Advances in the treatment of acute closed Achilles tendon rupture / 中华骨科杂志

ABSTRACT

Acute closed Achilles tendon rupture is a common sport injury.Rupture of the Achilles tendon may limit the ability of physical exercises and activities of daily life.Conservative treatment has long recovery time and high risk of re-rupture of Achilles tendon.In recent years,with the early functional rehabilitation exercise,including early weight bearing and ankle joint flexion and extension exercise under the protection of orthopaedic braces,re-rupture risk of Achilles tendon has been significantly reduced,thus conservative treatment is becoming more and more popular.The surgical treatment mainly includes traditional open surgery and minimally invasive surgery.Minimally invasive treatment has less trauma,low re-rupture rate like open surgery,low risk of wound infection and is helpful for early rehabilitation.However,the risk of the sural nerve injury is higher.Open surgery has clear operating field and low re-rupture rate and low risk of the sural nerve injury.However,it still has some problems such as superficial and deep infection of the incision,suture reaction,tissue adhesion and so on.Both of them can achieve satisfactory results in the treatment of acute closed Achilles tendon rupture.Although the mechanism of injury of acute closed rupture of the Achilles tendon and epidemic characteristics have a deeper understanding,including degenerative tendon rupture and mechanical rupture of Achilles tendon,the incidence rate showed a rising trend,and affected by the geographical,gender,age and other factors,due to the existence of a variety of patient groups,there is still controversy over the optimal treatment modalities resulting from the diversity of the patient population.According to the individual differences of different groups of patients,the combination of early rehabilitation exercise can achieve satisfactory clinical effects as long as the treatment methods are appropriate.At present,the effect of biological therapy on the healing of Achilles tendon and the prevention of deep vein thrombosis are still controversial.There is no definitive evidence for the effectiveness of biological therapy and the need for prophylactic anticoagulation.The purpose of this study is to summarize the treatment of acute closed Achilles tendon rupture,and to discuss the importance of early functional exercise for acute closed Achilles tendon rupture and its effect on prognosis.