Kearney R S, Parsons N, Underwood M, Costa M L
University of Warwick, Gibbet Hill Road, Coventry CV4 7AL, UK.
Bone Joint Res. 2015 Apr;4(4):65-9. doi: 10.1302/2046-3758.44.2000400.
The evidence base to inform the management of Achilles tendon rupture is sparse. The objectives of this research were to establish what current practice is in the United Kingdom and explore clinicians' views on proposed further research in this area. This study was registered with the ISRCTN (ISRCTN68273773) as part of a larger programme of research.
We report an online survey of current practice in the United Kingdom, approved by the British Orthopaedic Foot and Ankle Society and completed by 181 of its members. A total of ten of these respondents were invited for a subsequent one-to-one interview to explore clinician views on proposed further research in this area.
The survey showed wide variations in practice, with patients being managed in plaster cast alone (13%), plaster cast followed by orthoses management (68%), and orthoses alone (19%). Within these categories, further variation existed regarding the individual rehabilitation facets, such as the length of time worn, the foot position within them and weight-bearing status. The subsequent interviews reflected this clinical uncertainty and the pressing need for definitive research.
The gap in evidence in this area has resulted in practice in the United Kingdom becoming varied and based on individual opinion. Future high-quality randomised trials on this subject are supported by the clinical community. Cite this article: Bone Joint Res 2015;4:65-9.
用于指导跟腱断裂治疗的证据基础较为匮乏。本研究的目的是确定英国目前的治疗方法，并探讨临床医生对该领域进一步研究所提建议的看法。作为一项更大规模研究计划的一部分，本研究已在国际标准随机对照试验编号注册库（ISRCTN68273773）进行了注册。
我们报告了一项针对英国当前治疗方法的在线调查，该调查经英国足踝矫形外科学会批准，由其181名成员完成。其中共有10名受访者被邀请参加后续的一对一访谈，以探讨临床医生对该领域进一步研究所提建议的看法。
调查显示治疗方法存在很大差异，患者仅接受石膏固定治疗的占13%，先接受石膏固定然后进行矫形器治疗的占68%，仅接受矫形器治疗的占19%。在这些类别中，关于个体康复方面，如佩戴时间、足部在其中的位置和负重状态等，还存在进一步的差异。后续访谈反映了这种临床不确定性以及对确定性研究的迫切需求。
该领域证据的空白导致英国的治疗方法各不相同且基于个人观点。临床界支持未来针对该主题开展高质量的随机试验。引用本文：《骨与关节研究》2015年；4：65 - 9。
