慢性阿基里斯肌破裂的全球视角:一个ESSKA AFAS调查倡议
João Vide1,2,3,4, Francisco Santos3, Sofia Dantas5
1Hospital da Luz Lisboa, Lisbon, Portugal.
概括
慢性阿基里斯肌破裂 (CATR) 的管理在外科医生之间显示出国际差异. 虽然对于小缺陷而言,端到端的修复更受青,但由于证据有限,治疗算法仍然不清楚.
科学领域:
- 整形外科手术 整形外科手术
- 运动医学 运动医学
- 肌肉骨研究 研究
背景情况:
- 慢性阿基里斯肌破裂 (CATR) 提出了独特的管理挑战.
- 目前缺乏评估和治疗CATR的指导方针.
- 了解外科医生的倾向对于开发标准化方案至关重要.
研究的目的:
- 为了确定国际趋势在评估和管理的CATR在脚和脚骨科外科医生.
- 探索手术前规划,手术方法和技术选择中的变化.
- 调查CATR的康复策略和感知到的功能结果.
主要方法:
- 一个基于网络的问卷被分发给56个国际脚和脚整形学会.
- 分析了来自60个国家的667名外科医生的数据.
- 趋势是通过参与者的共识来定义的:"主要趋势" (≥75%),"趋势" (50%-75%),和"没有趋势" (<50%).
主要成果:
- 磁共振成像 (MRI) 是外科规划中首选的成像方式 (88%).
- 差距大小 (80%),受伤时间 (61%) 和患者年龄 (57%) 影响技术选择.
- 开放式维修是最常见的技术 (66%),对于缺陷<2厘米 (68%) 最喜欢端到端的维修.
- 康复方案显示异质性,但石膏固定在equinus (55%) 和步行鞋使用 (90%) 是常见的.
- 对CATR的功能结果被认为比急性破裂 (54%) 稍差一些.
结论:
- 在CATR管理中存在显著的国际差异,突出了需要更明确的指导方针的需要.
- 对缺陷<2厘米的端到端维修是一种一致的方法.
- 观察到的变异性强调了CATR.缺乏强有力的证据和确定的治疗算法.
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