1Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Ann Acad Med Singap. 2010 Jan;39(1):58-60.
Both conservative and operative management have been described in the literature for the management of chronic Achilles tendon ruptures with surgical management generally having more favourable results. In our institution, the favoured reconstructive technique was the use of 2 turndown tendon fl aps fashioned from the proximal Achilles tendon augmented by a tenomyodesis of the flexor hallucis longus. The purpose of this study was to assess the clinical outcome of all patients who underwent this procedure.
From the records, a total of 9 patients underwent the above-mentioned procedure of whom 6 patients had complete data collection sets [including SF-36, Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores, ankle range of motion (ROM), presence of residual symptoms and complications] at 2 years of follow-up.
Our results showed an average AOFAS Ankle-Hindfoot score of 94.2, VAS of 0 in all but 1 patient, and generally high scores (75-96) in all 8 domains of the SF-36 questionnaire. Patient satisfaction was also rated to be high from the surgical procedure.
We submit that the procedure adopted at our institution is able to reproduce satisfactory results with low morbidity in patients with this challenging condition.
对于慢性跟腱断裂的治疗,文献中既描述了保守治疗,也描述了手术治疗,手术治疗的结果通常更有利。在我们的机构中,首选的重建技术是使用 2 个从近端跟腱成形的翻转肌腱皮瓣,并进行跖屈肌腱延长术。本研究的目的是评估所有接受该手术的患者的临床结果。
从病历中,共有 9 名患者接受了上述手术,其中 6 名患者在 2 年随访时收集了完整的数据[包括 SF-36、视觉模拟量表(VAS)、美国矫形足踝协会(AOFAS)踝关节后足评分、踝关节活动范围(ROM)、残留症状和并发症]。
我们的结果显示,AOFAS 踝关节后足评分平均为 94.2,除 1 名患者外,VAS 均为 0,SF-36 问卷的 8 个领域的评分均较高(75-96)。患者对手术过程的满意度也很高。
我们认为,我们机构采用的手术方法在治疗这种具有挑战性的疾病时,能够取得满意的结果,且发病率较低。