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急性和慢性跟腱损伤采用手术修复并结合功能康复治疗:功能效果极佳,患者满意度高,且无再次断裂情况。

Surgical repair followed by functional rehabilitation for acute and chronic achilles tendon injuries: excellent functional results, patient satisfaction and no reruptures.

作者信息

Jacob Korula Mani, Paterson Roger

机构信息

SPORTSMED.SA, Adelaide, South Australia, Australia.

出版信息

ANZ J Surg. 2007 Apr;77(4):287-91. doi: 10.1111/j.1445-2197.2007.04035.x.

Abstract

BACKGROUND

We evaluated 46 patients who underwent surgical repair of the Achilles tendon at our institution during a 4.5-year period, followed by early weight bearing, aiming to assess their return to activities, rerupture rate and satisfaction.

METHODS

A cohort of 46 patients who underwent Achilles tendon repair at our institution during a 4.5-year period, with a modified triple mini-Becker suture technique, for both acute as well as chronic Achilles tendon ruptures were studied. These patients were reviewed at a minimum of 2.5 years follow up (average 4.5 years ranging from 2.5 to 6.5 years), by chart review and questionnaire, to determine the functional outcome as well as patient satisfaction following an active postoperative protocol involving full weight-bearing ambulation in a controlled ankle motion walker and active stretching, followed by a graduated strengthening programme.

RESULTS

We found a very high level of satisfaction, with few minor complications and no reruptures in either the early or the delayed repair groups.

CONCLUSION

We believe that surgical repair using this technique associated with an early return to protected full weight-bearing ambulation and an active early rehabilitation programme provides not only excellent functional results, patient satisfaction and a zero rerupture rate, but also much less morbidity in the first 3 months and a quicker overall recovery compared with non-operative treatment.

摘要

背景

我们评估了46例在我院接受跟腱手术修复的患者,手术时间跨度为4.5年,术后早期负重,旨在评估他们恢复活动的情况、再断裂率和满意度。

方法

研究了一组46例在我院接受跟腱修复的患者,手术时间跨度为4.5年,采用改良的三小切口Becker缝合技术,治疗急性和慢性跟腱断裂。通过病历审查和问卷调查,对这些患者进行了至少2.5年的随访(平均4.5年,范围为2.5至6.5年),以确定在术后积极方案(包括在可控踝关节活动步行器中完全负重行走和主动拉伸,随后进行逐步强化训练)后的功能结果以及患者满意度。

结果

我们发现患者满意度很高,早期和延迟修复组的轻微并发症均较少,且均无再断裂情况。

结论

我们认为,采用该技术进行手术修复,结合早期恢复到受保护的完全负重行走和积极的早期康复计划,不仅能带来出色的功能结果、患者满意度和零再断裂率,而且与非手术治疗相比,在最初3个月的发病率更低,总体恢复更快。

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