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急性跟腱断裂手术修复后的活动水平恢复情况:29例患者系列研究,平均随访46个月。

Activity level recovery after acute Achilles tendon rupture surgically repaired: a series of 29 patients with a mean follow-up of 46 months.

作者信息

Zayni Richard, Coursier Raphaël, Zakaria Moudasser, Desrousseaux Jean-François, Cordonnier Denis, Polveche Gilles

机构信息

Department of Orthopedic Surgery. Groupe Hospitalier de l'Est de la Meurthe-et-Moselle (GHEMM), France.

Department of Orthopedic Surgery. Groupement Hospitalier de l'Institut Catholique de Lille (GHICL), France.

出版信息

Muscles Ligaments Tendons J. 2017 May 10;7(1):69-77. doi: 10.11138/mltj/2017.7.1.069. eCollection 2017 Jan-Mar.

Abstract

BACKGROUND

Achilles tendon rupture is a common injury but its optimal management is still controversial. When decided, surgical repair can be performed by open or percutaneous techniques. Till now, there is no agreement on the ideal type of surgical management.

PURPOSE

To compare the outcomes of the percutaneous and open surgical treatment for acute Achilles tendon rupture and to assess the postoperative activity level recovery.

METHODS

Between 2008 and 2013, 29 patients were surgically treated for acute Achilles tendon rupture in our institution. 16 patients were operated by percutaneous technique and 13 by open repair. All patients received the same postoperative rehabilitation protocol. Patients were evaluated objectively and subjectively after an average of 46 months (23-91).

RESULTS

96.6% of patients had excellent and good results according to subjective assessment. No significant difference was observed with respect to the examined clinical variables between the open and percutaneous repair groups. 20.68% of patients had minor complications related to the operation with lesser complications in the percutaneous group. 89.6% of patients resumed sport activity with an average delay of 7,7 months (4-24) and 57,7% of them resumed at a level equal or superior to their level before injury, with higher rate in the percutaneous group.

CONCLUSION

Percutaneous technique has similar satisfactory outcomes to open surgery in repairing acute ruptured Achilles tendon with lesser complications and higher activity level recovery rate.

LEVEL OF EVIDENCE

Retrospective comparative study. Level III.

摘要

背景

跟腱断裂是一种常见损伤,但其最佳治疗方法仍存在争议。一旦决定进行手术修复,可采用开放或经皮技术。到目前为止,对于理想的手术治疗方式尚无共识。

目的

比较经皮和开放手术治疗急性跟腱断裂的效果,并评估术后活动水平的恢复情况。

方法

2008年至2013年期间,我院对29例急性跟腱断裂患者进行了手术治疗。16例采用经皮技术手术,13例采用开放修复手术。所有患者均接受相同的术后康复方案。平均46个月(23 - 91个月)后对患者进行客观和主观评估。

结果

根据主观评估,96.6%的患者效果优良。开放和经皮修复组在检查的临床变量方面未观察到显著差异。20.68%的患者有与手术相关的轻微并发症,经皮组并发症较少。89.6%的患者恢复了体育活动,平均延迟7.7个月(4 - 24个月),其中57.7%的患者恢复到等于或高于受伤前的水平,经皮组比例更高。

结论

在修复急性跟腱断裂方面,经皮技术与开放手术有相似的满意效果,并发症较少,活动水平恢复率更高。

证据水平

回顾性比较研究。三级。

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