Pintore E, Barra V, Pintore R, Maffulli N
Department of Orthopaedics and Traumatology, Clinica Malzoni, Agropoli, Salerno, Italy.
J Trauma. 2001 Jan;50(1):71-8. doi: 10.1097/00005373-200101000-00013.
We present the results of a single-center, single-surgeon study in 59 patients with a fresh (4 women and 23 men; mean age, 43.6 +/- 8.8 years) or a neglected (1 woman and 21 men; mean age, 41.3 +/- 7.4 years) Achilles tendon rupture.
Patients with a fresh rupture were operated on using end-to-end suture, and patients with a neglected rupture received the tendon of the peroneus brevis as an autologous graft. Patients were assessed during the sixth postoperative week, and during the sixth postoperative month. They were discharged within 1 year after the operation, and were reviewed at an average of 53 +/- 13 months after surgery.
Patients were generally satisfied with the procedure, but those with a neglected rupture tended to have a greater postoperative complication rate, greater loss of isokinetic strength variables at high speeds, and greater loss of calf circumference.
The management of acute and neglected subcutaneous tears of the Achilles tendon by peroneus tendon transfer is safe but technically demanding. It affords good recovery, even in patients with a neglected rupture of 6 weeks' to 9 months' duration. Patients with a neglected rupture are at a slightly greater risk of postoperative complications, and their ankle plantar flexion strength can be reduced.
我们展示了一项单中心、由单一外科医生进行的研究结果，该研究涉及59例新鲜（4名女性和23名男性；平均年龄43.6±8.8岁）或陈旧性（1名女性和21名男性；平均年龄41.3±7.4岁）跟腱断裂患者。
新鲜断裂患者采用端端缝合进行手术，陈旧性断裂患者接受腓骨短肌腱作为自体移植物。在术后第六周和术后第六个月对患者进行评估。他们在手术后1年内出院，并在术后平均53±13个月接受复查。
患者总体上对手术满意，但陈旧性断裂患者术后并发症发生率往往更高，高速等速肌力变量损失更大，小腿周径损失更大。
通过腓骨肌腱转移治疗急性和陈旧性跟腱皮下撕裂是安全的，但技术要求较高。即使是病程为6周至9个月的陈旧性断裂患者，也能实现良好的恢复。陈旧性断裂患者术后并发症风险略高，且其踝关节跖屈力量可能会降低。
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