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循证治疗跟腱断裂。

Evidence-based treatment of Achilles tendon rupture.

机构信息

From the Division of Orthopaedic Surgery, Hamilton Health Sciences Centre, Hamilton, Ont. (Cohen, Petrisor, Bhandari); Division of Orthopaedic Surgery, University of Montreal, Montréal, Que. (Sandman); Division of Orthopaedic Surgery, McGill University Health Centre, Montréal, Que. (Saran, Martineau); Department of Orthopaedics, St. Paul's Hospital, University of British Columbia, Vancouver, BC (Veljkovic, Leucht, Downey).

From the Division of Orthopaedic Surgery, Hamilton Health Sciences Centre, Hamilton, Ont. (Cohen, Petrisor, Bhandari); Division of Orthopaedic Surgery, University of Montreal, Montréal, Que. (Sandman); Division of Orthopaedic Surgery, McGill University Health Centre, Montréal, Que. (Saran, Martineau); Department of Orthopaedics, St. Paul's Hospital, University of British Columbia, Vancouver, BC (Veljkovic, Leucht, Downey)

出版信息

Can J Surg. 2023 Jul 4;66(4):E356-E357. doi: 10.1503/cjs.008321. Print 2023 Jul-Aug.

Abstract

The treatment of Achilles tendon rupture has recently seen a shift toward non-operative management, as supported by the literature, yet many surgeons continue to treat these injuries operatively. The evidence clearly supports non-operative management of these injuries except for Achilles insertional tears and for certain patient groups, such as athletic patients, for whom further research is warranted. This nonadherence to evidence-based treatment may be explained by patient preference, surgeon subspecialty, surgeon era of practice or other variables. Further research to understand the reasons behind this nonadherence would help to promote conformity in the surgical community across all specialties and adherence to evidence-based approaches.

摘要

最近,文献支持非手术治疗方法治疗跟腱断裂,然而许多外科医生仍继续采用手术治疗。除了跟腱止点撕裂和某些特定患者群体(如运动员)外,证据清楚地支持这些损伤的非手术治疗,对于这些患者群体,还需要进一步研究。这种不遵循基于证据的治疗方法可能是由于患者的偏好、外科医生的专业领域、外科医生的执业时代或其他变量所导致的。进一步研究不遵循基于证据的治疗方法背后的原因,将有助于促进所有专业的外科医生群体的一致性,并遵循基于证据的方法。

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本文引用的文献

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Surgeon Applications of Patient Preferences in Treatment Decision Making for First-Time Anterior Shoulder Dislocation.
Orthop J Sports Med. 2020 Dec 4;8(12):2325967120966145. doi: 10.1177/2325967120966145. eCollection 2020 Dec.
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Functional Rehabilitation for Nonsurgical Treatment of Acute Achilles Tendon Rupture.
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Surgical versus nonsurgical treatment of acute Achilles tendon rupture: a meta-analysis of randomized trials.
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