Carmont Michael R, Saha Arunansu, Rhind John-Henry, Nilsson Niklas, Karlsson Jón, Nilsson-Helander Katarina
Department of Trauma & Orthopaedic Surgery, Princess Royal Hospital, The Shrewsbury and Telford Hospital NHS Trust, Shropshire, UK.
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
Video J Sports Med. 2021 Sep 9;1(5):26350254211021859. doi: 10.1177/26350254211021859. eCollection 2021 Sep-Oct.
Chronic ruptures of the Achilles tendon may lead to symptomatic weakness, despite rehabilitation. Open reconstruction yields good outcome but has a high complication rate, notably wound problems. Endoscopically assisted free semitendinosus transfer restores ankle and preserves first metatarsophalangeal joint (MTPJ) function.
The main indication for the procedure is symptomatic chronic rupture of the Achilles tendon with a palpable tendon gap.
The procedure can be split into 4 stages: graft harvest, calcaneum and tunnel preparation, proximal graft attachment, and finally graft passage and screw insertion.
DISCUSSION/CONCLUSION: Following reconstruction, patients use a cast in full plantar flexion for 2 weeks, then a graduated walker for full weight-bearing.
尽管进行了康复治疗，跟腱慢性断裂仍可能导致有症状的无力。开放重建效果良好，但并发症发生率高，尤其是伤口问题。内镜辅助下游离半腱肌转移可恢复踝关节功能并保留第一跖趾关节（MTPJ）功能。
该手术的主要适应症是有症状的跟腱慢性断裂且可触及肌腱间隙。
该手术可分为4个阶段：取腱、跟骨和隧道准备、移植物近端附着，最后是移植物通过和螺钉插入。
讨论/结论：重建后，患者在全足底屈曲位使用石膏固定2周，然后使用渐进式助行器进行完全负重。
