论文部分内容阅读
为跟腱缺损修复提供一种新的有效的手术方法.方法 通过对42侧下肢标本解剖、观测大收肌肌腱的形态和血供的来源、走行和分布情况,设计了吻合膝降血管的大收肌肌腱游离移植修复跟腱缺损的术式.临床应用10例,其中陈旧性跟腱缺损8例,跟腱伴皮肤缺损2例,分别采用吻合血管的大收肌肌腱和大收肌肌腱－皮瓣游离移植修复.结果 全部病例随访2~8个月,THOMPSON征阴性10例,双足提踵试验阴性10例,单足提踵试验阴性8例,2例皮瓣均成活.无跟腱再断裂发生.结论 吻合血管大收肌肌腱游离移植修复跟腱缺损具有术式简单,再造跟腱外形接近正常,受区损伤小等优点.吻合血管大收肌肌腱游离移植为跟腱缺损修复提供了一种良好的方法.“,”Objective to provide a clinical method in the treatment of Achilles tendon defect. Methods Based on morphologic observation and blood supply of the adductor magnus tendon on 42 adult cadaverous lower limp specimens, free adductor magnus tendon transfer anastomosing the descending genicular vessel were designed for 10 clinical cases in the repair of Achilles tendon defect. Reconstruction of neglected Achilles tendon defect was performed with vascularized transfer of the adductor magnus tendon in 8 cases. The other 2 patients associated with the soft tissue loss were operated upon with composite free saphenous neuro- vascular flap and the adductor magnus tendon. Results The period of follow-up in all cases is 2-8 months. All of 10 reconstructed Achilles tendons showed significant improvement in “heel test” and Thompsons sign. No case had the complication of rerupture of the Achilles tendon. Conclusion The operation is a simple and ideal procedure. The vascularized adductor magnus tendon is a good donor in the reconstruction of the Achilles tendon defect.