跟腱断裂48例临床分析

目的　探讨跟腱断裂的治疗方法及误诊原因、预防措施。方法　回顾 4 8例跟腱断裂的手术方法 ,分析其中 17例误诊的原因并提出预防对策。结果　急性跟腱断裂 2 5例 ,陈旧性跟腱断裂 2 3例 ,其中因误诊导致陈旧性跟腱断裂 17例、术后再次跟腱断裂合并感染及软组织缺损 2例。 17例中误诊为踝部软组织挫伤 8例、踝关节扭伤 9例。 4 8例患者采用不同的方法进行修复重建 ,疗效优 2 8例 ,良 18例 ,差 2例。结论　跟腱断裂后早期手术治疗效果良好 ,应根据跟腱断裂部位、缺损多少选择不同的手术方法。对疑有跟腱断裂的患者未进行认真的体检是导致跟腱断裂误诊的重要原因。避免误诊、尽早手术及循序渐进的术后康复锻炼是提高疗效的有效措施。

Clinical analysis of calcaneal tendon rupture in 48 cases

Objective To explore the treatment methods of calcaneal tendon ruptures, and analyze the reasons of misdiagnosis and preventive measures. Methods 48 case of calcaneal tendon ruptures were reviewed, of which 17 cases of misdiagonosis were studied on causes and preventive measures. Results There were 25 cases of acute tendon rupture and 23 cases of old tendon rupture altogether. Of all the old cases, there were 17 cases of misdiagnosis, and 2 cases of re-rupture combined with infection and soft tissue defect. Of all the misdiagnosed cases, 8 cases were considered as ankle soft tissue injuries, 9 cases as ankle strains. As for the outcome, 28 cases were excellent, 18 were fair, and 2 were unsatisfied. Conclusion Timely surgery is beneficial to the calcaneal tendon ruptures. Various methods should be chosen according to the ruptured position and extent of the tissue defect. Halfheartedly physical examination is the primary reason resulting in the misdiagnosis.Avoiding mistaken diagnosis, timely surgery and gradual exercises in the recovery are effective measures in guaranteeing curative effect.