Optimal Outcomes for Acute Avulsion Fracture of the Achilles Tendon Treated With the Insertional Reattachment Technique: A Case Series of 31 Cases With Over 2 Years of Follow-up
| Autor: | Yanbin Pi, Chen Jiao, Yingfang Ao, Yuelin Hu, Qinwei Guo |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Visual Analog Scale Physical Therapy Sports Therapy and Rehabilitation Achilles Tendon 03 medical and health sciences 0302 clinical medicine Humans Medicine Orthopedics and Sports Medicine Patient Reported Outcome Measures Range of Motion Articular Aged Retrospective Studies Rupture 030222 orthopedics Achilles tendon business.industry Avulsion fracture 030229 sport sciences Middle Aged medicine.disease Magnetic Resonance Imaging Surgery Radiography medicine.anatomical_structure Haglund deformity Female business Ankle Joint Follow-Up Studies |
| Zdroj: | The American Journal of Sports Medicine. 47:2993-3001 |
| ISSN: | 1552-3365 0363-5465 |
| Popis: | Background:Avulsion fracture of the Achilles tendon is a less common but debilitating disorder. There is a paucity of literature on this problem.Purpose:To present a retrospective case series assessing the clinical outcomes of avulsion fracture of the Achilles tendon after a reattachment procedure and to identify potential factors predicting postoperative outcomes.Study Design:Case series; Level of evidence, 4.Methods:A consecutive case series of 35 patients with acute insertional rupture of the Achilles tendon who received a reattachment procedure between 2011 and 2017 were reviewed. All patients were measured and classified by magnetic resonance imaging (MRI) and surgical findings. Patient-reported outcomes were evaluated using the visual analog scale (VAS) for pain, American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Scale, Foot Function Index (FFI), Tegner score, and Ankle Activity Score (AAS). The range of motion and single-legged heel raise test were also conducted for both ankles.Results:Thirty-one out of 35 (88.57%) patients were followed up for an average of 43.65 months. The VAS pain score and AOFAS Ankle-Hindfoot score improved from 4.87 ± 1.61 preoperatively to 2.07 ± 1.57 postoperatively and from 58.32 ± 18.66 preoperatively to 87.32 ± 7.53 postoperatively, respectively (both P < .001). The mean FFI, AAS, and Tegner scores after the operation were 11.84 ± 1.62, 5.71 ± 2.18, and 4.61 ± 1.31, respectively. Compared with the intact ankle, the mean deficit in dorsiflexion in the involved ankle was 9.54°± 6.25° (range, 0.59°-23.70°; P < .001) and the mean deficit in plantarflexion in the involved ankle was 6.31°± 4.02° (range, 0.24°-14.92°; P < .001). Thirty patients could perform the single-legged heel raise on the operative leg. A larger body mass index was associated with worse postoperative AOFAS and FFI outcomes. Longer follow-up predicted statistically significantly better FFI scores. Better postoperative dorsiflexion was associated with better postoperative FFI, AAS, and Tegner scores, and a statistically significant interaction was found between the VAS score and plantarflexion deficit. Age, preoperative insertional tenderness, Haglund deformity, and MRI classification showed little association with postoperative outcomes.Conclusion:This study demonstrated that the reattachment procedure for acute avulsion fracture of the Achilles tendon can achieve firm fixation and promising outcomes. |
| Databáze: | OpenAIRE |
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