游离半腱肌腱自体移植经跟骨外侧锚定跟腱重建治疗急性跟腱断裂的临床评价-动脉网

Transversal calcaneal anchored Achilles tendon reconstruction with free semitendinosus tendon autograft for acute rupture of Achilles tendon: clinical evaluation

Nature 等信源发布 2024-08-01 01:56

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AbstractAchilles tendon reconstruction is an effective method of repairing Achilles tendon rupture defects. We introduce a new approach for Achilles tendon reconstruction using transversal calcaneal anchored autogenous semitendinosus tendon graft. The study aimed to evaluate the clinical role of this new Achilles tendon reconstruction.

跟腱重建是修复跟腱断裂缺损的有效方法。我们介绍了一种使用横向跟骨锚定自体半腱肌腱移植重建跟腱的新方法。该研究旨在评估这种新型跟腱重建的临床作用。

We retrospectively enrolled patients who underwent Achilles tendon reconstruction using transversal calcaneal anchored autogenous semitendinosus tendon graft for acute Achilles tendon rupture defects from 2016 to 2021. The clinical and radiological results were assessed at the preoperative and the final postoperative follow-up with Visual Analog Score (VAS) scores, American Orthopaedic Foot & Ankle Society (AOFAS) scores and Achilles tendon Total Rupture Scores (ATRS).

我们回顾性纳入了2016年至2021年使用横向跟骨锚定自体半腱肌腱移植进行跟腱重建治疗急性跟腱断裂缺损的患者。在术前和术后最后一次随访时，采用视觉模拟评分（VAS）评分，美国矫形足踝协会（AOFAS）评分和跟腱总断裂评分（ATRS）评估临床和放射学结果。

Besides, at the last postoperative follow-up, the difference in ankle range of motion between the two side of the patients and the incidence of postoperative complications were recorded. Results revealed patients had significantly lower VAS and higher AOFAS and ATRS (P < 0.01). Compared to the healthy ankle, the operative ankle showed significant deficits in ankle range of motion (P < 0.01).

此外，在术后最后一次随访中，记录患者两侧踝关节活动范围的差异以及术后并发症的发生率。结果显示，患者的VAS显着降低，AOFA和ATR升高（P<0.01）。与健康踝关节相比，手术踝关节的踝关节活动范围显着不足（P<0.01）。

Additionally, radiological results showed no noticeable signs of tunnel enlargement in the calcaneus and no patient had re-rupture. Transversal calcaneal anchored Achilles tendon reconstruction with free semitendinosus tendon autograft is an effective treatment option for patients with acute Achilles tendon rupture with large defects and have high postoperative exercise demands..

此外，放射学结果显示跟骨没有明显的隧道扩大迹象，也没有患者再次破裂。对于急性跟腱断裂伴较大缺损且术后运动需求高的患者，采用自体半腱肌腱游离移植重建跟腱是一种有效的治疗选择。。

IntroductionThe Achilles tendon, being the thickest and most robust tendon in the human body, is also one of the most frequently injured tendons1. Acute Achilles tendon rupture (AATR) is defined as rupture occurring within 2 weeks. With the continuous improvement in the general population’s level of sports participation, the annual incidence of AATR has reached 37 per 100,000 individuals2,3.

引言跟腱是人体内最厚，最坚固的肌腱，也是最常受伤的肌腱之一1。急性跟腱断裂（AATR）定义为2周内发生的断裂。随着普通人群体育参与水平的不断提高，AATR的年发病率已达到每10万人中有37人2,3。

AATR often occurs without aura, and typical symptoms include localized swelling of the Achilles tendon, foot pain, and weakness in ankle movements4. Currently, MRI, high-frequency ultrasound and shear wave elastography (SWE) are the most ubiquitous imaging methods used to diagnose Achilles tendon rupture.

AATR通常无先兆发生，典型症状包括跟腱局部肿胀，足部疼痛和踝关节运动无力4。目前，MRI，高频超声和剪切波弹性成像（SWE）是用于诊断跟腱断裂的最普遍的成像方法。

Among these, SWE refers to the assessment of the hardness and elastic properties of the tissue by transmitting an elastic wave through the tissue and measuring the speed (i.e., the shear wave velocity, SWV) at which the wave travels5.Appropriate post-injury treatment is crucial for patients following Achilles tendon rupture; failure to do so may result in motor deformities and associated motor dysfunctions such as difficulty lifting the heel, ultimately impacting the patient’s daily life, work, and overall quality of life4,6.

其中，SWE是指通过在组织中传递弹性波并测量波传播的速度（即剪切波速，SWV）来评估组织的硬度和弹性特性。适当的损伤后治疗对于跟腱断裂后的患者至关重要；如果不这样做，可能会导致运动畸形和相关的运动功能障碍，例如难以抬起脚跟，最终影响患者的日常生活，工作和整体生活质量4,6。

Although there is no consensus on the optimal treatment for AATR, surgical intervention is often considered the definitive choice for the majority of patients with Achilles tendon rupture7.Depending on the acuity of the injury and the size of the defect, the choice of surgical techniques for Achilles tendon rupture ranges from end-to-end suturing to complex reconstruction using augmentation8.

