Prabhakar Gautham, Kusnezov Nicholas, Rensing Nicholas, Abdelgawad Amr
Paul L. Foster School of Medicine, Texas Tech Health Sciences Center El Paso, El Paso, TX, USA; William Beaumont Army Medical Center, El Paso, TX, USA.
Case Rep Orthop. 2017;2017:9150538. doi: 10.1155/2017/9150538. Epub 2017 Mar 5.
Fracture of the calcaneal tuberosity with a concomitant Achilles tendon rupture presents a difficult challenge for the treating surgeon. The ultimate goal of treatment is to restore function of both the gastrocnemius-soleus complex and the Achilles tendon. This particular subset of fractures occurs often in diabetics and elderly patients with osteoporosis making fixation of the displaced fragment rather complex. If the Achilles tendon disruption is only discovered later once the fracture is healed, subsequent management is difficult with surgical treatment being more morbid. While this is a rare injury, the consequences of a missed chronic Achilles tendon disruption are severe with significant dysfunction. It is therefore important to have a high index of suspicion for concomitant injury and to be prepared for dual fixation. We present a novel hybrid surgical fixation technique, which may be used in this instance.
跟骨结节骨折合并跟腱断裂给治疗外科医生带来了艰巨挑战。治疗的最终目标是恢复腓肠肌-比目鱼肌复合体和跟腱的功能。这种特殊类型的骨折常见于糖尿病患者和患有骨质疏松症的老年患者，使得移位骨折块的固定相当复杂。如果跟腱断裂在骨折愈合后才被发现，后续治疗会很困难，手术治疗的创伤也更大。虽然这是一种罕见的损伤，但漏诊慢性跟腱断裂的后果很严重，会导致明显的功能障碍。因此，对于合并损伤要有高度的怀疑指数，并做好双重固定的准备。我们介绍一种新型的混合手术固定技术，可用于这种情况。
