摘要
目的探讨抗生素骨水泥联合V-Y腱成形术治疗跟腱断裂合并感染的疗效。方法 2014-01/2016-01月治疗跟腱断裂合并感染患者15例,其中男9例,女6例;年龄17~55(28±1.4)岁;7例初始损伤为开放伤合并感染,5例为闭合断裂伤术后感染,3例为陈旧性跟腱断裂合并感染。I期彻底清创后跟腱缺损长度为4~8(6±1.5)cm,在跟腱缺损处填塞抗生素骨水泥,对周围皮肤缺损较大者行皮瓣移植。感染控制后Ⅱ期取出抗生素骨水泥,应用V-Y腱成形术修复跟腱,术后末次随访采用美国骨科足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝关节与后足功能评分系统和Leppilahti跟腱修复评分系统进行疗效评定。结果本组患者均获得随访,随访时间11~24(16±2.5)个月,其中,1例出现踝关节僵直。AOFAS后足功能评分由术前(57.6±1.5)分明显提高至术后末次随访的(91.3±1.3)分,Leppilahti跟腱修复评分由术前(41.9±1.6)分明显提高至术后末次随访的(86.9±1.4)分,前后比较差异具有统计学意义(P<0.01)。结论抗生素骨水泥联合V-Y腱成形术不仅能有效控制跟腱感染而且能较完整的修复缺损跟腱,是一种治疗跟腱缺损合并感染的有效方法。
Objective To investigate effect of the antibiotic bone cement combining with V-Y tenoplasty in treatment of Achilles tendon rupture with infection.Methods From January 2014 to January 2016,15 Achilles tendon rupture cases with infection were treated.Among them,9 were male and 6 were female,the age was ranged from17 to 55（28±1.4）years.7 cases were initial open wound with infection,5 cases were postoperative infection of closed rupture,and 3 cases were old Achilles tendon rupture combining with infection.The Achilles tendon defect length was ranged from4 to 8（6±1.5）cm at stage I after debridement.The defect of achilles tendon was filled with antibiotic bone cement,and more damage of surrounding skin received flap transplantation.Achilles tendon was taken out antibiotic bone cement after infection control at stage II and repaired by V-Y tenoplasty.The therapeutic effects of last postoperative follow-up were measured by American Orthopaedic Foot and Ankle Society（AOFAS）,hindfoot score system and Leppilahti scoring system.Results All patients were followed up from11 to 24（16.0±2.5）months.One of them was ankle stiffness.AOFAS ankle hindfoot scores were improved from preoperative scores（57.6±1.5）to the last follow-up scores（91.3±1.3）,and it was significant difference between them（P〈0.01）.Leppilahti scores of achilles tendon repair were increased from preoperative to the last follow-up[（41.9±1.6）,（86.9±1.4）,P〈0.01].Conclusion The antibiotic bone cement combine with V-Y tenoplasty that can not only effectively control infection but also complete achilles tendon defect repair.It is an effective method for treatment of infection with the Achilles tendon defect.
出处
《华南国防医学杂志》
CAS
2017年第1期40-42,共3页
Military Medical Journal of South China
关键词
抗生素骨水泥
V-Y腱成形术
跟腱断裂
Antibiotic bone cement
V-Y tendoplasty
Achilles tendon rupture
