Leigheb M, Conte P, Neri P, Zorzolo I, Martinelli D, Martino F, Carriero A, Grassi F
S.C. Ortopedia e Traumatologia.
Acta Biomed. 2014 Sep 24;85 Suppl 2:102-6.
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.
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。