摘要
陈旧性跟腱断裂合并皮肤缺损的治疗较为复杂，常规治疗应在局部创面愈合后３个月行二期跟腱修复。１９８５年６月～１９９６年６月采用自体肌腱或筋膜瓣移植修复跟腱，同时用伤肢邻近带血管、神经蒂岛状皮瓣覆盖，石膏托外固定，治疗陈旧性跟腱断裂合并皮肤缺损１８例。结果表明，创面Ⅰ期愈合１６例，移植皮瓣远端皮缘坏死０．５ｃｍ～１ｃｍ的２例，经早期修复治愈。术后１年以上随访１５例，其中１２例关节功能恢复正常，３例跟腱与邻近组织粘连，影响踝关节过度背屈，足部蹬力下降。认为，采用肌腱或筋膜瓣加带血管神经蒂岛状皮瓣一期修复陈旧性跟腱断裂合并皮肤缺损，可缩短疗程，减轻患者的痛苦和经济负担。
Old achilles tendon rupture accompanied by skin defect was a common & annoying problem in clinic. From June, 1985 to June, 1996, 18 cases with this kind of injury were treated by one stage repair of the tendon and skin defect. In this series, there were 15 males and 3 females, the length of tendon defects were ranged from 4 cm～6.1 cm, and the area of skin defect were ranged from 5.9 cm×3 cm to 8.2 cm×6 cm. The procedures were: ①to debridement of the wound thoroughly; ②to repair the achilles tendon; ③to repair the skin defect with kinds of pedicle flap; ④immobilization of ankle and knee for 6 weeks. No infection was occured after the operation. The flaps survived in all cases. After followup for one year in 15 cases, 12 patients went back to their work. It was concluded that ①achilles tendon rupture should be treated carfully and properly during the emergency operation; ②different methods should be selected according to the length of tendon defect; ③because of its high survival and retained sensation after operation, the flap pedicled with posterior lateral malleolar artery is the best choice for repairing the skin defect.
出处
《中国修复重建外科杂志》
CAS
CSCD
1998年第3期162-163,共2页
Chinese Journal of Reparative and Reconstructive Surgery
