[摘要] 目的 使用腓肠肌逆转筋膜瓣移植配合Suture Anchor 加强对陈旧性跟腱断裂进行手术治疗，为临床提供一种新的治疗方法。方法 从2005年－2009年，对18例陈旧性跟腱断裂采用腓肠肌逆转筋膜瓣移植Suture Anchor 加强进行了手术治疗。具体方法是①将断裂肌腱的两端的瘢痕组织切除，直至暴露出腱性组织②测量肌腱缺损的长度，然后向近端延长切口，暴露腓肠肌及其完整筋膜③在距离跟腱近断端向近端相当于跟腱缺损加上3-4cm的位置上，横行切断腓肠肌深筋膜长约4cm，于其两边向远方平行切开深筋膜，分离深筋膜与肌肉之间（尽可能部损伤肌肉），形成蒂在远端的深筋膜瓣，一直向远端翻转，保留蒂部与近断端有2cm的连接④先将蒂部与近断端用缝线缝合固定，以免在筋膜瓣逆转时被撕开，然后将筋膜瓣卷成筒状，逆转后其断端与跟腱的远断端对接缝合⑤将Suture Anchor的螺钉置入跟骨结节内，两侧尾线向近端相互交叉编织缝合固定于腓肠肌的筋膜上。结果 所有患者皆获得了随访，随访时间6～12个月，平均8个月。术后1周即可开始进行功能锻炼，6个月后对踝关节功能进行评价。结论配合使用anchor固定对跟腱断裂进行手术治疗，具有固定强度好、可早期进行功能锻炼、避免肌腱粘连及踝关节获得良好活动度的优点，是可供临床使用的另一种良好的治疗方法。 宁夏医科大学总医院创伤骨科安维军

[关键词] Suture Anchor（缝合锚）；腓肠肌逆转筋膜瓣；跟腱断裂；

To surgical treat the obsolete Achilles
tendon rupture using the reverse fibulogastrol ficial flap grafting add to suture
anchor

  [Abstract] Use of the gastrocnemius fascia flap
with reversed Suture Anchor strengthen old rupture of Achilles tendon surgery,
to provide a new clinical treatment. Methods From 2005 -2009, the 18 patients
with chronic Achilles tendon rupture using gastrocnemius fascial flap Suture
Anchor reversal step up the surgery. ①
specific method is to break both ends of the tendon scar tissue removed, until
the exposed tendon tissue ②
measuring the length of tendon, and then extend to the proximal incision,
exposing the gastrocnemius and the integrity of fascia ③ ends at a distance of close to the Achilles tendon proximal tendon defect plus the equivalent of 3-4cm of the position, and horizontal cut deep
fascia of gastrocnemius length 4cm,
its sides cut parallel to the distant deep fascia, separation between the deep
fascia and muscle (as the Department of muscle injury), the formation of the deep fascia pedicle flap in the
remote has been turning to the remote, leave the pedicle and near the ends of
the connection with 2cm ④ first pedicle and near the ends with suture fixation to avoid gluten
membrane flap was torn when reversed, and then rolled into cylinder-shaped
fascial flap, after reversing its ends and the butt ends well Achilles tendon
suture ⑤ will Suture Anchor for screw placement in
calcaneal tuberosity, on both sides of the end of line sutured to the proximal
end of each cross-woven on a fixed in the gastrocnemius fascia. The results
were obtained in all patients followed up for 6 to 12 months, an average of 8
months. Can start after 1 week functional exercise, 6 months after the
evaluation of ankle joint function. Conclusion fixed anchor used in conjunction
with surgery on the Achilles tendon rupture treated with a fixed intensity, and
can be exercises early to avoid tendon and ankle joints for good adhesion
activity of the advantages for clinical use is another good treatment .

AN
Weijun,QIU Shaodong.  Orthopedic
Department of the Affiliated Hospical of Ningxia
Medical University,
Yinchuan 750004,China