Ateschrang Atesch, Körner Daniel, Joisten Konrad, Ahrend Marc-Daniel, Schröter Steffen, Stöckle Ulrich, Riedmann Stephan
Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany.
Department of Oral and Maxillofacial Surgery, Marien Hospital, Stuttgart, Germany.
Arch Orthop Trauma Surg. 2018 Feb;138(2):203-210. doi: 10.1007/s00402-017-2829-1. Epub 2017 Nov 1.
Numerous publications are dealing with acute Achilles tendon rupture. To our knowledge, no systematic trial has been published analyzing the incidence, risk factors and the potential clinical impact of postoperative tendon calcifications (PTC) after percutaneous Achilles tendon repair. Therefore, the aim of this study was to analyze these relevant aspects.
Between March 2003 and November 2010, a total of 126 patients with an acute, complete Achilles tendon rupture were treated with a percutaneous technique according to Ma and Griffith at a single university-based trauma department. The follow-up included a detailed clinical and sonographic examination. To assess the functional outcome and possible impact of PTC after percutaneous Achilles tendon repair, the Thermann and AOFAS scores were used. 81 patients (65 men and 16 women) with a median age of 46 years (range 24-76) were available for a follow-up examination. The median time of follow-up was 64 months (range 15-110 months).
PTC occurred in nine out of 81 patients (11.1%). All patients with PTC were male with a median age of 52 years (range 26-76 years). In the group of patients with PTC, the median overall Thermann score was 94 (range 68-100) and the median overall AOFAS score was 97 (range 85-100). In the group of patients without PTC, the median overall Thermann score was 88.5 (range 60-100) and the median overall AOFAS score was 97 (range 85-100). No significant differences were detected between the group of patients with PTC and the group of patients without PTC and the clinical outcome according to the Thermann (p = 0.21) and the AOFAS scores (p = 0.37). None of the patients with PTC sustained a re-rupture. The overall re-rupture rate was 4.9%. PTC was no risk factor for wound and neurological complications.
The incidence of PTC after percutaneous Achilles tendon repair was 11.1%. Male gender and advanced age seem to be risk factors for PTC. In this study, PTC had no negative impact on the postoperative clinical outcome.
众多出版物都在探讨急性跟腱断裂。据我们所知，尚未发表过系统试验来分析经皮跟腱修复术后肌腱钙化（PTC）的发生率、危险因素及潜在临床影响。因此，本研究旨在分析这些相关方面。
2003年3月至2010年11月期间，一所大学附属创伤科共126例急性、完全性跟腱断裂患者接受了Ma和Griffith经皮技术治疗。随访包括详细的临床和超声检查。为评估经皮跟腱修复术后PTC的功能结果及可能影响，采用了Thermann和AOFAS评分。81例患者（65例男性和16例女性）可供随访检查，中位年龄46岁（范围24 - 76岁）。中位随访时间为64个月（范围15 - 110个月）。
81例患者中有9例（11.1%）发生PTC。所有发生PTC的患者均为男性，中位年龄52岁（范围26 - 76岁）。在发生PTC的患者组中，Thermann总分中位数为94（范围68 - 100），AOFAS总分中位数为97（范围85 - 100）。在未发生PTC的患者组中，Thermann总分中位数为88.5（范围60 - 100），AOFAS总分中位数为97（范围85 - 100）。根据Thermann评分（p = 0.21）和AOFAS评分（p = 0.37），发生PTC的患者组与未发生PTC的患者组之间及临床结果均未检测到显著差异。发生PTC的患者均未再次断裂。总体再断裂率为4.9%。PTC不是伤口和神经并发症的危险因素。
经皮跟腱修复术后PTC的发生率为11.1%。男性和高龄似乎是PTC的危险因素。在本研究中，PTC对术后临床结果无负面影响。
