Majewski M, Schaeren S, Kohlhaas U, Ochsner P E
Department of Orthopaedic Surgery and Traumatology, University Hospital, University of Basel, Basel, Switzerland.
Disabil Rehabil. 2008;30(20-22):1726-32. doi: 10.1080/09638280701786831.
To report a comparative study on postoperative management following percutaneous repair of acute Achilles tendon ruptures.
One hundred and three patients with percutaneous repair after acute Achilles tendon rupture were prospectively entered in our departmental database. Before July 1999, 15 patients were treated postoperatively with below-knee cast immobilization; after July 1999, patients underwent early functional therapy using a special shoe. Patients were seen at 6 weeks, 12 weeks, and 12 months after surgery. Matched pairs were selected based upon gender, age, weight, height, body mass index, and the side involved. The total number of patients consisted of 14 matched pairs. Compared outcomes included clinical evaluation, time away from work, and time before return to sports.
Fifteen patients had an objective force reduction compared to the nonoperated side (9 cast group; 6 shoe group). The mean Achilles tendon score was 81 points in the cast group and 88 points in the shoe group. Patients in the cast group had a significantly (p = 0.042) longer time before return to work (67 days) compared to those in the shoe group (37 days).
Early mobilization in a special shoe is preferable to postoperative immobilization after percutaneous Achilles tendon repair. It provides a good clinical outcome and shortens the time for return to work and sports.
报告一项关于急性跟腱断裂经皮修复术后管理的对比研究。
103例急性跟腱断裂经皮修复术后患者被前瞻性纳入我们科室的数据库。1999年7月之前，15例患者术后采用膝下石膏固定治疗；1999年7月之后，患者采用特殊鞋进行早期功能治疗。术后6周、12周和12个月对患者进行随访。根据性别、年龄、体重、身高、体重指数和患侧进行配对。患者总数为14对匹配病例。比较的结果包括临床评估、误工时间和恢复运动前的时间。
与未手术侧相比，15例患者存在客观力量下降（石膏组9例；鞋组6例）。石膏组跟腱平均评分为81分，鞋组为88分。与鞋组患者（37天）相比，石膏组患者恢复工作前的时间显著更长（67天，p = 0.042）。
经皮跟腱修复术后，采用特殊鞋进行早期活动优于术后固定。它能提供良好的临床效果，并缩短恢复工作和运动的时间。
