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跟腱断裂的当前治疗理念。

Current treatment concepts for Achilles tendon rupture.

作者信息

Wang Chen-Chie, Chen Pei-Yu, Yang Kai-Chiang, Wang Chung-Li, Chen Ing-Ho

机构信息

Department of Orthopedic Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.

Department of Orthopedic, School of Medicine, Tzu Chi University, Hualien, Taiwan.

出版信息

Tzu Chi Med J. 2024 Jan 12;36(1):46-52. doi: 10.4103/tcmj.tcmj_113_23. eCollection 2024 Jan-Mar.

Abstract

Achilles tendon rupture is a common and primary cause of lower limb tendon injury suffered during sports-related activities. The causes of Achilles tendon rupture include the calf muscle and tendon overuse, poor tendon quality, and various medical conditions. Historically, acute Achilles tendon rupture was treated conservatively. However, historical techniques are now associated with an increased risk of rerupture. To address this problem, open repair has been proposed. Open repair is associated with a reduced risk of rerupture; however, it is also closely associated with wound complications, like wound infection, whose treatment is time-consuming and costly. Therefore, minimally invasive Achilles tendon repair has been proposed as a promising option with acceptable functional outcomes. Nevertheless, despite its benefits, minimally invasive Achilles tendon repair is associated with increased risks of sural nerve injury and rerupture. In this review, we evaluate the currently used treatment strategies for acute Achilles tendon rupture and their historical evolution to provide evidence-based recommendations for physicians.

摘要

跟腱断裂是运动相关活动中常见的下肢肌腱损伤的主要原因。跟腱断裂的原因包括小腿肌肉和肌腱过度使用、肌腱质量差以及各种疾病状况。从历史上看,急性跟腱断裂采用保守治疗。然而,传统技术现在与再断裂风险增加有关。为了解决这个问题,有人提出了开放修复。开放修复与再断裂风险降低有关;然而,它也与伤口并发症密切相关,如伤口感染,其治疗既耗时又昂贵。因此,微创跟腱修复已被提出作为一种有前景的选择,其功能结果可接受。尽管如此,尽管微创跟腱修复有其益处,但它与腓肠神经损伤和再断裂的风险增加有关。在本综述中,我们评估了目前用于急性跟腱断裂的治疗策略及其历史演变,为医生提供循证建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8286/10887342/783d7b8cae91/TCMJ-36-46-g001.jpg

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