Kết quả phẫu thuật tạo hình gân điều trị đứt cũ gân gót do chấn thương tại Bệnh viện Trung ương Quân đội 108

Abstract

Objective: To describe the clinical characteristics, imaging findings, intraoperative lesions, and outcomes of tendon reconstruction for chronic complete traumatic Achilles tendon rupture at 108 Military Central Hospital. Subject and method: A descriptive, non-controlled case-series study with retrospective and prospective data collection was conducted on 33 patients with chronic complete traumatic Achilles tendon rupture who underwent tendon reconstruction at 108 Military Central Hospital from January 2019 to March 2026. Two reconstruction techniques were used, including the Chernyavsky gastrocnemius aponeurosis turn-down flap and V-Y tendon advancement; all cases were reinforced with two high-strength sutures through calcaneal bone tunnels using the Bunnel technique. Outcomes were assessed using the Achilles Tendon Total Rupture Score (ATRS), the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and the ability to return to sports. Result: The mean age was 48.5 ± 10.8 years, and males accounted for 75.8%. Sports injuries were the main cause (66.7%). The mean intraoperative tendon gap was 5.1 ± 1.5cm. MRI showed a very strong correlation with the intraoperative tendon gap (r = 0.966, p<0.001). The gastrocnemius aponeurosis turn-down flap technique was applied in 30/33 patients (90.9%). The mean ATRS score was 92.8 ± 2.3 and the mean AOFAS score was 93.6 ± 2.8. All patients regained a normal gait. Among 24 patients who had participated in sports before injury, 95.8% returned to sports. Mild paresthesia was recorded in 2/33 patients (6.1%). Conclusion: Local tendon reconstruction provided favorable postoperative functional outcomes according to ATRS and AOFAS. MRI was useful for preoperative planning.