University of the Sciences, Philadelphia, PA, USA.
J Orthop Sports Phys Ther. 2012 Jun;42(6):521-9. doi: 10.2519/jospt.2012.3913. Epub 2012 Jan 25.
Case report.
The Achilles tendon is the most frequently ruptured tendon, and the incidence of Achilles tendon rupture has increased in the last decade. The rupture generally occurs without any preceding warning signs, and therefore preinjury data are seldom available. This case represents a unique opportunity to compare preinjury running mechanics with postinjury evaluation in a patient with an Achilles tendon rupture.
A 23-year-old female sustained a right complete Achilles tendon rupture while playing soccer. Running mechanics data were collected preinjury, as she was a healthy participant in a study on running analysis. In addition, patient-reported symptoms, physical activity level, strength, ankle range of motion, heel-rise ability, Achilles tendon length, and running kinetics were evaluated 1 year after surgical repair.
During running, greater ankle dorsiflexion and eversion and rearfoot abduction were noted on the involved side postinjury when compared to preinjury data. In addition, postinjury, the magnitude of all kinetics data was lower on the involved limb when compared to the uninvolved limb. The involved side displayed differences in strength, ankle range of motion, heel rise, and tendon length when compared to the uninvolved side 1 year after injury.
Despite a return to normal running routine and reports of only minor limitations with running, considerable changes were noted in running biomechanics 1 year after injury. Calf muscle weakness and Achilles tendon elongation were also found when comparing the involved and uninvolved sides.
病例报告。
跟腱是最常发生断裂的肌腱,在过去十年中,跟腱断裂的发病率有所增加。跟腱断裂通常没有任何前兆,因此很少有受伤前的数据。本病例为比较跟腱断裂患者受伤前和受伤后跑步力学的独特机会。
一名 23 岁女性在踢足球时发生右侧完全性跟腱断裂。她是一项跑步分析研究的健康参与者,因此在受伤前收集了跑步力学数据。此外,在手术修复后 1 年,评估了患者报告的症状、身体活动水平、力量、踝关节活动度、跟腱抬高能力、跟腱长度和跑步动力学。
与受伤前数据相比,受伤后患侧在跑步时踝关节背屈和外翻以及后足外展角度更大。此外,与健侧相比,患侧所有动力学数据的幅度在受伤后均较低。与受伤侧相比,受伤后 1 年患侧的力量、踝关节活动度、跟腱抬高和跟腱长度存在差异。
尽管患者恢复了正常的跑步习惯,并且报告仅在跑步方面存在轻微限制,但在受伤后 1 年仍发现跑步生物力学发生了相当大的变化。与健侧相比,患侧还发现小腿肌肉无力和跟腱延长。