| Popis: |
We evaluated the long-term results of surgical treatment of Achilles tendon ruptures.Fifteen male patients (mean age 39.5 years; range 28 to 58 years) underwent surgery for Achilles tendon ruptures. All the ruptures but one occurred during sport recreation. Eleven patients were treated within the first week of trauma. After surgery, a cast was applied for four weeks, after which it was switched to a polyethylene splint that did not allow dorsiflexion. Partial weight bearing was allowed in the fourth postoperative week. Subjective and objective evaluations were made according to the system by Thermann et al. Muscle strength was measured by an isokinetic dynamometer and gait analysis was performed. Data from the healthy sides were used for comparisons. The mean follow-up was 16.8 months (range 8 to 48 months).Seven patients (46.7%) had no pain, while six patients (40%), one patient (6.7%), and one patient complained of pain during heavy, medium, and light sports activities, respectively. Muscle strength did not decrease in nine patients (60%). Seven patients (46.7%) returned to preinjury activity levels. Twelve patients (80%) evaluated the outcome as very good or good. The mean muscle atrophy on the affected side was 0.43 cm. The overall results were very good or good in nine patients (60%), moderate in four patients (26.7%), and poor in two patients (13.3%). One patient had superficial infection and delayed healing. Isokinetic measurements showed decreased peak torque, and increased total work. By gait analysis, no significant relationship was found between the dorsiflexion and plantar flexion difference and forefoot ground reaction forces.Early surgical treatment of Achilles tendon ruptures followed by a shorter immobilization period is associated with satisfactory results, and in the long-term, with a higher rate of patient satisfaction. |
