Kingsley Peter
South East Coast Ambulance Service NHS Foundation Trust, Surrey.
Emerg Nurse. 2016 Mar;23(10):34-6; quiz p 37. doi: 10.7748/en.23.10.34.s24.
Rupture of the Achilles tendon is a significant injury, and the likelihood of a good recovery is directly associated with early diagnosis and appropriate referral. Such injuries are commonly assessed and identified by practitioners working in 'minors' areas of emergency departments or urgent care settings. The literature frequently describes rupture of the Achilles tendon as 'typically sport-related' affecting 'middle-aged weekend warriors', but this aetiology accounts for only about 70% of such injuries. Factors such as the natural ageing process, obesity and use of some commonly prescribed medications, can increase the risk of developing a tendinopathy and subsequent rupture, often from a seemingly insignificant incident. However, research suggests that injuries in this patient population are more likely be missed on first examination. This article describes risk factors that should alert clinicians to the possibility of Achilles tendon rupture in 'atypical' patient populations.
跟腱断裂是一种严重的损伤,良好恢复的可能性与早期诊断和适当转诊直接相关。此类损伤通常由在急诊科或紧急护理机构的“未成年人”区域工作的从业者进行评估和识别。文献中经常将跟腱断裂描述为“典型的与运动相关”,影响“中年周末战士”,但这种病因仅占此类损伤的约70%。自然衰老过程、肥胖以及使用一些常用处方药等因素,会增加发生肌腱病及随后断裂的风险,往往源于看似微不足道的事件。然而,研究表明,这一患者群体的损伤在首次检查时更有可能被漏诊。本文描述了一些危险因素,这些因素应提醒临床医生注意“非典型”患者群体中跟腱断裂的可能性。