So Eric, Consul Devon, Holmes Timothy
Fellow, The CORE Institute, Phoenix, AZ.
Resident, Grant Medical Center, Columbus, OH.
J Foot Ankle Surg. 2019 Jul;58(4):779-784. doi: 10.1053/j.jfas.2018.11.023. Epub 2019 Apr 20.
The treatment of neglected or chronically ruptured Achilles tendon is challenging. Various treatments for large defects associated with chronic Achilles ruptures have been described. Many surgeons recommend the use of a tendon transfer, turndown rotational flap, advancement flap, or reconstruction with Achilles tendon allograft with calcaneal bone block. Long-term outcomes of these procedures are unknown. We present 2 cases with the use of an Achilles tendon with calcaneus bone block allograft. At >8-year follow-up duration, both patients are afforded satisfactory levels of activity and are without pain or gait disturbance. This procedure is a viable option for Achilles ruptures with large defects, ruptures with small intact distal tendon portions, or re-ruptures of previously repaired Achilles tendons. The long-term outcomes of these case reports suggest that Achilles tendon reconstruction with bone block allograft is a viable option.
治疗被忽视的或慢性断裂的跟腱具有挑战性。已经描述了针对与慢性跟腱断裂相关的大缺损的各种治疗方法。许多外科医生建议使用肌腱转移、翻转旋转皮瓣、推进皮瓣或带跟骨骨块的跟腱同种异体移植进行重建。这些手术的长期效果尚不清楚。我们介绍2例使用带跟骨骨块的跟腱同种异体移植的病例。在超过8年的随访期内，两名患者的活动水平均令人满意，且无疼痛或步态障碍。对于有大缺损的跟腱断裂、远端肌腱部分完整但较小的断裂或先前修复的跟腱再次断裂，该手术是一种可行的选择。这些病例报告的长期结果表明，带骨块同种异体移植重建跟腱是一种可行的选择。
