高频超声对闭合性跟腱断裂重建术的应用价值

目的研究高频超声对闭合性跟腱损伤重建术的术前评估价值。方法30例跟腱疾病患者行高频超声检查，判断有无跟腱断裂、断裂范围（完全断裂或不完全断裂）、记录断裂部位（断端距跟骨止点的距离）、断端分离长度，并与临床及手术相对照。结果30例患者中完全断裂25例，不完全断裂5例（2例超声未检出）。损伤位置：位于跟腱ˉ跟骨连接部2例，跟腱ˉ肌腹连接部3例，跟腱中部25例（其中位于跟骨止点上方2-5 cm处24例），断裂部位以跟腱中部居多（83%）。断端分离程度：急性跟腱断裂（20例）中，14例断端分离≤3 cm、6例断端分离＞3 cm；陈旧性跟腱断裂（10例）中，9例断端分离＞3 cm、1例断端分离≤3 cm，陈旧性跟腱断裂患者以分离长度大于3 cm为主；急性跟腱断裂与陈旧性跟腱断裂相较，差异有统计学意义（P〈0.01）。与手术对照，完全断裂患者25例，超声及临床诊断符合率均为100%；不完全断裂患者5例，超声漏诊2例，诊断符合率为60%，临床误诊1例，诊断符合率为80%。结论高频超声对闭合性跟腱断裂尤其是完全断裂诊断符合率高，可为跟腱断裂重建术提供详尽的术前信息，具有较好的临床实用价值。

Value of high-frequency ultrasonography in closed Achilles tendon rupture

ObjectiveTo assess the value of high-frequency ultrasonography（US）in closed Achilles tendon rupture. Methods Thirty patients with clinically suspected Achilles tendon injury underwent US. The presence, extent, location and size of tendon rupture were correlated with surgery.Results The tendon rupture was complete（25/30）or partial（5/30）, located at the calcaneal attachment（2/30）, musculotendinous junction（3/30）, 2-5 cm above the calcaneal tubercle（24/30）or higher（1/30）. The size of tendinous gap in complete tendon rupture was ≤3cm（14/20）or 〉3cm（6/20）whereas chronic rupture was 〉3cm（9/10）or ≤3cm （1/10）. All 25 complete ruptures were diagnosed correctly on US and clinical examination. Partial rupture was missed on US（2/5）and clinical assessment（1/5）.Conclusion US provides detailed information for repairing closed Achilles tendon rupture.