Johansen Jens Kurt, Jordan Martin, Thomas Manfred, Walther Markus, Simatira Anna-Maria, Waizy Hazibullah
Foot and Ankle Department, Hvidovre Hospital, Denmark; Hvidovre Hospital, Kettegaards Allé 30, 2630 Hvidovre, Denmark.
Hessingpark-Clinic, Foot and Ankle Department, 86199 Augsburg, Germany.
Foot Ankle Surg. 2021 Jul;27(5):515-520. doi: 10.1016/j.fas.2020.06.011. Epub 2020 Sep 9.
Ruptures of the anterior tibial tendon can be both acute and chronic. The acute lesion can be caused by a sharp cutting trauma or by blunt or hyperplantarflexion trauma. Spontaneous ruptures are rare, and most ruptures are due to degenerative changes mainly affecting the distal avascular 5-30 mm of the tendon. Surgical repair is the preferred treatment for physically active patients. Overall, the literature shows that operative repair results in a very good outcome in most patients. This study compares the clinical outcome in patients with anterior tibial tendon rupture, treated with different surgical techniques.
This multicenter cohort study was conducted at four different Foot and Ankle specialized clinics. The study was approved by the local ethical committee. A total of 48 patients with surgically treated tibialis anterior rupture was included. The study protocol included the demographic and clinical data of each patient and the surgical treatment. The VAS-FA PROM was recorded pre- and postoperative in all patients. The mean follow-up were 30 (20.8-48.5) months.
A significant difference was found in age between patients who stated "good" versus "fair" (p = 0.002) and "very good" versus "fair", i.e. younger age for "fair" p = 0.036, thus showing that younger patients do worse than older patient after surgery when rating the results. However there was no significant difference for older versus younger age looking at the results "poor", "fair, good and very good". The group with chronic tendon ruptures had a significantly higher preoperative VAS-FA than the group sustaining non-traumatic rupture (p = 0.048). There was no significant linear relation between age, postoperative VAS-FA and VAS-FA improvement. Also, we did not find a significant linear relation between age and outcome. Please see Tables 2-4 for results.
The tibialis anterior tendon rupture can be both acute and chronic. We could not identify any significant differences in clinical outcome or PROM between acute and delayed suture of the tibialis anterior tendon rupture.
Level II. Prospective controlled cohort study.
胫前肌腱断裂可分为急性和慢性。急性损伤可由锐器切割伤或钝性伤或过度跖屈伤引起。自发性断裂罕见，大多数断裂是由于退行性改变，主要影响肌腱远端无血管的5 - 30毫米部分。手术修复是身体活跃患者的首选治疗方法。总体而言，文献表明手术修复在大多数患者中能取得很好的效果。本研究比较了采用不同手术技术治疗的胫前肌腱断裂患者的临床结果。
本多中心队列研究在四个不同的足踝专科诊所进行。该研究获得了当地伦理委员会的批准。共纳入48例接受手术治疗的胫前肌断裂患者。研究方案包括每位患者的人口统计学和临床数据以及手术治疗情况。所有患者在术前和术后均记录了VAS - FA患者报告结局量表。平均随访时间为30（20.8 - 48.5）个月。
在对结果评价为“良好”与“一般”（p = 0.002）以及“非常好”与“一般”的患者之间，年龄存在显著差异，即评价为“一般”的患者年龄更小（p = 0.036），这表明在对手术结果进行评分时，年轻患者术后情况比老年患者差。然而，在评价结果为“差”“一般、良好和非常好”时，年龄较大与较小患者之间没有显著差异。慢性肌腱断裂组术前VAS - FA显著高于非创伤性断裂组（p = 0.048）。年龄、术后VAS - FA和VAS - FA改善之间没有显著的线性关系。此外，我们也未发现年龄与结局之间存在显著的线性关系。结果请见表2 - 4。
胫前肌腱断裂可急性或慢性发生。我们未发现胫前肌腱断裂急性缝合与延迟缝合在临床结果或患者报告结局方面存在任何显著差异。
二级。前瞻性对照队列研究。
