Lin Song-qing, Xu Hao
Department of Orthopedic Surgery, Fuzhou General Hospital, Fuzhou, Fujian, P. R. China, 350025.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2003 Jul;17(4):328-30.
To explore the methods of treatment for old achilles tendon rupture merging with skin defect.
By following up retrospectively 10 patients from February 1995 to December 2001, we analyzed the operative methods, the points for attention and the results. Gastrocnemius musculocutaneous flaps were used in 3 cases, foot lateral skin flaps in 4 cases, superior medial malleolus skin flaps in 2 cases, and sural neural skin flap in 1 case. The Achilles tendon was sutured directly in 8 patients, with Lindholm's technique in 2 patients.
All flaps survived and the wound healed well in 8 cases and reruptured in 2 cases. According to Yin Qing-shui's criteria to test the efficacy, the results were excellent in 5 patients, good in 4 and poor in 1.
Repairing the old Achilles tendon rupture merging with skin defect by use of microsurgery has good results and plays an important role in reducing joint contracture and stiffness, and in saving the ability to push forward and flex.
探讨陈旧性跟腱断裂合并皮肤缺损的治疗方法。
回顾性随访1995年2月至2001年12月的10例患者,分析手术方法、注意事项及结果。3例行腓肠肌肌皮瓣移植,4例行足外侧皮瓣移植,2例行内踝上皮肤瓣移植,1例行腓肠神经皮瓣移植。8例患者直接缝合跟腱,2例采用Lindholm技术。
所有皮瓣均存活,8例伤口愈合良好,2例再断裂。按尹庆水标准评定疗效,优5例,良4例,差1例。
应用显微外科技术修复陈旧性跟腱断裂合并皮肤缺损效果良好,对减少关节挛缩和僵硬、保留蹬踏和屈伸功能具有重要作用。