Hepp W R, Blauth W
Arch Orthop Trauma Surg (1978). 1978 May 30;91(3):195-200. doi: 10.1007/BF00379751.
The authors report a dynamic plastic repair of the Achilles tendon in cases of neglected rupture: The peroneus brevis muscle is used to bridge the gap. The muscle remains intact at the proximal end, its tendon is dissected immediately above its insertion, then pulled through the calcaneus by a bore-hole and fastened to itself and to the ends of the Achilles tendon. If a plantaris tendon exists, it may be used to strengthen the defect by resecting it as far as possible proximally and then fanning it out to cover the gap. The distal end of the peroneus brevis tendon is sutured side-by-side to the peroneus longus tendon. This technique was first applied in 1968. During the last 5 years 8 patients underwent repair of the Achilles tendon by this method at the Department of Orthopaedic Surgery at the University of Kiel. In all cases the results obtained were good or excellent. The patients were very content and returned to a comparable level of preoperative activity. They were able to go as well on tip-toes as on the heels, though dorsal extension in several cases was slightly restricted. Calf atrophy up to 3 cm was found in several cases, which, however, was due partly to preoperational influences. In two cases wound healing complications occured without disturbing the functional results. The authors can recommend their technique, which seems to be superior to other methods especially in difficult cases with large gaps and unfavourably anatomic conditions.
使用腓骨短肌来桥接缺损。该肌肉在近端保持完整，在其止点上方立即切断其肌腱，然后通过跟骨钻孔将其拉过，固定于自身及跟腱两端。如果存在跖肌腱，可尽可能在近端将其切除，然后将其展开以覆盖缺损，从而加强修复效果。腓骨短肌腱的远端与腓骨长肌腱并排缝合。该技术于1968年首次应用。在过去5年中，基尔大学骨科有8例患者采用此方法修复跟腱。所有病例的结果均为良好或优秀。患者非常满意，恢复到了术前相当的活动水平。他们踮脚尖和用脚跟行走的能力相当，不过在几例病例中背伸稍有受限。在几例病例中发现小腿萎缩达3厘米，不过这部分归因于术前的影响因素。有2例出现伤口愈合并发症，但未影响功能结果。作者推荐他们的技术，该技术似乎优于其他方法，尤其是在存在大的缺损和不利解剖条件的困难病例中。
