摘要
目的探讨跟腱牵伸训练联合早期负重训练对跟腱断裂患者的康复效果。方法前瞻性研究2020年1月—2023年6月四川省骨科医院收治的行跟腱断裂手术的患者104例,男性62例,女性42例;年龄20~40岁,平均33.2岁;左侧断裂58例,右侧断裂46例;奔跑致伤32例,跳跃致伤39例,其他原因33例。随机数字表法分为联合组、对照组,各52例。对照组采用常规康复训练与早期负重训练干预治疗,联合组加用跟腱牵伸训练。比较两组跟腱断裂患者总有效率、踝关节功能、踝关节活动度、生活状态水平及并发症发生情况。结果治疗后3个月,联合组总有效率较对照组提高(94.2%vs.65.4%,P<0.05);联合组跟腱断裂评分、跟腱相对静息角、美国足踝协会踝-后足评分、踝关节背伸活动度、跖屈活动度高于对照组[(66.1±7.7)分vs.(57.4±6.1)分、(7.6±0.9)°vs.(5.2±0.7)°、(91.6±8.8)分vs.(80.2±8.5)分、(34.1±3.6)°vs.(31.5±3.2)°、(38.0±3.9)°vs.(35.5±3.7)°,P<0.05];且联合组日常生活活动能力量表评分、生活质量量表评分高于对照组[(71.9±8.4)分vs.(62.8±7.1)分、(74.3±8.3)分vs.(65.2±7.3)分,P<0.05],而疼痛、肌肉萎缩等并发症发生率低于对照组(3.8%vs.19.2%,P<0.05)。结论跟腱断裂患者术后接受跟腱牵伸及早期负重训练联合干预,可有效增强患肢活动功能,提高患者生活质量,效果较为理想,临床应用价值较高。
Objective To explore the therapeutic effect of a combined training of Achilles tendon stretching and early weight-bearing on patients with Achilles tendon rupture.Methods A total of 104 patients(62 males and 42 females aged 20-40 years,33.2 years on average)who underwent surgical repair for Achilles tendon rupture were prospectively selected from Jan.2020 to Jun.2023 in our hospital.Among them,58 cases affected the left side and 46 the right,with 32 injured by running,39 by jumping and 33 by others.Patients were randomly divided into combination group and control group(n=52 for each group).The control group received routine rehabilitation and early weight-bearing training,while the combination group received additional Achilles tendon stretching.The total effective rate,ankle joint function,ankle joint range of motion,living status,and complications were compared.Results Three months after the treatment,the total effective rate of the combination group was greatly higher than that of the control group(94.2%vs.65.4%,P<0.05).Moreover,the combination group showed much higher Achilles tendon rupture scores(66.1±7.7 vs.57.4±6.1),relative Achilles tendon resting angle(7.6°±0.9°vs.5.2°±0.7°),AOFAS ankle hindfoot scale scores(91.6±8.8 vs.80.2±8.5),ankle dorsiflexion range of motion(34.1°±3.6°vs.31.5°±3.2°),and plantar flexion range of motion(38.0°±3.9°vs.35.5°±3.7°),all revealing significant difference compared with the control group(all P<0.05).Besides,the activity of daily living(71.9±8.4 vs.62.8±7.1)and SF-36 scores(74.3±8.3 vs.65.2±7.3)were much better in the combination group(both P<0.05),and the incidence of complications such as pain and muscle atrophy was much lower(3.8%vs.19.2%,P<0.05).Conclusion The combined training of Achilles tendon stretching and early weight-bearing following surgical repair significantly improves functional recovery and quality of life in patients with Achilles tendon rupture,showing ideal therapeutic outcomes and high clinical applicability.
作者
张晓芳
敬竹子
易倩
Zhang Xiaofang;Jing Zhuzi;Yi Qian(Department of Rehabilitation,Sichuan Province Orthopedic Hospital,Chengdu 610041,China)
出处
《创伤外科杂志》
2025年第5期376-380,共5页
Journal of Traumatic Surgery
基金
四川省中医药管理局科学技术研究专项课题(2020LC0186)。
关键词
跟腱断裂
常规康复训练
早期负重训练
牵伸训练
临床疗效
Achilles tendon rupture
Routine rehabilitation training
Early weight-bearing training
Stretching training
Clinical efficacy
