Smith D G, Sangeorzan B J, Hansen S T, Burgess E M
University of Washington, Seattle 98102.
Foot Ankle Int. 1994 Jan;15(1):14-7. doi: 10.1177/107110079401500104.
In an attempt to prevent migration of the heel pad, 11 patients underwent a combined Syme's amputation and Achilles tendon tenodesis between December 1989 and April 1992. Ten patients healed the Syme's amputation, and one patient failed to heal the surgical wounds and required a below-knee amputation. In all 10 successful Syme's cases, the heel pad has remained stable with no migration, and no skin breakdown at an average follow-up of 18.5 months. Published series of Syme's amputations report that the incidence of heel pad migration is between 7.5% and 45%, and occurs primarily in the post-operative or early rehabilitation stage. We believe that tenodesis of the Achilles tendon is a technically easy addition to the Syme's amputation, that it keeps tension off of the incision during healing, and that it prevents migration of the heel pad.
为防止足跟垫移位，1989年12月至1992年4月期间，11例患者接受了Syme截肢术联合跟腱固定术。10例患者的Syme截肢术愈合，1例患者手术伤口未愈合，需要进行膝下截肢。在所有10例成功的Syme手术病例中，足跟垫保持稳定，无移位，平均随访18.5个月无皮肤破损。已发表的Syme截肢术系列报告称，足跟垫移位的发生率在7.5%至45%之间，主要发生在术后或早期康复阶段。我们认为，跟腱固定术在技术上是Syme截肢术的一个简单补充，它在愈合过程中减轻了切口的张力，并防止了足跟垫的移位。
