Functional outcome and correlation with ultrasound gap size of Achilles tendon rupture treated non-operatively with boot and wedges

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-02-01 DOI:10.1016/j.jor.2025.01.038

Rohit Ravindran Nair , Suzanne Lane, Brijesh Ayyaswamy, Pradeepsyam Prasad, Anoop Anand, Nithin Babu, Adersh Gopinathannair

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引用次数: 0

Abstract

Background

The need for surgical management of Achilles tendon ruptures has been decreasing due to a better understanding of their non-operative management. The primary aim of our study was to assess the functional outcome of Achilles tendon ruptures treated with fixed angle walking boots with wedges (FAWW) and its relationship with gap size, functional scores, single leg heel raise height difference (HHD) and calf circumference difference (CCD). The secondary aim was to look at the complication rates.

Methods

34 patients (29 males and 5 females), who presented with acute Achilles tendon ruptures to Blackpool Teaching Hospitals NHS Foundation Trust from October 2020 to April 2022, were treated with an equinus slab for 2 weeks followed by a fixed angle boot, with wedges being sequentially removed every 2 weeks. They were reviewed at 3, 6 and 12 months. At each visit, Achilles Tendon Rupture score (ATRS), HHD and CCD were measured. Any complication, such as deep vein thrombosis (DVT) or re-rupture, was recorded.

Results

The mean age group of patients was 50 years (28–87 years). The average ATRS at 3, 6 and 12 months were 29.84, 61.68 and 76, respectively. The mean HHD was 8.9 centimetres (cm) at 3 months, 3.79 cm at 6 months and 2.4 cm at 12 months. The mean CCD was 1.31 cm at 3 months, 0.88 cm at 6 months and 1.07 cm at 12 months. We did not find a significant correlation between Achilles tendon gap size measured by ultrasound and ATRS, HHD and CCD in our study.

Conclusions

Non-operative management of Achilles tendon ruptures with boot and wedges gives a good functional outcome, which has no relationship with tendon gap size at the time of initial rupture.

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非手术带靴和楔治疗跟腱断裂的功能结局及其与超声间隙大小的相关性

背景：由于对跟腱断裂的非手术治疗有了更好的了解，对手术治疗的需求正在减少。本研究的主要目的是评估带楔的固定角度步行靴（FAWW）治疗跟腱断裂的功能结果及其与间隙大小、功能评分、单足跟抬高高度差（HHD）和小腿围差（CCD）的关系。第二个目的是观察并发症的发生率。方法：2020年10月至2022年4月，在布莱克浦教学医院NHS基金会信托基金接受急性跟腱断裂治疗的34例患者（男29例，女5例），采用马蹄板治疗2周，然后采用固定角度靴，每2周依次去除楔形。分别在第3、6和12个月时进行复查。每次就诊均测量跟腱断裂评分（ATRS）、HHD和CCD。记录任何并发症，如深静脉血栓形成（DVT）或再破裂。结果患者平均年龄50岁（28 ~ 87岁）。3个月、6个月和12个月的平均ATRS分别为29.84、61.68和76。3个月时平均HHD为8.9厘米，6个月时为3.79厘米，12个月时为2.4厘米。平均CCD在3个月时为1.31 cm， 6个月时为0.88 cm， 12个月时为1.07 cm。在我们的研究中，我们没有发现超声测量的跟腱间隙大小与ATRS、HHD和CCD之间有显著的相关性。结论非手术治疗跟腱断裂与靴靴加楔的效果良好，与初次断裂时跟腱间隙大小无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.