Wallace R G H, Heyes G J, Michael A L R
Ulster Hospital Dundonald, Upper Newtownards Road, Dundonald, Belfast BT16 1RH, UK.
J Bone Joint Surg Br. 2011 Oct;93(10):1362-6. doi: 10.1302/0301-620X.93B10.26187.
Controversy surrounds the most appropriate treatment method for patients with a rupture of the tendo Achillis. The aim of this study was to assess the long term rate of re-rupture following management with a non-operative functional protocol. We report the outcome of 945 consecutive patients (949 tendons) diagnosed with a rupture of the tendo Achillis managed between 1996 and 2008. There were 255 female and 690 male patients with a mean age of 48.97 years (12 to 86). Delayed presentation was defined as establishing the diagnosis and commencing treatment more than two weeks after injury. The overall rate of re-rupture was 2.8% (27 re-ruptures), with a rate of 2.9% (25 re-ruptures) for those with an acute presentation and 2.7% (two re-ruptures) for those with delayed presentation. This study of non-operative functional management of rupture of the tendo Achillis is the largest of its kind in the literature. Our rates of re-rupture are similar to, or better than, those published for operative treatment. We recommend our regime for patients of all ages and sporting demands, but it is essential that they adhere to the protocol.
跟腱断裂患者最合适的治疗方法存在争议。本研究的目的是评估采用非手术功能方案治疗后的长期再断裂率。我们报告了1996年至2008年间连续诊治的945例（949条肌腱）跟腱断裂患者的治疗结果。其中女性255例，男性690例，平均年龄48.97岁（12至86岁）。延迟就诊定义为受伤两周后才确诊并开始治疗。再断裂的总体发生率为2.8%（27例再断裂），急性就诊患者的再断裂率为2.9%（25例再断裂），延迟就诊患者的再断裂率为2.7%（2例再断裂）。这项关于跟腱断裂非手术功能治疗的研究是该领域文献中规模最大的。我们的再断裂率与已发表的手术治疗结果相似或更好。我们建议所有年龄段和不同运动需求的患者采用我们的治疗方案，但他们必须严格遵守该方案。
