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[跟腱过度使用损伤的治疗与诊断]

[Treatment and diagnosis of overuse injury in the Achilles tendon].

作者信息

Larsson Elin, Nilsson Helander Katarina, Karlsson Jón, Brorsson Annelie

机构信息

vikarierande underläkare, doktorand, Sahlgrenska universitetssjukhuset, Mölndal.

docent, överläkare, Sahlgrenska universitetssjukhuset, Mölndal.

出版信息

Lakartidningen. 2022 Mar 15;119:21182.

Abstract

Achilles tendinopathy is a common overuse injury, especially among runners. It should be divided into midportion Achilles tendinopathy and insertional Achilles tendinopathy, as the treatments are different. Achilles tendinopathy is a clinical diagnosis, which includes a combination of pain, swelling and stiffness. If pain is located 2-6 cm above the insertion to the calcaneus, it is considered a midportion tendinopathy. Pain located more distally, close to the insertion, is defined as insertional tendinopathy. Both midportion and insertional Achilles tendinopathies are primarily treated with physiotherapy during three to six months. Exercise has the highest level of evidence and is more successful in midportion Achilles tendinopathy. Insertional tendinopathy more often requires surgical treatment, with removal of bony exostosis and chronically inflamed bursa.

摘要

跟腱病是一种常见的过度使用性损伤,在跑步者中尤为常见。由于治疗方法不同,它应分为跟腱中部病变和跟腱止点病变。跟腱病是一种临床诊断,包括疼痛、肿胀和僵硬等症状。如果疼痛位于跟骨止点上方2-6厘米处,则被认为是跟腱中部病变。疼痛位置更靠近远端、接近止点的,则被定义为跟腱止点病变。跟腱中部病变和跟腱止点病变在最初三到六个月主要采用物理治疗。运动疗法有最高级别的证据支持,且对跟腱中部病变更为有效。跟腱止点病变更常需要手术治疗,切除骨赘和慢性发炎的滑囊。

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