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[感染性跟腱切除术。软组织覆盖且未进行肌腱重建后的结果]

[Resection of infected achilles tendon. Results after soft tissue coverage without tendon reconstruction].

作者信息

Boorboor P, Lahoda L U, Spies M, Kuether G, Waehling K, Vogt P M

机构信息

Klinik und Poliklinik für Plastische, Hand- und Wiederherstellungschirurgie, Verbrennungs- und Replantationszentrum, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover, Deutschland.

出版信息

Chirurg. 2006 Dec;77(12):1144-51. doi: 10.1007/s00104-006-1235-y.

Abstract

BACKGROUND

Structural full-thickness defects of the Achilles tendon represent a severely disabling injury which should be treated by reconstruction. This study presents functional outcomes from standardised follow-up of non-reconstructed Achilles tendons with soft tissue coverage alone.

PATIENTS AND METHODS

Seven patients were treated with various techniques of soft tissue reconstruction without restoration of the Achilles tendon. After a mean of 11 months postoperatively, the lower extremity was evaluated generally with regard to function, AOFAS score (ankle and hindfoot), and isokinetic torque testing by the Biodex system.

RESULTS

All patients showed high mobility, muscle strength, and range of motion at follow-up. The average AOFAS score was 84.7 (maximum 100), and the torque loss in plantar flexion was 44.5% on average compared to the uninvolved side and thus comparable with results after secondary tendon reconstruction.

CONCLUSION

After complete loss of the Achilles tendon, compensatory techniques can hinder significant loss of torque and endurance, compared with secondary tendon reconstruction, allowing unsupported mobility and even top athletic performance.

摘要

背景

跟腱全层结构缺损是一种严重致残性损伤,应通过重建进行治疗。本研究展示了仅采用软组织覆盖的非重建跟腱标准化随访的功能结果。

患者与方法

7例患者接受了各种软组织重建技术治疗,未修复跟腱。术后平均11个月时,对下肢进行了功能、美国足踝外科协会(AOFAS)评分(踝关节和后足)以及通过Biodex系统进行的等速扭矩测试的综合评估。

结果

所有患者在随访时均表现出高活动度、肌肉力量和活动范围。AOFAS平均评分为84.7(满分100),与未受累侧相比,跖屈扭矩平均损失44.5%,因此与二期肌腱重建后的结果相当。

结论

跟腱完全缺失后,与二期肌腱重建相比,代偿技术可防止扭矩和耐力显著丧失,实现无支撑活动甚至顶级运动表现。

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