改良经皮与开放跟腱延长术治疗跟腱挛缩症疗效比较_《中国修复重建外科杂志》

作者：

谢美明 , 李伟 , 谢庆云 , 蒋凯 , 张波 , 潘显明

成都军区总医院骨科（成都，610083）;

关键词：

跟腱挛缩症改良经皮小切口跟腱延长术开放跟腱延长术跟腱修复

DOI：

10.7507/1002-1892.20130037

视频：

导出 下载 收藏 扫码 引用

摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的通过与开放跟腱延长术比较，探讨改良经皮小切口跟腱延长术治疗跟腱挛缩症的疗效。方法回顾分析2008年5月－2012年5月收治并符合纳入标准的42例跟腱挛缩症患者临床资料。其中19例（19足）采用改良经皮小切口跟腱延长术（试验组），术中根据跟腱挛缩程度分别于跟腱内、外侧不同平面作长约0.5 cm横切口，根据足内、外翻畸形决定跟腱半切平面，在跟腱内、外侧分别半切跟腱；23例（24足）采用开放跟腱延长术（对照组）。两组患者性别、年龄、病程、踝关节背伸活动度、Hannover跟腱评分等一般资料比较，差异均无统计学意义（P gt; 0.05），具有可比性。结果与对照组比较，试验组手术时间及术后住院时间均缩短，术中出血量显著减少，比较差异均有统计学意义（P lt; 0.05）。术后对照组1例发生切口感染，其余患者切口均Ⅰ期愈合。两组患者均获随访，试验组随访时间6～35个月，对照组8～34个月。试验组1例足内翻矫形不明显，其余足内外翻畸形均矫形满意。两组末次随访时踝关节背伸活动度及Hannover跟腱评分与术前比较，差异均有统计学意义（P lt; 0.05），两组间比较差异均无统计学意义（P gt; 0.05）。除对照组1例双足患者外，其余两组患者患侧踝关节背伸活动度及Hannover跟腱评分与健侧比较，差异均有统计学意义（P lt; 0.05）。结论改良经皮小切口跟腱延长术治疗跟腱挛缩症疗效与开放跟腱延长术相似，且具有创伤小、恢复快、有效矫正足内、外翻畸形等优点。

引用本文： 谢美明,李伟,谢庆云,蒋凯,张波,潘显明. 改良经皮与开放跟腱延长术治疗跟腱挛缩症疗效比较. 中国修复重建外科杂志, 2013, 27(2): 164-168. doi: 10.7507/1002-1892.20130037 复制

1.	Greenhagen RM, Johnson AR, Bevilacqua NJ. Gastrocnemius recession or tendo-achilles lengthening for equinus deformity in the diabetic foot? Clin Podiatr Med Surg, 2012, 29(3): 413-424.
2.	彭程, 孙大川, 黄淮, 等. 微创跟腱延长术联合系统康复治疗跟腱挛缩畸形. 中国骨伤, 2012, 25(1): 78-79.
3.	Stauff MP, Kilgore WB, Joyner PW, et al. Functional outcome after percutaneous tendo-Achilles lengthening. Foot Ankle Surg, 2011, 17(1): 29-32.
4.	谢美明, 唐康来, 邓银栓, 等. 经皮双向半切跟腱延长治疗跟腱挛缩症. 中华医学杂志, 2012, 92(33): 2345-2348.
5.	Thermann H, Zwipp H, Tscherne H. Functional treatment concept of acute rupture of the Achilles tendon. 2 years results of a prospective randomized study. Unfallchirurg, 1995, 98(1): 21-32.
6.	Magnusson SP, Narici MV, Maganaris CN, et al. Human tendon behaviour and adaptation, in vivo. J Physiol, 2008, 586(1): 71-81.
7.	Chang HJ, Burke AE, Glass RM. JAMA patient page. Achilles tendinopathy. JAMA, 2010, 303(2): 188.
8.	初海坤, 徐衍斌, 初海鹏, 等. 改良经皮缝合法与开放缝合法修复新鲜闭合性跟腱断裂的疗效比较. 中国修复重建外科杂志, 2012, 26(6): 708-711.
9.	Hoefnagels EM, Waites MD, Belkoff SM, et al. Percutaneous Achilles tendon lengthening: a cadaver-based study of failure of the triple hemisection technique. Acta Orthop, 2007, 78(6): 808-812.
10.	覃承诃, 肖庭辉, 金丹, 等. Sheffield足踝U型外固定支架治疗重度跟腱挛缩畸形. 中华创伤骨科杂志, 2011, 13(8): 787-789.
11.	Sugisaki N, Kawakami Y, Kanehisa H, et al. Effect of muscle contraction levels on the force-length relationship of the human Achilles tendon during lengthening of the triceps surae muscle-tendon unit. J Biomech, 2011, 44(11): 2168-2171.
12.	Farshad M, Gerber C, Snedeker JG, et al. Helical cutting as a new method for tendon-lengthening in continuity. J Bone Joint Surg (Am), 2011, 93(8): 733-738.
13.	Maquirriain J. Achilles tendon rupture: avoiding tendon lengthening during surgical repair and rehabilitation. Yale J Biol Med, 2011, 84(3): 289-300.
14.	Salamon ML, Pinney SJ, Van Bergeyk A, et al. Surgical anatomy and accuracy of percutaneous achilles tendon lengthening. Foot Ankle Int, 2006, 27(6): 411-413.
15.	张天久, 俞松, 杨小红, 等. 跟腱延长前移术治疗脑性瘫痪痉挛型马蹄足的疗效. 实用儿科临床杂志, 2012, 27(10): 795-796, 799.
16.	Majewski M, Rohrbach M, Czaja S, et al. Avoiding sural nerve injuries during percutaneous Achilles tendon repair. Am J Sports Med, 2006, 34(5): 793-798.

