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使用Tenolig经皮修复跟腱断裂:姿势控制和步态模式的定量分析

Percutaneous repair of Achilles tendon ruptures with Tenolig: quantitative analysis of postural control and gait pattern.

作者信息

Mezzarobba S, Bortolato S, Giacomazzi A, Fancellu G, Marcovich R, Valentini R

机构信息

Physiotherapy Degree, University of Trieste, Azienda Ospedaliero-Universitaria di Cattinara, Italy.

出版信息

Foot (Edinb). 2012 Dec;22(4):303-9. doi: 10.1016/j.foot.2012.09.001. Epub 2012 Oct 24.

Abstract

BACKGROUND

Surgical approach in Achilles tendon's rupture involved during the last years has becoming safer and less invasive as possible. Lots of study investigate the outcomes of the mini-invasive technique with Tenolig proving its good results, but never in the long-term.

OBJECTIVES

Our study want to emphasize the effectiveness of this treatment exploring the postural and gait patterns in a 24-month follow up.

METHOD

Patients did self-training exercises without specific supervision, instead of a particular postoperative rehabilitation protocol. We compared 21 patients to a control group of 19 health subjects using a clinical examination, a podobarometric and an optokinetic analysis.

RESULTS

Data shows no differences in time-distance parameters, despite a reduction of propulsion phase data, confirmed also by kinetic analysis. Podobarometric results show only a decrease in the anterior pressure of the injured limb (p=0.09). In standing an increase of anterior-posterior oscillation of the COP (center of pressure) (p=0.03).

CONCLUSIONS

The results underline the long-term outcome effectiveness of the technique but some functional alterations remain. This could be the reason of the weakness, which always affected the patients. Reduction of the triceps elongation and restoration of strength during the propulsion phase should be the key points in postoperative physiotherapy.

摘要

背景

近年来,跟腱断裂的手术入路已变得尽可能更安全、侵入性更小。许多研究调查了采用Tenolig的微创技术的效果,证实其效果良好,但从未进行长期研究。

目的

我们的研究旨在通过24个月的随访,探讨这种治疗方法在姿势和步态模式方面的有效性,以强调其有效性。

方法

患者进行自我训练练习,无需特定监督,而非采用特定的术后康复方案。我们使用临床检查、足底压力测量和视动分析,将21例患者与19名健康受试者的对照组进行比较。

结果

数据显示,尽管推进阶段数据有所减少,但时间-距离参数无差异,动力学分析也证实了这一点。足底压力测量结果仅显示受伤肢体的前压力降低(p = 0.09)。站立时,压力中心(COP)的前后摆动增加(p = 0.03)。

结论

结果强调了该技术的长期疗效,但仍存在一些功能改变。这可能是一直影响患者的虚弱的原因。在推进阶段减少三头肌伸长并恢复力量应是术后物理治疗的关键点。

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