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汤普森小腿挤压试验:跟腱修补术后随访中的临床与超声相关性

Thompson calf squeezing test: clinical and ultrasound correlations in the follow up of Achille's tenorraphy.

作者信息

Leigheb M, Conte P, Neri P, Zorzolo I, Martinelli D, Martino F, Carriero A, Grassi F

机构信息

S.C. Ortopedia e Traumatologia.

出版信息

Acta Biomed. 2014 Sep 24;85 Suppl 2:102-6.

Abstract

In the follow up of Achille's tenorraphy, negativization of Thompson calf queezing test is not always omogeneous and absolute. Aim of the paper is to correlate Thompson test to different anatomical-ultrasound and functional parameters. We investigated clinically and by ultrasound 61 patients operated on of Achille's tenorraphy at Novara Hospital with follow-up of 10 to 46 months. Negative controls were contralateral tendons. We excluded patients with previous and/or contralateral Achille's tendon ruptures, those operated after 7 days, diabetics or with autoimmune diseases, if used topic steroids, < 18 years, those rejecting the study. Measured parameters were: age, gender, height, weight, side, open vs percutaneous approach, time from operation, neutral angle and range of motion of the ankle, maximal circumference of the leg, Single Heel Rise Test, Visual-Analogue-Scale Foot and Ankle (VAS FA) score; with ultrasound: length of tendons, mio-tendinous U.S.-structure, dynamic diastasis of tendon scar, tendon sliding. Thompson test is positive if no plantar-flexion of the foot occurs at calf squeezing, negative if plantar-flexion is normal (75% patients) and intermediate if reduced or slight reactive (25%).We found correlation of Thompson test with age (p<0,05) and with tendon length (p>0,05), being intermediate tests more represented in older patients and in those with longer healed tendons. In conclusion post-operative negativization of Thompson test can be incomplete as observed in older patients and in those healed with elongated tendon.

摘要

在跟腱修复的随访中,汤普森小腿挤压试验的阴性化并不总是均匀且绝对的。本文的目的是将汤普森试验与不同的解剖超声和功能参数进行关联。我们对诺瓦拉医院61例行跟腱修复手术的患者进行了临床和超声检查,随访时间为10至46个月。阴性对照为对侧肌腱。我们排除了既往有和/或对侧跟腱断裂的患者、术后7天以后手术的患者、糖尿病患者或患有自身免疫性疾病的患者、使用局部类固醇药物的患者、年龄小于18岁的患者以及拒绝参与研究的患者。测量的参数包括:年龄、性别、身高、体重、患侧、开放手术与经皮手术入路、手术时间、踝关节中立位角度和活动范围、小腿最大周长、单足跟抬起试验、足踝视觉模拟评分(VAS FA);超声检查测量的参数包括:肌腱长度、肌-腱超声结构、肌腱瘢痕的动态分离、肌腱滑动。如果挤压小腿时足部无跖屈,则汤普森试验为阳性;如果跖屈正常,则为阴性(75%的患者);如果跖屈减少或反应轻微,则为中间型(25%)。我们发现汤普森试验与年龄(p<0.05)和肌腱长度(p>0.05)相关,中间型试验在老年患者和肌腱愈合较长的患者中更为常见。总之,如在老年患者和肌腱延长愈合的患者中观察到的那样,汤普森试验术后的阴性化可能不完整。

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