Department of Orthopaedic Surgery, Shimane University School of Medicine, 89-1 Enya-cho, Izumo-shi, Shimane-Pref. 693-8501, Japan.
Am J Sports Med. 2010 Feb;38(2):287-92. doi: 10.1177/0363546509351557. Epub 2009 Dec 31.
Immobilization or orthosis is required after conventional Achilles tendon surgery. Hypothesis This new Achilles tendon repair approach enables early rehabilitation without any postoperative immobilization or orthosis.
Case series; Level of evidence, 4.
Twenty consecutive patients (14 men and 6 women; mean age, 43.4 years; range, 16-70 years) who had acute subcutaneous Achilles tendon rupture were treated by the new method, with an average follow-up of 2.9 years (range, 2-4.8 years). Among them, 15 injuries were sports-related and 5 were work-related. The authors applied a side-locking loop technique of their own design for the core suture, using braided polyblend suture thread, with peripheral cross-stitches added. The patients started active and passive ankle mobilization from the next day, partial weightbearing walking from 1 week, full-load walking from 4 weeks, and double-legged heel raises from 6 weeks after surgery.
The range of motion recovery equal to the intact side averaged 3.2 weeks. Double-legged heel raises and 20 continuous single-legged heel raise exercises were possible at an average of 6.3 weeks and 9.9 weeks, respectively. T2-weighted magnetic resonance signal intensity recovered to equal that of the intact portion of the same tendon at 12 weeks. The patients resumed sports activities or heavy labor at an average of 14.4 weeks. The Achilles tendon rupture score averaged 98.3 at 24 weeks. There were no complications.
This new Achilles tendon repair approach enables early mobilization exercise without costly specialized orthosis or immobilization and allows an early return to normal life and sports activities, reducing the physical and economic burden on patients.
传统跟腱手术后需要固定或矫形。假说：这种新的跟腱修复方法可以在无需任何术后固定或矫形的情况下实现早期康复。
病例系列；证据水平，4。
20 例连续患者（14 名男性和 6 名女性；平均年龄 43.4 岁；范围 16-70 岁）采用新方法治疗急性皮下跟腱断裂，平均随访 2.9 年（范围 2-4.8 年）。其中 15 例为运动相关损伤，5 例为工作相关损伤。作者采用自行设计的侧锁环技术进行核心缝合，使用编织聚混合缝线，并增加周围交叉缝合。患者术后第 2 天开始进行主动和被动踝关节活动，第 1 周开始部分负重行走，第 4 周开始全负重行走，第 6 周开始进行双脚跟抬高练习。
运动范围恢复至健侧平均为 3.2 周。双脚跟抬高和 20 次连续单脚跟抬高练习分别在平均 6.3 周和 9.9 周时可完成。T2 加权磁共振信号强度在 12 周时恢复至与同一肌腱完整部分相等。患者平均在 14.4 周时恢复运动活动或重体力劳动。跟腱断裂评分在 24 周时平均为 98.3。无并发症发生。
这种新的跟腱修复方法可以在无需昂贵的特殊矫形器或固定的情况下进行早期活动练习，使患者能够更早地恢复正常生活和运动活动，减轻患者的身体和经济负担。