1. Greenhagen RM, Johnson AR, Bevilacqua NJ. Gastrocnemius recession or tendo-achilles lengthening for equinus deformity in the diabetic foot? Clin Podiatr Med Surg, 2012, 29(3): 413-424.
2. 彭程, 孙大川, 黄淮, 等. 微创跟腱延长术联合系统康复治疗跟腱挛缩畸形. 中国骨伤, 2012, 25(1): 78-79.
3. Stauff MP, Kilgore WB, Joyner PW, et al. Functional outcome after percutaneous tendo-Achilles lengthening. Foot Ankle Surg, 2011, 17(1): 29-32.
4. 谢美明, 唐康来, 邓银栓, 等. 经皮双向半切跟腱延长治疗跟腱挛缩症. 中华医学杂志, 2012, 92(33): 2345-2348.
5. Thermann H, Zwipp H, Tscherne H. Functional treatment concept of acute rupture of the Achilles tendon. 2 years results of a prospective randomized study. Unfallchirurg, 1995, 98(1): 21-32.
6. Magnusson SP, Narici MV, Maganaris CN, et al. Human tendon behaviour and adaptation, in vivo. J Physiol, 2008, 586(1): 71-81.
7. Chang HJ, Burke AE, Glass RM. JAMA patient page. Achilles tendinopathy. JAMA, 2010, 303(2): 188.
8. 初海坤, 徐衍斌, 初海鹏, 等. 改良经皮缝合法与开放缝合法修复新鲜闭合性跟腱断裂的疗效比较. 中国修复重建外科杂志, 2012, 26(6): 708-711.
9. Hoefnagels EM, Waites MD, Belkoff SM, et al. Percutaneous Achilles tendon lengthening: a cadaver-based study of failure of the triple hemisection technique. Acta Orthop, 2007, 78(6): 808-812.
10. 覃承诃, 肖庭辉, 金丹, 等. Sheffield足踝U型外固定支架治疗重度跟腱挛缩畸形. 中华创伤骨科杂志, 2011, 13(8): 787-789.
11. Sugisaki N, Kawakami Y, Kanehisa H, et al. Effect of muscle contraction levels on the force-length relationship of the human Achilles tendon during lengthening of the triceps surae muscle-tendon unit. J Biomech, 2011, 44(11): 2168-2171.
12. Farshad M, Gerber C, Snedeker JG, et al. Helical cutting as a new method for tendon-lengthening in continuity. J Bone Joint Surg (Am), 2011, 93(8): 733-738.
13. Maquirriain J. Achilles tendon rupture: avoiding tendon lengthening during surgical repair and rehabilitation. Yale J Biol Med, 2011, 84(3): 289-300.
14. Salamon ML, Pinney SJ, Van Bergeyk A, et al. Surgical anatomy and accuracy of percutaneous achilles tendon lengthening. Foot Ankle Int, 2006, 27(6): 411-413.
15. 张天久, 俞松, 杨小红, 等. 跟腱延长前移术治疗脑性瘫痪痉挛型马蹄足的疗效. 实用儿科临床杂志, 2012, 27(10): 795-796, 799.
16. Majewski M, Rohrbach M, Czaja S, et al. Avoiding sural nerve injuries during percutaneous Achilles tendon repair. Am J Sports Med, 2006, 34(5): 793-798.

上一篇
血友病足踝部病变的外科治疗
下一篇
累及跟距关节及跟骰关节损伤的跟骨骨折手术治疗

《中国修复重建外科杂志》

改良经皮与开放跟腱延长术治疗跟腱挛缩症疗效比较

摘要 全文 图表 视频 参考文献 施引文献 补充材料

上一篇

下一篇

Format

Content

《中国修复重建外科杂志》

改良经皮与开放跟腱延长术治疗跟腱挛缩症疗效比较

摘要 全文 图表 视频 参考文献 施引文献 补充材料

上一篇

下一篇

Format

Content

摘要全文图表视频参考文献施引文献补充材料