Rehabilitation nursing for 10 cases of chronic achilles tendon rupture undergoing transplantation of flexor hallucis longus and plantaris tendon and gastrocnemius fascia flap repairing
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摘要: 目的 探讨拇长屈肌腱(flexor hallucis longus,FHL)联合跖肌腱移植和腓肠肌腱膜修复陈旧性跟腱断裂的康复护理方法。 方法 2012年1月-2015年1月,选择宁波大学医学院附属医院10例陈旧性跟腱断裂患者,其中男性8例,女性2例,年龄22~54岁,根据美国矫形足踝外科协会(AOFAS)踝与后足标准评分为(69.5±2.1)分,平均年龄(35.3±1.3)岁,从受伤至受伤干预后的时间4~8个月,平均时间为(5.31±1.04)个月,采用FHL联合跖肌腱移植和腓肠肌腱膜修复陈旧性跟腱断裂,围手术期从心理护理、患肢护理、物理治疗及康复训练4个方面进行针对性的康复护理。 结果 本组10例患者,患者术后切口均Ⅰ期愈合,无并发症发生。围手术期进行康复护理后都获得随访,随访时间12~36个月,平均时间13.7个月。恢复到正常工作状态为3~12个月,平均时间为(5.03±1.03)个月,恢复到正常运动时间为6~18个月,平均时间(8.31±1.30)个月,术后12个月AOFAS踝与后足疗效评价标准评分为(96.3±1.6)分,患者术前术后比较差异有统计学意义(P<0.05);其中优6例,良3例,可1例,优良率90.0%。 结论 前中后期科学的康复护理模式提高了患者跟腱断裂术后自我管理能力,减少再次断裂的发生,对促进FHL联合跖肌腱移植和腓肠肌腱膜修复陈旧性跟腱断裂的患者术后康复有积极作用。Abstract: Objective To evaluate the effect of rehabilitated nursing in patients undergoing the transplantation of flexor hallucis longus and plantaris tendon and gastrocnemius fascia flap repairing. Methods From January, 2012 to January, 2015, 10 cases was observed with using psychological nursing, limb care, physical therapy, and rehabilitation training and recovery guide, including 8 males and 2 females with a median age of (35.3±1.32) years (range, 22-54 years). The score was (69.5±2.07) according to American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot score system. The interval time was (5.31±1.04) months(range, 4-8 months) from injury time to intervene time. Results Ten patients were followed up 12-36 months (mean, 13.7 months). NO any complication was occurred and all incisions were primary healing. The average interval to return to work was (5.03±1.03) months (range from 3 to 12 months) and recovery to sports (8.31±1.30) months (range from 6 to 18 months). At 12 months after operation, the AOFAS ankle and hindfoot score was 96.3±1.6, showing significant difference when compared with that before operation. These Results were excellent in 6 cases, good in 3 cases, and fair in 1 case with an excellent and good rate of 90.0%. Conclusion The self-management ability of Achilles tendon rupture was improved with scientific rehabilitation nursing mode, reducing the occurrence of Achilles tendon rupture, providing a positive Method to the rehabilitation of the Flexor Hallucis Longus transfer with turndown gastrocnemius fascia flap and reinforced with plantaris tendon repairing for chronic Achilles tendon rupture.
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Key words:
- Achilles tendon rupture /
- Tendon transfer /
- Rehabilitation nursing
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