自体肌腱移植修复陈旧性跟腱损伤△

Repair of old Achilles tendon rupture by tendon autografts

摘要:

[目的] 评价自体肌腱移植修复陈旧性跟腱损伤的临床疗效。[方法] 回顾性分析 2016 年 7 月—2021 年 10 月自体肌腱移植修复陈旧性跟腱损伤 7 例患者的临床资料，评价围手术期及随访结果。[结果] 所有患者术程顺利，手术时间 （106.4±13.6）min，术中出血量（35.3±12.3）ml，断端缺损（5.1±2.1）cm，住院时间平均（11.6±1.3）d。所有患者切口均Ⅰ期愈合。随访时间 （46.1±19.6） 个月。随着术前、术后 6 个月和末次随访的时间推移，VAS 评分显著减少 [(2.9±0.9), (1.7±0.8), (0.6±0.5), P＜0.001]，AOFAS 评分 [(57.4±10.0), (81.1±4.5), (95.1±4.0), P＜0.001]、踝 ROM [(27.4±3.0)°, ( 50.3±3.3)°, ((56.6±3.5)°, P＜ 0.001]、ATRS 评分 [(41.1±5.8), (71.6±4.4), (93.3±4.2), P＜0.001] 均显著增加，三头肌肌力 [例, III/IV/V, (7/0/0), (0/2/5), (0/0/7), P＜ 0.001] 显著改善。[结论]对于陈旧性跟腱损伤，应用腓骨长肌腱或半腱肌移植修复仍可取得满意的临床疗效。

Abstract:

[Objective] To evaluate the clinical efficacy of repair of old Achilles tendon injury with tendon autografts. [Methods] A retrospective study was conducted on 7 patients who had old Achilles tendon rupture repaired by tendon autografts from July 2016 to October 2021. The documents regarding to perioperative period and follow-up were evaluated. [Results] All patients had Achilles tendon repaired smoothly with operation time of (106.4±13.6) min, intraoperative blood loss of (35.3±12.3) ml, tendon defect of the broken end of (5.1±2.1) cm, and hospital stay of (11.6±1.3) days. All patients got incision healed in stage I and followed up for (46.1±19.6) months. As time went from the point preoperatively, 6 months postoperatively to the latest follow-up, the VAS score significantly reduced [(2.9±0.9), (1.7±0.8), (0.6±0.5), P＜0.001], whereas AOFAS score [(57.4±10.0), (81.1±4.5), (95.1±4.0), P＜0.001], ankle ROM [(27.4±3.0)°, (50.3±3.3)°, (56.6± 3.5)°, P＜0.001], ATRS score [(41.1±5.8), (71.6±4.4), (93.3±4.2), P＜0.001] significantly increased, and triceps muscle strength [case, III/IV/ V (7/0/0), (0/2/5), (0/0/7), P＜0.001] improved significantly. [Conclusion] For the old Achilles tendon rupture, repair with tendon autografts, such as peroneus longus or semitendinosus, can still achieve satisfactory clinical consequence.