Lui T H
Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui, NT, Hong Kong SAR, China.
Foot Ankle Surg. 2009;15(2):58-61. doi: 10.1016/j.fas.2008.06.004.
Achilles tendon ruptures occur commonly in the midsubstance of the tendon, usually 2-6 cm proximal to the insertion to the calcaneus. Ruptures near its insertion into the calcaneus are less common and mostly found in hyperpronators with a heel spur (Haglund's deformity). Avulsion of the bony insertion of the Achilles tendon at the calcaneus is infrequent and is diagnosed by radiography. Open reduction and internal fixation is indicated to achieve bone to bone healing and restoration of the function and continuity of the triceps surae mechanism. Screw fixation is not effective to resist the pull out tension of the triceps surae. Moreover, the prominent screw head may cause skin impingement. More secure fixation method is necessary in order to allow early functional rehabilitation. We describe a technique to fix the avulsed fragment of Achilles tendon insertion with 2 suture anchors. This can neutralize the pull of the triceps surae and early post-operative rehabilitation programme is allowed.
跟腱断裂通常发生在肌腱的中部，通常在跟腱附着于跟骨处近端2 - 6厘米处。跟腱在其附着于跟骨处附近的断裂较少见，多见于伴有足跟骨刺（Haglund畸形）的过度旋前者。跟腱在跟骨处的骨性附着点撕脱很少见，通过X线摄影诊断。切开复位内固定术用于实现骨对骨愈合以及恢复小腿三头肌机制的功能和连续性。螺钉固定对于抵抗小腿三头肌的拔出张力无效。此外，突出的螺钉头可能会导致皮肤受压。为了允许早期功能康复，需要更可靠的固定方法。我们描述了一种用2个缝线锚钉固定跟腱附着处撕脱碎片的技术。这可以抵消小腿三头肌的拉力，并允许进行早期术后康复计划。
