Achilles tendon rupture reconstruction
The tendon is the tendon of the calf triceps, located at the back of the ankle, ending at the posterior end of the calcaneal tuberosity. It is the longest and most powerful tendon of the human body, assisting in jumping, running and weight-bearing movements, and can withstand great tension. . Achilles tendon rupture occurs less frequently in daily life, but it is more common in sports injuries. It is common in gymnastics, skills, ball games, track and field and other running and jumping events. The Achilles tendon rupture is mostly young and middle-aged. The Achilles tendon rupture is often completely broken. The patient feels painful and painful when he is injured. He is shocked. Most patients or other people present at the time of the injury will hear the sputum. Sound, immediately enough movement, can not lift or walk, pain in the gastrocnemius muscle or accompanied by numbness, bloating, calf muscle atrophy, dorsiflexion angle is smaller than the opposite side, heel is more prominent, single foot lifting test (+), Thomposon (+). At present, there are many surgical methods for the treatment of Achilles tendon rupture. The key fracture reconstruction includes Lindhlom method, Bosworth repair, and Bunnell suture method, which can restore the normal walking function. Treatment of diseases: Achilles tendon rupture Indication Part I Achilles tendon rupture, range <50%; Type II Achilles tendon rupture, range 50% and repair the degenerative necrotic tissue due to injury, heel rupture defect <3cm, simple suture can be repaired; Type III Achilles tendon rupture, range 50% and repair the degenerative necrotic tissue due to injury, the heel rupture defect is 3 ~ 6cm; Type IV Achilles tendon is completely ruptured, and the defect of the Achilles tendon rupture due to injury is removed >6 cm. Contraindications 1. Patients with bleeding-prone diseases should wait for the coagulation function to return to normal before performing surgery; 2, allergic to local anesthetics, or anti-anaesthetic should pay attention. Preoperative preparation Skin care: Wash the calf and foot with warm water and soap solution 1 day before surgery. Use 1/1000 Xinjieer solution for 30 minutes before and after the operation. Cover the foot with a sterile towel. Surgical procedure Under continuous epidural anesthesia, the patient takes a prone position and a balloon tourniquet in the middle of the thigh. For open injury, routinely cleans and disinfects the wound, carefully debrides the appropriate expansion, fully reveals the Achilles tendon and slightly trims it, for closure Sexual injury, using the medial incision of the Achilles tendon, revealing the Achilles tendon, clearing blood clots and scars. For type I and type II fractures, the knee flexion is 30° moderate degree of flexion, and the broken end is slightly trimmed, and the 7th silk thread is used, and the cross stitching or 8 cross stitching is performed. For type III and IV Achilles tendon injuries, the length of the Achilles tendon defect was measured at 30° knee flexion and 30° knee flexion, and then the Kellssler sutured the Achilles tendon at the low tension, in the middle of the gastrocnemius muscle and the diaphragm. An inverted V-shaped incision is made, the depth is 1/2 of the Achilles tendon, and the inverted Flap is covered to cover the Achilles tendon rupture. The inverted iliac crest is sutured vertically with a No. 7 thread and fixed to the Achilles tendon to form a bridge. The inversion was performed with a No. 1 silk thread for suture fixation. complication 1. Infection: If you do not pay attention to hygiene or anti-infection, it is easy to cause wound infection. If it happens, seek medical attention immediately; 2. Minhang.
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