尽管对AATR的最佳治疗方法尚未达成共识，但大多数跟腱断裂患者通常认为手术干预是最终的选择7。根据损伤的敏锐度和缺损的大小，跟腱断裂手术技术的选择范围从端到端缝合到使用增强的复杂重建8。

According to most studies, an Achilles tendon rupture with a defect at the broken ends of up to 3 cm can be treated through in situ end-to-end anastomosis, while surgical.

根据大多数研究，跟腱断裂的断裂端缺损可达3厘米，可以在手术时通过原位端对端吻合进行治疗。

Data availability

数据可用性

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

在当前研究期间生成和/或分析的数据集可根据合理要求从通讯作者处获得。

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Download referencesAcknowledgementsWe are grateful to the Science and Technology Department of Shaanxi Province and Xi’an Jiaotong University for the supporting in this study. This work was supported by the basic Research Program of Natural Science of Shaanxi Province (No. 2023-JC-YB-710) and the Free Exploration and Innovation Project of Xi’an Jiaotong University (No.

下载参考文献致谢我们感谢陕西省科学技术厅和西安交通大学对本研究的支持。这项工作得到了陕西省自然科学基础研究计划（No.2023-JC-YB-710）和西安交通大学自由探索与创新项目（No。

xzy012023117).Author informationAuthor notesThese authors contributed equally: Chen Zhang and Miao Li.Authors and AffiliationsDepartment of Orthopedic Surgery, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710004, ChinaHan Xue, Ruochen Li, Guangwei Wu, Zheyue Zhu & Chen ZhangDepartment of Ultrasound, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710004, ChinaFengxu Xiao & Miao LiAuthorsHan XueView author publicationsYou can also search for this author in.

xzy012023117）。作者信息作者注意到这些作者做出了同样的贡献：Chen Zhang和Miao Li。作者和附属机构西安交通大学第二附属医院整形外科，西安，710004，ChinaHan Xue，Ruochen Li，Guangwei Wu，Zheyue Zhu＆Chen Zhang西安交通大学第二附属医院超声科，西安，710004，ChinaFengxu Xiao＆Miao Liauthors Shan XueView作者出版物您也可以在中搜索这位作者。

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PubMed谷歌学者FengXu XiaoView作者出版物您也可以在

PubMed Google ScholarRuochen LiView author publicationsYou can also search for this author in

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PubMed Google ScholarGuangwei WuView作者出版物您也可以在

PubMed Google ScholarZheyue ZhuView author publicationsYou can also search for this author in

PubMed谷歌学者Zheyue ZhuView作者出版物您也可以在

PubMed Google ScholarChen ZhangView author publicationsYou can also search for this author in

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PubMed Google ScholarContributionsAll of the authors contributed to the conception and design of this study. H.X. was responsible for patient follow-up, data analysis and manuscript drafting. F.X.X. was responsible for patient follow-up and imaging analysis. R.C.L., G.W.W. and Z.Y.Z.

PubMed谷歌学术贡献所有作者都为本研究的概念和设计做出了贡献。H、 X.负责患者随访，数据分析和手稿起草。F、 X.X.负责患者随访和影像学分析。R、 C.L.，G.W.W.和Z.Y.Z。

participated in patient follow-up and data analysis. M.L. and C.Z. aided in design of the study and participated in its coordination, critical revision of the manuscript, and final approval of the version to be published. All authors have read and approved the final manuscript.Corresponding authorsCorrespondence to.

参与患者随访和数据分析。M、 L.和C.Z.协助设计了这项研究，并参与了其协调，稿件的批判性修订以及将要出版的版本的最终批准。所有作者都阅读并批准了最终稿件。通讯作者通讯。

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Reprints and permissionsAbout this articleCite this articleXue, H., Xiao, F., Li, R. et al. Transversal calcaneal anchored Achilles tendon reconstruction with free semitendinosus tendon autograft for acute rupture of Achilles tendon: clinical evaluation.

转载和许可本文引用本文Xue，H.，Xiao，F.，Li，R。等人。用游离半腱肌腱自体移植重建横向跟骨锚定跟腱治疗急性跟腱断裂：临床评估。

Sci Rep 14, 17815 (2024). https://doi.org/10.1038/s41598-024-68582-6Download citationReceived: 06 February 2024Accepted: 25 July 2024Published: 01 August 2024DOI: https://doi.org/10.1038/s41598-024-68582-6Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

Sci Rep 1417815（2024）。https://doi.org/10.1038/s41598-024-68582-6Download引文收到日期：2024年2月6日接受日期：2024年7月25日发布日期：2024年8月1日OI：https://doi.org/10.1038/s41598-024-68582-6Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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KeywordsAcute rupture of Achilles tendonReconstructionCalcaneal tunnel techniqueAutologous tendon transplantationFunctional outcome

关键词急性跟腱断裂重建跟骨隧道技术自体肌腱移植功能结果

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