保守治疗跟腱断裂：与手术治疗比较的系统回顾。

IF 2.1 Q3 ORTHOPEDICS

Orthopedic Reviews Pub Date : 2025-09-04 eCollection Date: 2025-01-01 DOI:10.52965/001c.143568

Leonardo Santana, Rafael Rodrigues, Nilton Junior, João Cruz

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引用次数: 0

摘要

背景：跟腱断裂是常见的，特别是在活跃的个体，并显著影响功能。对于保守治疗和手术治疗是否有更好的疗效，争论仍然存在。目的：比较保守和手术治疗跟腱断裂的再破裂率、功能恢复和并发症发生率。方法：按照PRISMA指南进行系统评价。使用MEDLINE选择2015年至2025年间发表的比较保守和手术治疗的随机对照试验（rct）。采用Cochrane RoB 2.0评估偏倚风险。结果：共纳入8项rct。保守治疗复发率高，并发症少。手术治疗在减少复发的同时，增加了神经损伤和感染的风险。两组间的长期功能结果一般具有可比性。结论：两种方法均不具有普遍优势。手术修复可预防再破裂，但保守治疗可避免手术并发症。临床决定应考虑个人因素，如年龄、活动水平和患者偏好。

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Conservative treatment of achilles tendon rupture: a systematic review comparative with surgical treatment.

Background: Achilles tendon ruptures are common, particularly in active individuals, and significantly affect function. Controversy persists over whether conservative or surgical treatment offers superior outcomes.

Objective: To compare conservative and surgical treatments for Achilles tendon rupture regarding rerupture rates, functional recovery, and complication incidence.

Methods: A systematic review was conducted following PRISMA guidelines. Randomized controlled trials (RCTs) comparing conservative and surgical treatments published between 2015 and 2025 were selected using MEDLINE. Risk of bias was assessed using Cochrane RoB 2.0.

Results: Eight RCTs were included. Conservative treatment showed a higher rerupture rate but fewer complications. Surgical treatment, while reducing rerupture, increased risks of nerve injuries and infections. Long-term functional outcomes were generally comparable between groups.

Conclusion: Neither approach proved universally superior. Surgical repair may be preferred to prevent rerupture, but conservative treatment avoids operative complications. Clinical decisions should consider individual factors such as age, activity level, and patient preferences.

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来源期刊

Orthopedic Reviews ORTHOPEDICS-

CiteScore

2.70

自引率

4.80%

发文量

122

审稿时长

10 weeks

期刊介绍： Orthopedic Reviews is an Open Access, online-only, peer-reviewed journal that considers articles concerned with any aspect of orthopedics, as well as diagnosis and treatment, trauma, surgical procedures, arthroscopy, sports medicine, rehabilitation, pediatric and geriatric orthopedics. All bone-related molecular and cell biology, genetics, pathophysiology and epidemiology papers are also welcome. The journal publishes original articles, brief reports, reviews and case reports of general interest.