ABSTRACT
Resumen: Objetivo: Analizar los resultados clínicos y funcionales de los pacientes con rotura aguda del cuerpo del tendón de Aquiles tratados de forma conservadora mediante bota ortopédica y carga precoz. Material y métodos: Estudio observacional prospectivo con 19 pacientes con rotura aguda de tendón de Aquiles tratados de forma ortopédica. Se analizaron las variables demográficas, la escala ATRS (Achilles tendon Total Rupture Score), la función mediante el test de puntillas, masa muscular gemelar y el equino en reposo residual. Los registros clínicos y funcionales se realizaron a las seis semanas, tres, seis y 12 meses. Se realizó un análisis estadístico mediante Stata 14. Resultados: A los 12 meses, 94% de los pacientes realizaban puntillas monopodales, la media de la atrofia gemelar fue de 1.03 cm ± 0.51 respecto a extremidad contralateral y la diferencia de equino residual respecto el lado sano era de 5.63 grados ± 4.17, 83.24% de los pacientes realizaban su práctica deportiva habitual previa a la rotura. La media de ATRS de la muestra era de 87.41 puntos ± 17.78. Se registraron dos rerroturas parciales (11%) a los tres meses de seguimiento que continuaron con tratamiento ortopédico. Conclusiones: El tratamiento ortopédico funcional mediante bota ortopédica y carga precoz presenta buenos resultados clínicos y funcionales, considerándolo un tratamiento válido para las roturas agudas del tendón de Aquiles.
Abstract: Objective: The purpose of this study is to assess the clinical and functional results of patients with acute middle third of Achilles tendon rupture treated conservatively by orthopedic boot and early weight-bearing. Material and methods: This is a prospective observational study with 19 patients with acute Achilles tendon rupture treated by conservative treatment. Demographic variables, ATRS score, function using heel-rise test, calf circumference and Achilles tendon resting angle were analyzed. The clinical and functional registration was performed at six weeks, three, six and 12 months of injury. A statistical analysis was performed. Results: At one year follow-up, the 94% of patients were capable of standing single heel rise, the mean of twin atrophy was 1.03 cm ± 0.51 compared to uninjured side and the difference of Achilles tendon resting angle was 5.63 degrees ± 4.17 compared to contralateral limb. The 83.24% of patients returned to play and the mean of ATRS score was 87.41 points ± 17.78. Two partial re-rupture (11%) were occurred at three months of follow-up, which continued with orthopedic treatment. Conclusions: Based on the results, functional orthopedic treatment using orthopedic boot and early weight-bearing presents good clinical and functional outcomes, considering it a valid treatment for acute Achilles tendon ruptures.
ABSTRACT
There is no consensus on the best treatment for acute Achilles tendon rupture. Functional rehabilitation after surgical treatment has been widely recognized, but the functional rehabilitation of non-surgical treatment has not been specifically studied. Based on the clinical practice of all kinds of Achilles tendon rupture, the best dynamic functional rehabilitation scheme and evaluation method were discussed. In order to bring more effective rehabilitation strategies for patients with Achilles tendon rupture, and reduce the rate of re-rupture and complications.
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PURPOSE: The accepted general management principle after ankle arthrodesis is to maintain non-weight bearing for 6 to 8 weeks. The aim of this study was to report clinical outcome of patients allowed early weight bearing after arthroscopic arthrodesis. MATERIALS AND METHODS: We analyzed medical records and radiographs to determine fusion rate and complication risk of 22 sequential patients allowed to walk under short leg cast within 3 days after arthroscopic ankle arthrodesis using 2 screws from January 2008 to June 2012. The minimum follow-up period was 18 months, and the mean age of the patients was 67 years. RESULTS: The mean visual analog scale was decreased from 8.9 points preoperatively to 2.3 points after 12 months. Complete ankle fusion was achieved in 19 patients (86.4%) at 3-month follow-up. There were 2 cases of delayed union and one case of nonunion at 12-month follow-up. There was no other complication such as wound problem, persistent swelling of the ankle. CONCLUSION: Bony union may not be interfered even though patients were allowed to walk under cast within a few days after arthroscopic ankle arthrodesis.
Subject(s)
Humans , Ankle , Arthrodesis , Arthroscopy , Follow-Up Studies , Leg , Medical Records , Visual Analog Scale , Walking , Weight-Bearing , Wounds and InjuriesABSTRACT
Objective To compare the influence of early weight bearing exercise and plaster fixed method on postoperative function and fracture healing of unstable ankle fracture patients.Methods 50 cases of unstable ankle fracture patients who did surgical treatment in our hospital were selected as the research object,and were randomly divided into an observation group and a control group.The observation group was applied with early postoperative weight bearing exercise,while the control group patients was applied with postoperative plaster fix with 2 weeks.The postoperative function and fracture healing situation of both groups were compared.Results At postoperative 24 hours and 1 week,the perimeter difference of two groups were not statistically different (P＞0.05).At postoperative 6 weeks,the perimeter difference was (0.53 ±0.31) cm in the observation group and (1.25±0.47)cm in the control group,the comparative differences was statistical significance (t=6.39,P＜0.05).The total effective rate of alleviate swelling in the observation group at postoperative 6 weeks was 96.0％,which was higher than that of the control group (76.0％) with statistical difference (x2=4.15,P＜0.05).At postoperative 24 hours,postoperative 1 week and postoperative 6 weeks,the pain index comparison difference between the two groups was not statistically significant (P＞0.05).The Baird-Jackson score of the observation group at postoperative 3 months was not different with the control group with statistically significant (P＞0.05) ; At the postoperative 6 months,the Baird-Jackson score of the observation group was (95.21 ± 8.25),which was higher than that in the control group (82.52±6.96) with statistical difference (t=5.88,P＜0.05).Conclusion The early weight bearing exercise can promote haemal circumfluence,relieve swelling,and be helpful for function recovery and fracture healing of unstable ankle fracture patients.
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PURPOSE: We evaluated the results of early full weight bearing after an autogenous bone graft and metal screw fixation of severe varus deformity with a medial tibial bone defect in total knee arthroplasty. MATERIALS AND METHODS: From August 1996 to March 2004, 34 patients (43 cases) were selected for the analysis. The average age was 68 and the mean follow up period was 72 month. The clinical results were evaluated using the knee range of motion and the Hospital for Special Surgery (HSS) score. The radiological results were evaluated using the tibiofemoral angle, the presence of loosening, radiolucent lines and osteolysis and the component's location. RESULTS: The mean HSS score increased from 46 to 87 points on the final follow up. The mean range of motion was increased from 71degrees to 118degrees on the final follow up. The mean femorotibial angle showed varus deformity angulation (23.5degrees) at pre-operative surgery, 6.2degrees valgus deformity for the first 7 postoperative days and 6.1 valgus at the last follow up. CONCLUSION: These findings suggest that an autogenous structural bone graft and metal screw fixation has fine results and makes early ambulation possible for the patient who has severe varus deformity with a medial tibial bone defect.