Maffulli Nicola, Via Alessio Giai, Oliva Francesco
Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Salerno, Italy.
Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England.
Open Orthop J. 2017 Jul 31;11:660-669. doi: 10.2174/1874325001711010660. eCollection 2017.
The Achilles tendon, the largest and strongest tendon in the human body, is nevertheless one of the tendons which most commonly undergoes a complete subcutaneous tear. Achilles tendon ruptures are especially common in middle aged men who occasionally participate in sport. Even though Achilles tendon ruptures are frequent, up to 25% of acute injuries are misdiagnosed, and present as chronic injuries.
This is a review article about diagnosis and management of chronic Achilles tendon ruptures. Minimally invasive Achilles tendon reconstruction is discussed.
The optimal surgical procedure is still debated, however, less invasive peroneus brevis reconstruction technique and free hamstring autograft provide good functional results.
The management of chronic ruptures is more demanding than acute tears, because of the retraction of the tendon ends, and the gap makes primary repair impossible. Wound complications and infections are frequent after open procedures. Minimally invasive treatments provide good functional results and lower complications rate.
跟腱是人体最大且最强壮的肌腱，但却是最常发生完全性皮下撕裂的肌腱之一。跟腱断裂在偶尔参加运动的中年男性中尤为常见。尽管跟腱断裂很常见，但高达25%的急性损伤会被误诊，并表现为慢性损伤。
这是一篇关于慢性跟腱断裂诊断与治疗的综述文章。文中讨论了微创跟腱重建术。
最佳手术方式仍存在争议，然而，微创的短腓骨肌重建技术和游离腘绳肌自体移植可提供良好的功能效果。
由于肌腱两端回缩，慢性跟腱断裂的处理比急性撕裂更具挑战性，且间隙使得一期修复变得不可能。开放手术术后伤口并发症和感染很常见。微创治疗可提供良好的功能效果且并发症发生率更低。
