小切口腓肠肌腱翻瓣术治疗5例陈旧性跟腱断裂

Small incision gastrocnemius tendon turndown flap to treat 5 cases with chronic Achilles tendon rupture

目的评价小切口腓肠肌腱翻瓣术治疗陈旧性跟腱断裂的临床疗效。方法回顾性分析2017年1月至2019年9月收治的陈旧性跟腱断裂5例,其中男4例,女1例,28~67岁。左足3例,右足2例。所有患者均行小切口腓肠肌腱翻瓣术治疗。术后予短腿石膏固定踝跖屈20°位,4周后拆除石膏穿跟腱靴行走4周,在此期间逐渐降低足跟高度。术后常规随访。使用美国足踝外科协会(AOFAS)踝-后足功能评分对手术效果进行评价。结果5例患者均获得随访6~38个月,平均23个月。AOFAS踝-后足功能评分由术前71.4提高到术后96.4。所有患者手术切口均一期愈合,无再断裂发生。结论小切口腓肠肌腱翻瓣术治疗陈旧性跟腱断裂疗效确切。

Objective To evaluate the efficacy of small incision gastrocnemius tendon turndown flap in the treatment of the chronic Achilles tendon rupture.Methods The clinical data of 5 cases with chronic Achilles tendon rupture treated in our department during Jan.2017 and Sep.2019 were retrospectively analyzed,including 4 males and 1 female,average age 46.5(28-67)years old,with 3 ruptures in the left feet and 2 in the right feet.All cases were treated with small incision gastrocnemius tendon turndown flap.After operation,the patients wore a blow-knee cast to hold the ankle at 20°of plantar flexion for 4 weeks,then partial-weightbearing walked with ankle-foot orthosis for 4 weeks,during which the heel height was reduced gradually.All patients were followed up.The efficacy of operation was evaluated with AOFAS ankle-hind foot function score.Results During the follow-up of 6 to 38(average 23)months,the AOFAS score increased from 71.4 pre-operation to 96.4 post-operation.All patients’incisions was healed in one stage,and no re-rupture occurred.Conclusion Small incision gastrocnemius tendon turndown flap is effective to treat chronic Achilles tendon rupture.