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跟腱急性撕裂开放修复术后早期负重无不良影响。

No adverse effect of early weight bearing following open repair of acute tears of the Achilles tendon.

作者信息

Maffulli N, Tallon C, Wong J, Peng Lim K, Bleakney R

机构信息

Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, North Staffordshire Hospital, Stoke on Trent, Staffordshire, England.

出版信息

J Sports Med Phys Fitness. 2003 Sep;43(3):367-79.

Abstract

AIM

To study the effects of early weight bearing following acute repair of ruptured Achilles tendon.

METHODS

Using a comparative longitudinal study design, following repair of an Achilles tendon rupture, patients in Group 1 were immobilised with their ankle in gravity equinus, were encouraged to weight bear on the operated limb as soon as possible to full weight bearing, and received a single a cast change at 2 weeks, when the ankle was immobilised in a plantigrade position. Patients in Group 2 were immobilised with their ankle in full equinus, and received a cast change at 2 weeks, when the ankle was immobilised in mid equinus, and at 4 weeks, when the ankle was immobilised in a plantigrade position. They were advised to weight bear 4 weeks from the operation.

RESULTS

Patients in Group 1 attended less outpatient visits, completely discarded their crutches at an average of 2.5 weeks from the operation (Group 2: average of 5.7 weeks from the operation), (p=0.013), and a greater proportion of them were satisfied with the results of surgery. At ultrasound scan, the average thickness of the repaired tendon was 12.1 mm (SD 2), with no difference in the thickness of the ruptured tendon regardless of the method of postoperative management. There was no significant difference in isometric strength between the two groups of patients.

CONCLUSION

Early weight bearing with the ankle plantigrade is not detrimental to the outcome of repair following rupture of the Achilles tendon.

摘要

目的

研究急性跟腱断裂修复术后早期负重的效果。

方法

采用比较纵向研究设计,跟腱断裂修复术后,第1组患者踝关节固定于重力性马蹄足位,鼓励患者尽快在手术肢体上负重直至完全负重,并在2周时更换一次石膏,此时踝关节固定于跖行位。第2组患者踝关节固定于全马蹄足位,在2周时更换石膏,此时踝关节固定于中度马蹄足位,在4周时再次更换石膏,此时踝关节固定于跖行位。建议他们在术后4周开始负重。

结果

第1组患者门诊就诊次数较少,平均在术后2.5周完全丢弃拐杖(第2组:平均在术后5.7周),(p = 0.013),并且他们中对手术结果满意的比例更高。超声检查时,修复肌腱的平均厚度为12.1毫米(标准差2),无论术后处理方法如何,断裂肌腱的厚度均无差异。两组患者的等长肌力无显著差异。

结论

踝关节跖行位早期负重对跟腱断裂修复的结果并无不利影响。

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