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急性跟腱断裂术后康复:至少随访 6 个月的功能结果。

Rehabilitation After Surgical Repair of Acute Achilles Tendon Rupture: Functional Outcome With a Minimum Follow-Up of 6 Months.

机构信息

Junior Doctor, Department of Surgery, Meander Medical Center Amersfoort, Amersfoort, the Netherlands; Junior Doctor, Department of Intensive Care, Radboud University Medical Center, Nijmegen, the Netherlands.

Trauma Surgeon, Department of Surgery, Meander Medical Center Amersfoort, Amersfoort, the Netherlands.

出版信息

J Foot Ankle Surg. 2021 May-Jun;60(3):482-488. doi: 10.1053/j.jfas.2020.09.003. Epub 2020 Sep 6.

Abstract

The best treatment and rehabilitation of Achilles tendon ruptures remains controversial. Current literature focuses mainly on objective outcomes despite possible incongruity with patient-reported functional outcomes. Therefore, we aimed to identify the course of patient-reported symptoms, function and quality of life during the early rehabilitation period. In this prospective cohort study, 33 patients with an acute Achilles tendon rupture treated with minimally invasive tendon repair were included in this study. They were followed up at 6, 12, 18 and 24 weeks after surgery with the Foot and Ankle Outcome Score questionnaire. At 6 weeks, patient-reported outcomes were poor regarding quality of life and sports. They however were quite high in the domains activities of daily living, symptoms and pain. All scores improved over the course of 6 months (symptoms (p = .03), activities of daily living (p = .001), sports (p = .002) and quality of life (p = .001). Pain did not improve significantly (p = .12), but patients had good pain scores from the start. There were no significant differences between patients with or without physical therapy. There were 3 minor complications and no re-ruptures in this cohort. In conclusion, patient-reported outcomes improve significantly during the first 6 months after surgery, except for pain. Scores for sports and quality of life remain suboptimal.

摘要

跟腱断裂的最佳治疗和康复仍存在争议。尽管与患者报告的功能结果可能不一致,但目前的文献主要集中在客观结果上。因此,我们旨在确定在早期康复期间患者报告的症状、功能和生活质量的变化过程。在这项前瞻性队列研究中,纳入了 33 名接受微创跟腱修复治疗的急性跟腱断裂患者。他们在手术后 6、12、18 和 24 周时接受足部和踝关节结局评分问卷随访。在 6 周时,患者报告的生活质量和运动相关结果较差,但在日常生活活动、症状和疼痛方面得分较高。所有评分在 6 个月的过程中均有所改善(症状(p=0.03)、日常生活活动(p=0.001)、运动(p=0.002)和生活质量(p=0.001)。疼痛没有显著改善(p=0.12),但患者从一开始就有较好的疼痛评分。接受或不接受物理治疗的患者之间没有显著差异。该队列中无 3 例轻微并发症和再断裂。总之,患者报告的结果在手术后的前 6 个月内显著改善,除了疼痛。运动和生活质量的评分仍然不理想。

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