Becher C, Donner S, Brucker J, Daniilidis K, Thermann H
International Center for Hip-, Knee- and Foot Surgery, ATOS Clinic, Heidelberg, Germany.
St. Josefs Hospital, Wiesbaden, Germany.
Foot Ankle Surg. 2018 Apr;24(2):110-114. doi: 10.1016/j.fas.2016.12.003. Epub 2017 Jan 4.
This study compared outcomes after treatment of acute Achilles tendon (AT) rupture via percutaneous suturing, with those after chronic AT rupture treated via open reconstruction.
This retrospective study included 30 patients who underwent either percutaneous suturing for acute AT rupture (group AR, n=16) or open reconstruction for chronic AT rupture (group CR, n=14). Function was evaluated by calf muscle circumference, and endurance through isokinetic measurement and single-leg heel-rise test. Score evaluation included AT Total Rupture Score, Victorian Institute of Sports Assessment-Achilles questionnaire, and visual analogue scale pain score. Postoperative tendon thickness was measured using ultrasonography and MRI.
Follow-up was conducted 4.97±1.79 years postoperatively. The groups were similar in age and body mass index. There was no significant difference between groups in calf circumference, isokinetic measurement, heel-rise test, and score evaluation. There was significantly less mediolateral tendon thickening in group AR compared with group CR on ultrasonography (p=0.01) and MRI (p=0.001).
Open reconstruction for chronic AT rupture may result in comparable clinical and functional outcomes, but a thicker tendon compared with percutaneous suturing after acute AT rupture.
本研究比较了经皮缝合治疗急性跟腱断裂与开放重建治疗慢性跟腱断裂后的疗效。
这项回顾性研究纳入了30例患者，其中16例急性跟腱断裂患者接受经皮缝合（AR组），14例慢性跟腱断裂患者接受开放重建（CR组）。通过小腿肌肉周长评估功能，通过等速测量和单腿提踵试验评估耐力。评分评估包括跟腱完全断裂评分、维多利亚运动评估机构-跟腱问卷和视觉模拟评分法疼痛评分。术后使用超声和磁共振成像测量肌腱厚度。
术后4.97±1.79年进行随访。两组在年龄和体重指数方面相似。两组在小腿周长、等速测量、提踵试验和评分评估方面无显著差异。超声检查（p=0.01）和磁共振成像（p=0.001）显示，AR组中外侧肌腱增厚明显少于CR组。
慢性跟腱断裂的开放重建可能会带来相当的临床和功能结果，但与急性跟腱断裂经皮缝合相比，肌腱更厚。
