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[1]朱彥昭,申成春,蔣麗娜,等.改良Krackow技術(shù)治療跟腱缺血區(qū)斷裂[J].中醫(yī)正骨,2015,27(05):52-54.
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改良Krackow技術(shù)治療跟腱缺血區(qū)斷裂()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年05期
頁碼:
52-54
欄目:
臨床報道
出版日期:
2015-05-30

文章信息/Info

作者:
朱彥昭申成春蔣麗娜黃雷張峰徐榮明
浙江省寧波市第六醫(yī)院,浙江 寧波 315040
關(guān)鍵詞:
跟腱 腱損傷 跟腱斷裂 改良Krackow技術(shù)
摘要:
目的:探討應(yīng)用改良Krackow技術(shù)治療跟腱缺血區(qū)斷裂的臨床療效和安全性。方法:2010年3月至2013年3月收治32例跟腱缺血區(qū)斷裂患者,男26例,女6例。年齡22~45歲,中位數(shù)33.5歲。左側(cè)14例,右側(cè)18例。體格檢查示跟腱局部可觸及明顯凹陷、Thompson征陽性、患足跖屈力量減弱、提踵試驗陽性。術(shù)前X線片確認無跟骨骨折及骨質(zhì)疏松; MRI檢查確認跟腱缺血區(qū)完全斷裂,斷端分離均超過2 cm。均有明確外傷史,受傷至手術(shù)時間1~4 d,中位數(shù)2.5 d。采用改良Krackow技術(shù)縫合斷裂的跟腱,采用美國足與踝關(guān)節(jié)協(xié)會(American orthopaedic foot and ankle society,AOFAS)踝-后足功能評分標準和Arner Lindholm評分標準評定手術(shù)療效,并隨訪觀察并發(fā)癥發(fā)生情況。結(jié)果:所有患者均順利完成手術(shù),術(shù)中未發(fā)生重要血管、神經(jīng)損傷,術(shù)后跟腱斷端凹陷消失,跟腱連續(xù)性恢復(fù)。所有患者均獲隨訪,隨訪時間12~36個月,中位數(shù)18.5個月。1例患者發(fā)生切口感染,給予清創(chuàng)、換藥后切口愈合,其余患者的切口均甲級愈合。無皮膚壞死、瘢痕攣縮、跟腱再斷裂、腓腸神經(jīng)瘤等并發(fā)癥發(fā)生。所有患者均恢復(fù)正常生活; 19例患者對手術(shù)效果非常滿意,13例對手術(shù)效果基本滿意; 除2例因其他原因改變職業(yè)外,其余患者均恢復(fù)原來工作。術(shù)后12個月時患者AOFAS踝-后足功能評分由術(shù)前(44.2±6.9)分提高至(96.7±5.4)分,按Arner Lindholm標準評定,優(yōu)26例、良6例。結(jié)論:應(yīng)用改良Krackow技術(shù)治療跟腱缺血區(qū)斷裂,操作簡單、并發(fā)癥少、踝關(guān)節(jié)功能恢復(fù)好,值得推廣應(yīng)用。

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備注/Memo

備注/Memo:
2015-03-09收稿 2015-04-29修回
通訊作者:朱彥昭 E-mail:[email protected]
更新日期/Last Update: 2015-05-30