中国修复重建外科杂志

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急性跟腱断裂术后早期功能锻炼的研究进展

赵嘉国 1 , , 郭文煊 2 , 曾宪铁 1 , 阚世廉 3

1. 天津市天津医院足踝外科（天津 300211） ;
2. 天津中医药大学研究生院（天津  300193） ;
3. 天津市天津医院手外科（天津 300211）

收稿日期: 2018-07-31;  修回日期:2019-01-07; 

基金项目: 天津市“131”创新型人才培养工程

通讯作者: 赵嘉国, Email: orthopaedic@163.com

Research progress of early postoperative rehabilitation for acute Achilles tendon rupture after surgical repair

ZHAO Jiaguo 1 , , GUO Wenxuan 2 , ZENG Xiantie 1 , KAN Shilian 3

1. Department of Foot and Ankle Surgery, Tianjin Hospital, Tianjin, 300211, P.R.China ;
2. School of Graduates, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, P.R.China ;
3. Department of Hand Surgery, Tianjin Hospital, Tianjin, 300211, P.R.China

Corresponding Author: ZHAO Jiaguo, Email: orthopaedic@163.com

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目的 总结急性跟腱断裂术后早期功能锻炼的研究进展。 方法 查阅近年来国内外关于急性跟腱断裂术后早期功能锻炼的临床随机对照研究和系统评价，并进行分析总结。 结果 急性跟腱断裂术后早期功能锻炼主要包括早期屈伸活动、早期负重、早期负重联合屈伸活动。临床随机对照研究结果显示，术后早期屈伸活动、早期负重或者两者联合，患者恢复效果与早期固定相似或优于早期固定。系统评价结果显示，早期功能锻炼有利于跟腱功能恢复，并且缩短了术后恢复时间，不会增加术后再断裂等并发症发生率。 结论 急性跟腱断裂术后早期在支具保护下行功能锻炼有利于早期功能恢复，但早期活动和负重的方式和最佳时机尚无统一标准，需要进一步研究。

Objective To summarize the latest research progress of early postoperative rehabilitation for acute Achilles tendon rupture after surgical repair. Methods The high-quality randomized controlled trials and systematic reviews/meta-analyses regarding early postoperative rehabilitation for acute Achilles tendon rupture in recent years were reviewed. Results There are three functional rehabilitations after acute Achilles tendon rupture surgery, including early postoperative mobilization, early weight-bearing with immobilization, and early weight-bearing combined with mobilization. The results of randomized controlled trials show that the effectiveness of early postoperative rehabilitation is similar or better than the early postoperative immobilization. The results of systematic reviews/meta-analyses show that the early postoperative rehabilitation is beneficial to the early function recovery of the Achilles tendon, can reduce the time for functional recovery, and do not adversely affect the outcomes. Conclusion Early postoperative rehabilitation is beneficial to the functional recovery, and do not increase postoperative complications. There is still no uniform protocol of early postoperative rehabilitation and the timing of weight-bearing, and more studies are needed.

关键词: 急性跟腱断裂; 手术治疗; 早期功能锻炼

Key words: Acute Achilles tendon rupture; surgical treatment; early functional rehabilitation

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