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METHOD FOR THE SURGICAL TREATMENT OF ACUTE ACHILLES TENDON RUPTURE

机译：急性胆囊腱断裂的外科手术治疗方法

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FIELD: medicine.;SUBSTANCE: invention relates to the field of medicine, namely to traumatology, and can be used to treat complete acute Achilles tendon rupture. Access to the site of damage to the Achilles tendon is carried out by making a Z-shaped incision along the posterior surface of the tibia in the projection of the Achilles tendon rupture. Adaptation of the ends of a torn tendon is carried out, juxtaposition of the ends with an adaptive, epitopendose, blanket stitch. Tendon is conventionally divided into 3 equal parts in the longitudinal direction. Front surface of the tendon is stitched, for which a needle is inserted at the border of 1 and 2 parts of the proximal end of the torn tendon in the direction from the tendon rupture, without seizing the entire thickness of the tendon. Then, having passed 5 mm of tendon thickness, the needle is inserted at the border of 1 and 2 parts. Further, departing from the exit of 3–4 mm, the needle is inserted at an angle of 45° relative to the parallel course of the tendon fibers in the proximal direction, the exit point of the needle is the border of 2 and 3 parts of the tendon. Then the needle is inserted into the place of exit thereof at an angle of 45° so that the needle passes under the epitenon in the proximal direction and is visible through the epitenon. Then, in the place of exit, deep, perpendicular to tendon, but not intersected the entire thickness of the tendon thread is passaged with the exit point at the border of 2 and 3 parts. Then the needle is inserted into the place of exit thereof at an angle of 45° so, that the needle passes under the epitenon in the distal direction to the border of 1 and 2 parts and is visible through the epitenon of the intersection formed with the previous stitch. Next, the needle is inserted into the place of exit thereof at an angle of 45° in the distal direction to the border of 2 and 3 parts. Then, retreating 3–4 mm, the needle is inserted parallel to the fibers and perpendicular to the tendon rupture line in the distal direction until the needle is completely out of the proximal end of the tendon, and the length of the stitched tendon should not exceed 3.0 cm. Next, give the foot equinus position. Assistant holds the tendon with clamps, without locking the ratchet. Same thread steadily continues to sew the front surface of the distal end of the tendon, using the techniques outlined above. Then the transition to the relief surface is performed, at this juncture the assistant rotates the tendon with the help of clamps. Relief surfaces of the proximal and distal ends of the tendon are stitched in the same way as the front surfaces. Ends of the threads are interconnected. Knot is arranged between the broken ends of the stitched tendon. Wound is sutured in layers. Plaster immobilization is performed on the front surface of the leg by the splint in the equinus position of the foot on the upper third of the tarsus.;EFFECT: method provides a reduction in the time of rehabilitation of the patient and a more rapid restoration of working capacity thereof due to steadily flashing of the front and relief tendon walls in four sectors.;1 cl, 11 dwg, 1 ex
机译：发明领域本发明涉及医学领域，即创伤学，可用于治疗完全的急性跟腱断裂。通过在跟腱断裂的突出处沿着胫骨的后表面做一个Z形切口，可以接近跟腱的损伤部位。进行撕裂的肌腱末端的适应，将末端与适应性表位的毯式针脚并置。传统上，肌腱在纵向上分为三个相等的部分。缝合腱的前表面，在不抓住腱的整个厚度的情况下，在从腱断裂的方向上将一根针插入到断裂的腱的近端的1和2部分的边界处。然后，在肌腱厚度超过5毫米后，将针插入1个和2个部分的边界。此外，从3-4 mm的出口离开，针相对于腱纤维在近端方向上的平行走向以45°的角度插入，针的出口点是2和3部分的边界肌腱。然后，将针以45°的角度插入针的出口位置，以使针在近端方向通过表皮之下，并通过表皮可见。然后，在出口处，垂直于肌腱但不相交的深处，穿过肌腱螺纹的整个厚度，使出口点位于2和3部分的边界处。然后将针以45°的角度插入针的出口位置，以使针沿远侧方向穿过表皮之下至1和2部分的边界，并通过与针形成的相交处的表皮可见前一针。接下来，将针头以远侧方向与2个和3个部分的边界成45°角插入其出口处。然后退后3-4毫米，将针平行于纤维并垂直于腱断裂线沿远侧方向插入，直到针完全脱离腱近端为止，并且缝合的腱长度不应超过3.0厘米。接下来，给出脚的平衡位置。助手用夹子固定肌腱，而不会锁定棘轮。使用上面概述的技术，相同的线稳定地继续缝制肌腱远端的前表面。然后执行到起伏面的过渡，此时，助手借助夹具旋转肌腱。腱近端和远端的释放表面以与前表面相同的方式缝合。线程的末端相互连接。在缝合的腱的折断端之间布置结。伤口被分层缝合。在the骨上三分之一的脚的等位位置用夹板将石膏固定在腿的前表面。效果：该方法可减少患者的康复时间，并能更快地恢复由于四个扇区的前部和后部筋腱壁稳定地闪蒸而导致其工作能力; 1 cl，11 dwg，1 ex

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