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[手术治疗跟腱断裂的长期结果]

[Long-term results of surgically treated Achilles tendon ruptures].

作者信息

Krüger-Franke M, Scherzer S

机构信息

Staatliche Orthopädische Klinik München.

出版信息

Unfallchirurg. 1993 Oct;96(10):524-8.

PMID:8235671
Abstract

The rupture of the Achilles tendon is a frequent sports injury. Between 1978 and 1988 we treated 358 men and 54 women, with an average age of 43 years, for this. In most cases the site of rupture was 3-5 cm proximal to the distal insertion of the tendon. The long-term subjective results of operative treatment of Achilles tendon ruptures (122 patients) were "good" or "very good" on follow-up examination in 85% of cases, and 97% of the patients treated surgically would choose the same therapy in the event of a new rupture. The isokinetic results demonstrated a (9.1%) loss of static and a 16.7% loss of dynamic strength in plantar flexion of the upper ankle joint compared with the healthy side. Ultrasound examination revealed thickening of the tendon itself and of the dorsal paratendon, with alterations in the tendon structure. In spite of the good results, the high rate of complications, 15.1%, shows that new and extensive studies on functional conservative therapy of Achilles tendon rupture are necessary to find whether conservative or operative therapy is better.

摘要

跟腱断裂是一种常见的运动损伤。1978年至1988年间,我们共治疗了358名男性和54名女性跟腱断裂患者,平均年龄为43岁。多数情况下,断裂部位在跟腱远端附着点近端3 - 5厘米处。对122例跟腱断裂患者进行手术治疗的长期主观结果显示,随访检查时85%的病例结果为“良好”或“非常好”,并且97%接受手术治疗的患者在再次发生断裂时会选择相同的治疗方法。等速测试结果表明,与健侧相比,患侧踝关节背屈静态力量损失9.1%,动态力量损失16.7%。超声检查显示跟腱本身及背侧腱旁组织增厚,腱结构改变。尽管治疗效果良好,但15.1%的高并发症发生率表明,有必要对跟腱断裂的功能性保守治疗进行新的广泛研究,以确定保守治疗还是手术治疗效果更佳。

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