摘要
目的：探讨肌肉包埋法旷置大段裸露跟腱并二期修复治疗伴皮肤缺损的跟腱断裂的手术方法和疗效。方法对自2005年8月至2014年4月收治的32例伴皮肤缺损的跟腱断裂患者资料进行回顾性分析，其中男21例，女11例；年龄23～69岁，平均（46．2±3．5）岁，所有患者均伴有小腿后侧近踝部软组织碾挫伤、皮肤缺损，范围为3 cm ×4 cm ～5 cm ×12 cm，跟腱自止点近端2～4 cm 断裂、抽脱、游离，完全裸露。所有患者均采用小腿三头肌肌肉包埋法旷置大段裸露跟腱并二期修复跟腱断裂、同时转移皮瓣修复皮肤缺损，术后随访患者，按 Arner-Lindholm 疗效评定标准对其进行疗效评定。结果术后随访11～32个月，平均18个月。疗效评定，优22例，良7例，差3例，优良率为90．62％。结论肌肉包埋法旷置大段裸露跟腱并二期修复治疗伴严重皮肤缺损的跟腱断裂，有利于患者功能的及早恢复。
Objective To discuss the methods and evaluate the effects of initial muscle-enclosing protection of large segment of exposed Achilles tendon and second stage repair of Achilles tendon rupture complicated with cuta-neous defect.Methods Among patients treated between August 2005 to April 2014 in our hospital,there were 32 patients,who were diagnosed with Achilles tendon rupture complicated with cutaneous defect.Of the 32 patients, there are 21 male and 11 female.Their ages range from 23 to 69,with an average age of 46.2 ±3.5.In all the patients＆amp;nbsp;described above,there are soft tissue contusion injuries and cutaneous defects on their posterior lower legs near the ankles,with the area of skin defects ranging from 3cm ×4cm to 5 ×12cm,and the Achilles tendons were ruptured, extracted,dissociated and completely uncovered.All patients were initially treated with triceps surae muscle-enclosing method to put aside and protect the large segment of exposed Achilles tendon.Later,the ruptured Achilles tendons were repaired,together with the transfer of skin flap to repair skin defects,at the second stage.The therapeutic effects were evaluated during postoperative follow-up periods.Results The mean follow-up period was 18 months,ranged from 11 to 32 months.According to the therapeutic effect evaluation standard of Arner-Lindholm,there were Excellent results in 22 patients,Good in 7 cases and Poor in 3 cases,with a combined excellent/good rate of 90.62%.Conclusion Initial muscle-enclosing protection of large segment of exposed Achilles tendon and second stage repair of Achilles tendon rupture complicated with cutaneous defect is advantageous to the function of patients with rapid recovery.
出处
《中国基层医药》
CAS
2016年第2期285-288,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
肌肉包埋
跟腱
创伤和损伤
皮肤缺损
修复
Muscle-enclosing
Achilles tendon
Trauma and injure
Cutaneous defect
Repair
