Gorschewsky O, Vogel U, Vogel F, van Laar B
Abt. Orthopädie Permanence West, Klinik für Sporttraumatologie Bern.
Z Orthop Ihre Grenzgeb. 1997 Nov-Dec;135(6):516-21. doi: 10.1055/s-2008-1039738.
Various studies (3, 6, 9, 14, 22, 28, 30, 33) have shown that, on average (26), the surgical treatment of a freshly ruptured Achilles tendon can be considered a more appropriate and better treatment than a conservative immobilisation therapy. On the other hand the rate of complications in openly executed reconstructions is quite considerable at 11-29% (13, 19, 20, 31). It therefore seems reasonable to develop a process which, by using minimal invasive measures on the tendon, reduces the risk of complications arising from surgery and simultaneously makes an early post operative treatment encouraging maximum mobility possible.
We have developed a percutaneous tenodesis of the Achilles tendon using two Lengemann extension wires and fibrin bonding at the point of rupture (8, 18). This process has been applied to 21 patients since 1995. Check-up period for further examination: 1 year.
Exclusively male patients have been treated, average age 42 years. The Achilles tendon ruptures occurred in sporting activities and were handled with operations in an average time span of 22 hours. In one case there was a re-rupture resulting from traumatic conditions. All other results were good to very good and free of complications.
The percutaneous tenodesis of the Achilles tendon using Lengemann extension wires and fibrin bonding provides a simple, good value and reliable process which should be used for freshly occurred Achilles tendon ruptures.
Particularly worthy of mention are the problem-free treatment, the good results and the broad acceptance by the patients. These advantages make the demonstrated process ideal for routine clinical application.
多项研究（3、6、9、14、22、28、30、33）表明，平均而言（26），对于新鲜断裂的跟腱，手术治疗比保守固定治疗更合适且效果更好。另一方面，开放式重建手术的并发症发生率相当高，为11%-29%（13、19、20、31）。因此，开发一种通过对肌腱采取微创措施来降低手术引发并发症风险，同时使术后早期治疗能够鼓励最大程度活动的方法似乎是合理的。
我们采用两根伦格曼延长线并在断裂点进行纤维蛋白黏合，开发了一种经皮跟腱固定术（8、18）。自1995年以来，该方法已应用于21例患者。进一步检查的随访期为1年。
仅治疗男性患者，平均年龄42岁。跟腱断裂发生在体育活动中，平均在22小时内进行手术处理。有1例因创伤情况导致再次断裂。所有其他结果良好至非常好，且无并发症。
使用伦格曼延长线和纤维蛋白黏合的经皮跟腱固定术提供了一种简单、有价值且可靠的方法，应用于新鲜发生的跟腱断裂。
特别值得一提的是治疗过程顺利、效果良好以及患者广泛接受。这些优点使所展示的方法非常适合常规临床应用。
