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[陈旧性跟腱断裂的重建:拇长屈肌转移术与腓肠肌翻转皮瓣术的比较]

[Reconstruction of neglected Achilles tendon rupture: flexor hallucis longus transfer versus gastrocnemius turn-down flaps].

作者信息

Zhao F, Hu Y L, Jiao C, Jiang D, Guo Q W

机构信息

Institute of Sports Medicine, Peking University Third Hospital, Beijing 100191, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2019 Feb 19;99(7):542-546. doi: 10.3760/cma.j.issn.0376-2491.2019.07.013.

Abstract

To compare the outcome of either flexor hallucis longus transfer or turn-down of proximal Achilles tendon tissue repair in treating chronic Achilles tendon rupture. The clinical data of 21 patients who underwent repair of Myerson type Ⅲ chronic Achilles tendon rupture at Peking University Sports Medicine Research Institute from May 2012 to March 2015 were retrospectively analyzed. Among them, 11 cases were treated with flexor hallucis longus (FHL) transfer, and 10 cases were treated with gastrocnemius turn-down flaps repair. The American Orthopedic Foot & Ankle Society (AOFOS) hindfoot score and Tegner motor function score before and after surgery were recorded and compared between the two groups. Data comparison between groups was performed with test. The patients in the both group were followed up for an average of (21±7) months. The postoperative AOFOS hindfoot score in the long flexor and gastrocnemius groups were both significantly higher than those before surgery, and the differences were statistically significant (97.7±2.6 vs 72.0±8.1 and 96.0±5.5 vs 78.5±6.4, 10.70, 6.42, both 0.05).The postoperative Tegner scores of the two groups were also significantly higher than those before surgery (4.2±1.4 vs 0.7±0.4 and 4.1±0.8 vs 0.6±0.5,7.29, 9.35, both 0.05). There were no significant differences in postoperative AOFOS hindfoot scores and Tegner motor function scores between the two groups (both 0.05). The flexor hallucis longus transfer and turn-down of proximal Achilles tendon tissue repair can both get satisfactory results in treating chronic Achilles tendon rupture.

摘要

比较踇长屈肌转移术与近端跟腱组织翻转修复术治疗慢性跟腱断裂的疗效。回顾性分析2012年5月至2015年3月在北京大学运动医学研究所接受MyersonⅢ型慢性跟腱断裂修复术的21例患者的临床资料。其中,11例行踇长屈肌(FHL)转移术,10例行腓肠肌翻转皮瓣修复术。记录并比较两组患者手术前后的美国矫形足踝协会(AOFOS)后足评分和Tegner运动功能评分。组间数据比较采用检验。两组患者平均随访(21±7)个月。长屈肌组和腓肠肌组术后AOFOS后足评分均显著高于术前,差异有统计学意义(97.7±2.6对72.0±8.1以及96.0±5.5对78.5±6.4,t值分别为10.70、6.42,均P<0.05)。两组术后Tegner评分也显著高于术前(4.2±1.4对0.7±0.4以及4.1±0.8对0.6±0.5,t值分别为7.29、9.35,均P<0.05)。两组术后AOFOS后足评分和Tegner运动功能评分比较差异均无统计学意义(均P>0.05)。踇长屈肌转移术与近端跟腱组织翻转修复术治疗慢性跟腱断裂均可取得满意疗效。

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