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内镜下长屈肌腱转移治疗慢性跟腱断裂:技术要点与短期经验

Endoscopic Transfer of Flexor Hallucis Longus Tendon for Chronic Achilles Tendon Rupture: Technical Aspects and Short-Time Experiences.

作者信息

Husebye Elisabeth Ellingsen, Molund Marius, Hvaal Kjetil Harald, Stødle Are Haukåen

机构信息

Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway (EEH, KHH, AHS).

Department of Orthopaedic Surgery, Ostfold Hospital, Grålum, Norway (MM).

出版信息

Foot Ankle Spec. 2018 Oct;11(5):461-466. doi: 10.1177/1938640017754234. Epub 2018 Jan 17.

Abstract

BACKGROUND

Chronic Achilles tendon ruptures can lead to reduced power of plantar flexion in the ankle with impaired gait ability. The open 1- or 2-incision technique for flexor hallucis longus transfer has proven good functional outcome but has the disadvantage of relatively extensive surgery performed at a vulnerable location. To reduce the risk of soft tissue problems, the flexor hallucis longus transfer can be performed endoscopically.

MATERIAL AND METHOD

An endoscopic technique for flexor hallucis longus transfer is presented together with the experiences from the first six patients operated with this method.

RESULTS

No wound healing problems or infections. Five of 6 patients managed single leg heel raise on the affected side 12 months after surgery.

CONCLUSION

The functional results are promising. The soft tissue dissection is minor, and no patients had postoperative wound healing problems or infection. Endoscopic flexor hallucis longus transfer may be an operative procedure that can be considered also in patients with potential wound healing problems.

LEVELS OF EVIDENCE

Level IV: Technical note/case series without controls.

摘要

背景

慢性跟腱断裂可导致踝关节跖屈力量减弱,步态能力受损。用于拇长屈肌转移的单切口或双切口开放技术已被证明具有良好的功能效果,但存在在易受损部位进行相对广泛手术的缺点。为降低软组织问题的风险,拇长屈肌转移可通过内镜进行。

材料与方法

介绍了一种拇长屈肌转移的内镜技术以及采用该方法进行手术的首批6例患者的经验。

结果

无伤口愈合问题或感染。6例患者中有5例在术后12个月能够患侧单腿提踵。

结论

功能结果令人满意。软组织分离范围小,无患者出现术后伤口愈合问题或感染。内镜下拇长屈肌转移术可能也是一种可考虑用于有潜在伤口愈合问题患者的手术方法。

证据级别

四级:无对照的技术说明/病例系列。

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