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内镜下拇长屈肌转位治疗慢性跟腱断裂——技术描述及早期术后结果

Endoscopic Flexor Halluces Longus transfer for Chronic Achilles Tendon rupture - technique description and early post-operative results.

作者信息

Baumfeld Daniel, Baumfeld Tiago, Figueiredo André Rocha, de Araujo Junior Luis Fernando, Macedo Benjamim, Silva Thiago Alexandre Alves, Raduan Fernando, Nery Caio

机构信息

Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.

Hospital Madre Teresa, Belo Horizonte, Brazil.

出版信息

Muscles Ligaments Tendons J. 2017 Sep 18;7(2):341-346. doi: 10.11138/mltj/2017.7.2.341. eCollection 2017 Apr-Jun.

Abstract

BACKGROUND

Achilles tendon ruptures may lead to proximal retraction of the stump if not treated acutely, increasing the chances of poorer functional outcomes. The flexor halluces longus transfer is a well-established treatment option, usually performed as an open procedure. The aim of this paper is to report the preliminary results and describe the technique of endoscopic flexor halluces longus transfer.

MATERIAL AND METHODS

Six patients with chronic Achilles tendon injuries or re-ruptures were treated with endoscopic FHL transfer. The Achilles Tendon Rupture Score was used to clinically evaluate the patients. Single leg heel rise ability, functional hallux weakness, complications and procedure length were also checked.

RESULTS

On average, we took 56 minutes to perform the surgery. All patients had a major increase in the ATRS score value postoperatively. Single leg heel rise was possible for all patients without limitation. None of the patients noticed functional weakness of the hallux during daily life activity and no wound or soft tissue complications were seen.

CONCLUSION

Endoscopic FLH transfer is a reliable option for patients with high skin risk and soft tissue complications. Other studies are needed to compare this technique with the open procedure, gold standard by now, to ensure its safety and efficacy.

LEVEL OF EVIDENCE

摘要

背景

跟腱断裂若未及时治疗,可能导致残端近端回缩,增加功能预后较差的几率。拇长屈肌转移术是一种成熟的治疗选择,通常作为开放手术进行。本文旨在报告初步结果并描述内镜下拇长屈肌转移术的技术。

材料与方法

6例慢性跟腱损伤或再断裂患者接受了内镜下拇长屈肌转移术治疗。采用跟腱断裂评分对患者进行临床评估。还检查了单腿提踵能力、拇趾功能无力、并发症及手术时长。

结果

手术平均用时56分钟。所有患者术后跟腱断裂评分值均大幅提高。所有患者均能无限制地进行单腿提踵。所有患者在日常生活活动中均未察觉到拇趾功能无力,且未出现伤口或软组织并发症。

结论

内镜下拇长屈肌转移术对于皮肤风险高和有软组织并发症的患者是一种可靠的选择。需要进行其他研究,将该技术与目前的金标准开放手术进行比较,以确保其安全性和有效性。

证据级别

4级。

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