Early weight-bearing walking with inflatable boots after repair of acute Achilles tendon rupture based on the concept of rapid rehabilitation
10.3760/cma.j.cn115530-20230531-00273
- VernacularTitle:快速康复理念下急性跟腱断裂修复术后佩戴充气靴早期负重的疗效分析
- Author:
Wenfu YANG
1
;
Xuejun WU
;
Jingui LIN
;
Yongliang YOU
;
Shibei LIN
Author Information
1. 福州市第二医院（厦门大学附属福州第二医院、福建医科大学第三临床医学院）骨科，福建省创伤骨科急救与康复临床医学研究中心，福州市创伤医学中心，福州 350007
- Keywords:
Achilles tendon;
Rehabilitation;
Wounds and injuries;
Weight-bearing
- From:
Chinese Journal of Orthopaedic Trauma
2023;25(7):589-594
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate early weight-bearing walking with inflatable boots after repair of acute Achilles tendon rupture based on the concept of rapid rehabilitation.Methods:A retrospective study was conducted to analyze the data of 69 patients with acute Achilles tendon rupture who had been treated at Department of Orthopaedics, The Second Fuzhou Hospital Affiliated to Xiamen University from April 2020 to July 2021. There were 56 males and 13 females with a mean age of 37.0(31.0, 47.0) years and a body mass index of (23.7±2.6) kg/m 2. There were 55 cases of closed injury and 14 cases of open injury; 62 cases had simple Achilles tendon injury and 7 cases were complicated with neurovascular tendon injury. The patients were divided into 2 groups according to their rehabilitation methods. The treatment group of 23 cases was subjected to weight-bearing walking with inflatable boots early after repair while the control group of 46 cases to traditional plaster bracket fixation for 4 weeks before weight-bearing walking with inflatable boots. The 2 groups were compared in terms of hospitalization time, wound infection rate, return to sports time, single heel lifting time, Achilles tendon re-rupture rate, Victorian Institute of Sports Assessment (VISA-A), Achilles tendon total rupture score (ATRS), and American Orthopaedic Foot & Ankle Society ankle-hindfoot score (AOFAS-AH). Results:There was no statistically significant difference in the comparison of preoperative general data between the 2 groups, showing comparability ( P>0.05). All patients were followed up for 11 (10, 11) months after surgery. In the treatment group, the hospitalization time [4 (3, 5) days] and single heel lifting time [(12.5±1.4) weeks] were significantly shorter than those in the control group [6 (5, 9) days and (17.0±1.5) weeks], the return to sports time [21 (20, 22) months] was significantly earlier than that in the control group [23 (22, 24) months], and the VISA-A score [(89.4±1.3) points] was significantly higher than that in the control group [(78.5±1.7) points] ( P<0.05). There was no statistically significant difference in the wound infection rate between the 2 groups ( P>0.05). At 3 and 6 months after surgery, respectively, the treatment group had significantly higher ATRS scores [(85.5±1.4) and (89.0±1.6) points] and AOFAS ankle-hindfoot scores [(89.0±1.7) and (92.0±1.5) points] than the control group [(79.3±1.8) and (87.0±1.3) points; (80.2±1.9) and (88.4±1.9) points] (all P<0.05). In all patients, the AOFAS ankle-hindfoot score at 6 months postoperatively was significantly higher than that at 3 months postoperatively ( P<0.05). Achilles tendon re-rupture occurred in none of the patients. Conclusion:After repair of acute Achilles tendon rupture, compared with traditional plaster bracket fixation, early weight-bearing walking with inflatable boots can lead to better short-term clinical outcomes to enhance recovery after surgery without increasing the rate of open wound infection or re-rupture.
