急性跟腱断裂术后加速康复疗效观察

Observation of the Clinical Effectiveness of Accelerated Rehabilitation of Acute Achilles Tendon Rupture Surgically Repaired

目的探讨加速康复计划在急性跟腱断裂修补术后的临床疗效。方法回顾性分析我院2012年6月—2014年10月收治的35例急性跟腱断裂患者临床资料,其中男33例,女2例,年龄18~42岁。所有患者均为急性闭合性跟腱断裂,伤后2~5天内待肿胀消退后行切开断端缝合、跖肌腱加强术。术后患者被随机指定进行相应康复计划。其中加速康复计划组18例,传统康复计划组17例。比较两组患者术后感染率、再断裂率及肌力恢复情况。术后6个月及末次随访时通过跟腱断裂总体评分(ATRS)、Leppilahti评分评价其临床疗效。结果35例患者均获得完整随访,时间为9~15个月,平均12个月。两组患者术后再断裂率及感染率差异均无统计学意义(P均>0.05)。而加速康复计划组ATRS评分、Leppilahti评分及肌力恢复均优于传统康复计划组(P均<0.05)。结论急性跟腱断裂修补术后辅助加速康复计划在不增加跟腱再断裂率的基础上可促进小腿三头肌肌力恢复,明显改善功能评分,进而加速患者术后功能恢复。

Objective To evaluate the clinical effect of accelerated rehabilitation after surgical acute Achilles tendon rupture repair.Methods Thirty five cases of acute Achillles-tendon rupture were reviewed from June 2012 to October 2014 in our hospital.There were 33 males and 2 females,aged from 18 to 42 years with an average of 31 years.All patients were acute closed Achilles tendon rupture.After 2 to 5 days,all cases with swelling subsided are opened suturing and strengthening with plantar tendon.Postoperative patients were randomly assigned to the appropriate rehabilitation plan.Among them,18 were accelerated rehabilitation programs and 17 were traditional rehabilitation programs.Postoperative infection rates,rate of re-rupture,and muscle strength recovery were compared between the two groups.At 6 months and at the final follow-up,the Achilles tendon rupture score(ATRS)and Leppilahti score were used to evaluate the clinical efficacy.Results All patients were followed up for 9 to 15 months with an average of 12 months.There was no significant difference in the rates of re-rupture and infection between the two groups(P all>0.05).The accelerated Achilles tendon rupture score(ATRS),Leppilahti score and muscle strength recovery were better than the traditional rehabilitation plan group,the difference was statistically significant(P all<0.05).Conclusion Surgically repair of acute Achilles tendon rupture combined with accelerated rehabilitation program does not only increase the Achilles tendon rupture rate,but also promote strength recovery of triceps surae muscle,improve functional score and then accelerate recovery of patients with postoperative function.