要创造良好的腱周环境。拇长屈肌腱转位技术治疗顽固性跟腱止点病可获得满意的疗效。

Objective To investigate the clinical result of flexor hallucis longus tendon augmentation for treatment of intractable insertional achilles tendinopathy(IAT).Methods The 30 patients(30 feet)with IAT were performed the achilles tendon debridement and hallucis longus tendon augmentation.The VISA-A questionnaire was used for clinical result evaluation.Results All patients with IAT were followed up for 25~43 months.The average VISA-A score was(37.50±2.70)points preoperatively,and improved to average(80.80±3.10)points at final follow-up(P<0.01).One case was resutured after delayed wound healing and the other patients had no complications.Conclusions The key of the procedure is not only to excise the degenerative tendon but also to remove the mechanical factors around the tendon.Treatment of IAT with flexor hallucis longus tendon can achieve satisfactory results.