Kolfschoten Nicky, Metz Roderik, Verleisdonk Egbert-Jan M M
Diakonessenhuis, afd. Heelkunde, Utrecht, The Netherlands.
Ned Tijdschr Geneeskd. 2009;153:A235.
The acute Achilles tendon rupture is a typical sports injury, which most commonly occurs in men. The diagnosis is easy to make but there is no consensus on best treatment: surgical or conservative treatment? In the case of surgical repair, the risk of a re-rupture is considerably smaller compared to conservative treatment by cast immobilisation. The results of conservative treatment using a functional brace are not good enough to serve as a good alternative for surgery. If surgical treatment is chosen, minimally invasive surgery should be performed. The risk of re-rupture is the same as in open reconstruction but the risk of, a possibly severe, wound infection is smaller. Independent of the suture technique chosen, the postoperative rehabilitation should be functional as opposed to full immobilisation. Too little is currently known about the treatment of acute Achilles tendon rupture for a broadly supported treatment guideline to be realised.
急性跟腱断裂是一种典型的运动损伤，最常见于男性。诊断容易，但对于最佳治疗方法（手术治疗还是保守治疗）尚无共识。在手术修复的情况下，与采用石膏固定的保守治疗相比，再次断裂的风险要小得多。使用功能性支具进行保守治疗的效果不足以成为手术的良好替代方案。如果选择手术治疗，应进行微创手术。再次断裂的风险与开放重建相同，但严重伤口感染的风险较小。无论选择何种缝合技术，术后康复都应注重功能恢复，而非完全固定。目前对于急性跟腱断裂的治疗了解甚少，难以制定出得到广泛支持的治疗指南。
