Motta P, Errichiello C, Pontini I
Major Trauma & Burn Center, Centro Ortopedico Traumatologico, Turin, Italy.
Am J Sports Med. 1997 Mar-Apr;25(2):172-6. doi: 10.1177/036354659702500205.
The two objectives of surgical treatment of closed Achilles tendon ruptures in physically active patients are the restoration of the musculotendinous structure to its proper length and tendon healing. However, faulty wound healing and postoperative tendon rupture are just two complications that can occur. We developed a new surgical procedure that permits better tendon repair by using three specially constructed barbed wire hooks and Aldam's cutaneous approach. The integrity of the suture permits an immediate controlled movement of the ankle with a postoperative orthopaedic brace. Weightbearing can be started after 2 months. We operated on 78 physically active patients with 78 closed Achilles tendon ruptures between February 1989 and November 1994. We reexamined 71 patients after an average of 24.5 months. All the tendons had healed completely without wound complications. Early assisted movement of the ankle also helped avoid the need for functional rehabilitation. This technique is easily performed, and the immediate movement of the foot and ankle helps the remodeling of scar tissue, at the same time inhibiting the formation of skin adherences that can later interfere with full movement of the joint.
对于身体活跃的患者，闭合性跟腱断裂的手术治疗有两个目标，即恢复肌肉肌腱结构至其正常长度以及实现肌腱愈合。然而，伤口愈合不良和术后肌腱断裂只是可能出现的两种并发症。我们开发了一种新的手术方法，通过使用三个特殊构造的带刺铁丝钩和阿尔丹皮肤入路，能实现更好的肌腱修复。缝线的完整性允许术后使用矫形支具时立即对踝关节进行可控活动。术后2个月后可开始负重。1989年2月至1994年11月期间，我们对78例身体活跃且患有78处闭合性跟腱断裂的患者进行了手术。平均24.5个月后，我们对71例患者进行了复查。所有肌腱均完全愈合，无伤口并发症。早期辅助踝关节活动也有助于避免进行功能康复训练。该技术操作简便，足部和踝关节的即时活动有助于瘢痕组织重塑，同时抑制可能随后干扰关节充分活动的皮肤粘连形成。
