Clinical Study Of Postoperative Achilles Tendon Rupture Treated With Two Different Fixation Methods

Objective: To compare two plaster fixation methods for the repair of clinical treatment of the fresh Achilles tendon rupture closed.Methods: The patients who have the Achilles tendon rupture in our group from 2014.2 to2015.6,will have a detailed explanation about long leg plaster and short legs plaster, then choose fixation method and sign the informed consent by themselves.47 patients were included in the study, 25 cases of long legs plaster fixation(long leg plaster group), 22 cases of short leg plaster fixation(short leg plaster group).Long leg plaster group: 21 males, 4female; aged 21 to 48 years, mean 35.4 years;(short leg plaster group: 19 males and 3females; aged 18 to 52 years, mean 34.6 years. The time patients treated in two group range from 1 day to 2 weeks after they were injured with modified Kessler suture. In long leg plaster group, the plaster immobilization was postoperatively performed during which the patients were placed with the knees 30°bended and the ankle into a 30°planter- flexed position. In short leg plaster group, the plaster immobilization was postoperatively performed during which the patients were placed with the ankle into a 30°planter- flexed position only. The stitches were removed from the incision based on wound healing at postoperative approximately 2weeks.Non-weight bearing exercises were initialized with plaster immobilization postoperatively. The plaster cast was removed at postoperative 6 weeks.Postoperative rehabilitation exercises under the guidance of doctors, Mild weight-bearing exercise were performed in gradual manner, The patients were able to completely bear weight and carry out flatfoot walk and jogging exercise at postoperative 6 months. The average follow-up duration was 12.5 months. recording two wound healing, with or without Achilles tendon adhesions, re-rupture, sural nerve area feel the situation; At follow-up, the postoperative effects, functions, rehabilitation, complications and satisfaction survey were registered according to AOFAS score and Arner-Lindholm standard. Telephone follow-up to understand the recovery annually.SPSS22.0 statistical software for statistical analysis.Results: Two groups of patients were followed up for at least 10 months, up to 18 months with an average of 12.5 months; Wound healing: long leg plaster group had 3 cases with incision superficial infection, no deep infections,healed by debridement and changing dressing; short leg plaster group had 2 cases with incision superficial infection, no deep infections,healed by debridement and changing dressing too; sural nerve injury: long leg plaster group 0 cases, Short leg plaster group 1 cases and who sural nerve paresthesia recovery after 6 months; Achilles tendon adhesions: long leg plaster group 3 cases, short leg plaster group 0 cases; two groups had no re-rupture. There was no significant statistical differences in incidence of re-rupture, complications incision, tendon adhesion, sural nerve injury and incidence of total complications between two groups(P>0.05). Follow-up time was 3 months,6 months,10 months postoperatively, This two groups of postoperative follow-up through the AOFAS score standard evaluation of ankle joint function assessment after statistics analysis, there was no significant difference between two groups(P>0.05). Follow-up time was 10 months postoperatively, This two groups of postoperative follow-up through the Arner-Lindholm standard assessment after statistics analysis, there was no significant difference between two groups(P>0.05). But two groups of postoperative satisfaction had significant difference, the short leg plaster group was higher(P <0.05).Conclusion: Two fixation methods for Achilles tendon rupture in postoperative clinical effect is no significant difference,the patient satisfaction of the short leg plaster group is higher than the long leg plaster group.