Reilmann H, Förster E W, Weinberg A M, Brüggemann F, Peukert J
Unfallchirurgische Klinik, Städtisches Klinikum Braunschweig.
Unfallchirurg. 1996 Aug;99(8):576-80.
In a prospective study in the period from May 1989 to April 1994, 161 patients at the Unfallchirurgische Klinik in Braunschweig were treated for rupture of the Achilles tendon using a conservative functional method. A follow-up examination was carried out on 132 patients (81%) after an average of 12.6 months. Conservative therapy was indicated if dynamic ultrasonography showed sufficient adaptation of the rupture. Continuous retention of the adapted tendon fragments was guaranteed by means of special footwear that raises the back of the foot (Variostabil). The average age of the patients was 39.5 years. In 97 cases (73.5%) the injury was caused by sports. In 68 ruptures the dehiscence was compensated in plantar flexion. In 48 cases the dehiscence was 1-5 mm, and in 16 cases it was between 6 and 10 mm. The average period of hospitalization was 4.8 days (1/19). The period of inability to work was an average of 4 weeks (27.4 days (0/98)). The rupture healed on an average of 9.5 weeks (5.9/23). Complications included seven cases of re-rupture (5.3%), and, in the course of treatment, four patients (3%) suffered profound leg vein thrombosis that in one case developed into postthrombotic syndrome. In two cases there was tendovaginitis of the Achilles tendon. Early functional conservative therapy using the VARIO-STABIL shoe is a suitable method for treating a newly ruptured Achilles tendon. When there is a precise indication, the method is equally as good as operative therapy and because of the low complication rate, it is even preferable.
在1989年5月至1994年4月期间的一项前瞻性研究中，不伦瑞克市创伤外科诊所的161例跟腱断裂患者采用保守功能疗法进行治疗。平均12.6个月后，对132例患者（81%）进行了随访检查。如果动态超声显示断裂处充分愈合，则采用保守治疗。通过一种抬高足跟的特殊鞋具（Variostabil）确保愈合的肌腱碎片持续保持固定。患者的平均年龄为39.5岁。97例（73.5%）损伤由运动引起。68例断裂在跖屈位时裂隙得到代偿。48例裂隙为1 - 5毫米，16例裂隙在6至10毫米之间。平均住院时间为4.8天（1/19）。平均误工时间为4周（27.4天（0/98））。断裂平均在9.5周愈合（5.9/23）。并发症包括7例再次断裂（5.3%），并且在治疗过程中，4例患者（3%）发生严重的下肢静脉血栓形成，其中1例发展为血栓后综合征。2例发生跟腱腱鞘炎。使用VARIO - STABIL鞋进行早期功能保守治疗是治疗新发跟腱断裂的一种合适方法。在有明确指征时，该方法与手术治疗效果相当，且由于并发症发生率低，甚至更可取。
