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治疗插入性跟腱病的手术策略

Surgical Strategies for the Treatment of Insertional Achilles Tendinopathy.

作者信息

Barg Alexej, Ludwig Todd

机构信息

Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.

Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.

出版信息

Foot Ankle Clin. 2019 Sep;24(3):533-559. doi: 10.1016/j.fcl.2019.04.005. Epub 2019 Jun 18.

Abstract

Insertional Achilles tendinopathy is one of the most common Achilles tendon disorders and often results in substantial heel pain and functional disability. There is consensus that treatment of insertional Achilles tendinopathy should start with nonoperative modalities. Surgery should be reserved for patients who fail exhaustive conservative treatment for a period of 3 months to 6 months and include débridement of insertional calcifications. Intratendinous degenerative tissue should be débrided and any Haglund deformity resected. Different surgical techniques have been described for reattachment of the distal Achilles tendon. The authors' preferred surgical technique includes the knotless double-row footprint reconstruction. Postoperative complications are not rare.

摘要

插入性跟腱病是最常见的跟腱疾病之一,常导致严重的足跟疼痛和功能障碍。目前的共识是,插入性跟腱病的治疗应从非手术方式开始。手术应保留给经过3至6个月彻底保守治疗仍失败的患者,手术包括清除插入部的钙化灶。应清除腱内的退变组织,并切除任何Haglund畸形。对于跟腱远端的重新附着,已经描述了不同的手术技术。作者首选的手术技术包括无结双排足迹重建。术后并发症并不少见。

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