A new conservative-dynamic treatment for the acute ruptured Achilles tendon.

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State: Public
Version: Final published version
Serval ID
serval:BIB_D9C05CB90728
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A new conservative-dynamic treatment for the acute ruptured Achilles tendon.
Journal
Archives of Orthopaedic and Trauma Surgery
Author(s)
Neumayer F., Mouhsine E., Arlettaz Y., Gremion G., Wettstein M., Crevoisier X.
ISSN
1434-3916 (Electronic)
ISSN-L
0936-8051
Publication state
Published
Issued date
2010
Volume
130
Number
3
Pages
363-368
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
INTRODUCTION: There is a trend towards surgical treatment of acute ruptured Achilles tendon. While classical open surgical procedures have been shown to restore good functional capacity, they are potentially associated with significant complications like wound infection and paresthesia. Modern mini-invasive surgical techniques significantly reduce these complications and are also associated with good functional results so that they can be considered as the surgical treatment of choice. Nevertheless, there is still a need for conservative alternative and recent studies report good results with conservative treatment in rigid casts or braces.
PATIENTS/METHOD: We report the use of a dynamic ankle brace in the conservative treatment of Achilles tendon rupture in a prospective non-randomised study of 57 consecutive patients. Patients were evaluated at an average follow-up time of 5 years using the modified Leppilahti Ankle Score, and the first 30 patients additionally underwent a clinical examination and muscular testing with a Cybex isokinetic dynamometer at 6 and 12 months.
RESULTS: We found good and excellent results in most cases. We observed five complete re-ruptures, almost exclusively in case of poor patient's compliance, two partial re-ruptures and one deep venous thrombosis complicated by pulmonary embolism.
CONCLUSION: Although prospective comparison with other modern treatment options is still required, the functional outcome after early ankle mobilisation in a dynamic cast is good enough to ethically propose this method as an alternative to surgical treatment.
Keywords
Achilles Tendon/injuries, Adult, Aged, Braces, Female, Follow-Up Studies, Humans, Male, Middle Aged, Muscle Strength Dynamometer, Patient Compliance, Prospective Studies, Recurrence, Rupture/physiopathology, Rupture/therapy, Treatment Outcome
Pubmed
Web of science
Create date
24/02/2010 13:59
Last modification date
20/08/2019 15:59
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