腓肠肌腱瓣V-Y成形术治疗陈旧性跟腱断裂及其相关解剖研究

发布时间：2018-05-07 08:46

本文选题：V-Y肌腱瓣 + 跟腱断裂　；参考：《中南大学》2008年硕士论文

【摘要】： 目的:分析腓肠肌腱瓣V-Y成形术治疗陈旧性跟腱断裂的手术方法及临床疗效,并对其相关解剖进行研究,以对临床手术提供解剖依据及指导。方法:1.对我院2003年2月～2007年7月采用腓肠肌腱瓣V-Y成形术治疗陈旧性跟腱断裂患者共13例,回顾性调查其临床资料及随访,并采用Arner-lindholm评定法分析疗效;2.对30例下肢标本,不分男女,对其跟腱周围软组织浅静脉、腓肠神经、腓肠肌、比目鱼肌及跟腱等进行大体解剖并观测,再对10例腓肠肌肌腱接近平均长度的下肢标本,每组2例,分别模拟跟腱缺损3、4、5、6、7cm进行V-Y成形术手术。结果:1.全部病例随访7～60月,平均24月。优9例(69.2%),良4例(30.7%),无差级。优良率100%。2.跟腱缺损在3-6cm范围内V-Y成形术均较好进行,但跟腱缺损达7cm时,手术难度加大。结论:对于陈旧性跟腱断裂,腓肠肌腱瓣V-Y成形术是一种方法简单、疗效满意的手术方法,其主要适用于3-6cm以内的跟腱缺损,在6-7cm范围可谨慎使用,超过7cm的缺损不宜采用此术式。
[Abstract]:Objective: to analyze the operative method and clinical effect of V-Y reconstruction of gastrocnemius tendon flap for the treatment of old Achilles tendon rupture, and to study its related anatomy, so as to provide anatomic basis and guidance for clinical operation. Method 1: 1. From February 2003 to July 2007, 13 patients with old Achilles tendon rupture were treated by V-Y plasty of gastrocnemius tendon flap. The clinical data and follow-up were retrospectively investigated, and the curative effect was analyzed by Arner-lindholm method. The soft tissue superficial vein, sural nerve, gastrocnemius muscle, soleus muscle and Achilles tendon were dissected and observed in 30 cases of lower limbs, regardless of male and female, and 10 cases of lower extremities whose tendons of gastrocnemius were close to average length were studied. Two patients in each group were treated with V-Y angioplasty. The result is 1: 1. All patients were followed up for 7 ~ 60 months (mean 24 months). Excellent 9 cases were 69.2%, good 4 cases were 30.7%, no difference was found. The excellent and good rate is 100. 2. V-Y reconstruction of Achilles tendon defect was performed well in 3-6cm, but it was more difficult when Achilles tendon defect reached 7cm. Conclusion: for the old rupture of Achilles tendon, V-Y reconstruction of gastrocnemius tendon flap is a simple and effective surgical method. It is mainly suitable for Achilles tendon defect within 3-6cm, and can be used carefully in the range of 6-7cm. This procedure should not be used for defects over 7cm.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R687.2;R322

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