Thordarson David B, Shean Christopher J
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
J Am Acad Orthop Surg. 2005 May-Jun;13(3):186-96. doi: 10.5435/00124635-200505000-00005.
Nerve and tendon lacerations of the foot and ankle region are relatively common. Acute nerve and tendon injuries should be repaired with appropriate techniques at the time of initial wound exploration. Primary nerve repair may help minimize the risk of painful neuroma formation; primary tendon repair can lead to better functional results than delayed repair. Most chronic nerve injuries, except those to the tibial nerve or its major divisions, are managed by resection of a painful neuroma and burying the nerve ending in a protected area. Delayed reconstruction of tendon injuries is performed when correction of the functional deficit outweighs the morbidity of surgery.
足踝部的神经和肌腱撕裂相对常见。急性神经和肌腱损伤应在初次伤口探查时采用适当技术进行修复。一期神经修复有助于将疼痛性神经瘤形成的风险降至最低；一期肌腱修复比延迟修复能带来更好的功能结果。除胫神经及其主要分支损伤外，大多数慢性神经损伤通过切除疼痛性神经瘤并将神经末梢埋于受保护区域来处理。当功能缺陷的纠正超过手术的发病率时，进行肌腱损伤的延迟重建。
