Leppilahti J, Forsman K, Puranen J, Orava S
Department of Surgery, Oulu University Hospital, Finland.
Clin Orthop Relat Res. 1998 Jan(346):152-61.
A new clinical scoring system, including subjective assessment of symptoms and evaluation of ankle range of motion and isokinetic measurement of ankle plantar flexion and dorsiflexion strengths, is presented in 101 patients (86 men, 15 women) who had repair of a closed Achilles tendon rupture. Twenty-one patients were competitive athletes and 70 were recreational athletes. Eighty-one percent of the ruptures were related to sports, and 32% occurred while playing volleyball. Twenty-six patients had previous Achilles tendon symptoms. At followup, an average of 3.1 years after repair, the overall result scores were excellent in 34 cases, good in 46, fair in 17, and poor in four. Only age was a predictor of overall results. The isokinetic strength scores were excellent or good in 72 cases, fair in 18, and poor in 11. Presence of systemic diseases, activity level, previous Achilles tendon symptoms, and later return to physical exercise were predictors of strength results. Gender, body weight, height, period between rupture and operation, surgeon, rupture site, operative method, complications, and thickness, width, and area of the Achilles tendon at followup were not related significantly to the outcome.
在101例闭合性跟腱断裂修复患者（86例男性，15例女性）中，提出了一种新的临床评分系统，包括症状的主观评估、踝关节活动范围评估以及踝关节跖屈和背屈力量的等速测量。21例患者为竞技运动员，70例为业余运动员。81%的断裂与运动有关，32%发生在打排球时。26例患者既往有跟腱症状。随访时，平均在修复后3.1年，总体结果评分中，34例为优，46例为良，17例为中，4例为差。只有年龄是总体结果的预测因素。等速力量评分中，72例为优或良，18例为中，11例为差。全身性疾病的存在、活动水平、既往跟腱症状以及恢复体育锻炼的时间是力量结果的预测因素。性别、体重、身高、断裂与手术之间的时间、外科医生、断裂部位、手术方法、并发症以及随访时跟腱的厚度、宽度和面积与结果均无显著相关性。
