Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Correlation between a Rupture of the Hypovascular Zone and Early Single Heel Raising after Achilles Tendon Repair

아킬레스건 봉합술 후 조기 단일 하지 거상과 아킬레스건 허혈성 구간 침범과의 상관관계

  • Song, Si-Jung (Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital) ;
  • Lee, Moses (Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital) ;
  • Shin, Myung Jin (Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital) ;
  • Suh, Jin Soo (Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital)
  • 송시정 (인제대학교 일산백병원 정형외과) ;
  • 이모세 (인제대학교 일산백병원 정형외과) ;
  • 신명진 (인제대학교 일산백병원 정형외과) ;
  • 서진수 (인제대학교 일산백병원 정형외과)
  • Received : 2017.11.06
  • Accepted : 2017.12.13
  • Published : 2018.03.15
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Abstract

Purpose: To analyze the correlation between a rupture of the hypovascular zone and early single heel raising after Achilles tendon repair. Materials and Methods: From January 2012 to August 2015, 68 patients, who underwent surgical treatment for a Achilles tendon rupture using Krackow method, were analyzed retrospectively. The patients were divided into two groups according to possibility of single heel raises within 3 months postoperatively. During the periodic outpatient observations, the visual analogue scale, Achilles tendon total rupture score (ATRS), and timing capable single heel raises were evaluated. In addition, the preoperative defect size and distance between the calcaneal osteotendinous junction and the rupture site were measured by ultrasound in all cases. Results: Twenty-three patients could perform a single heel raise within 3 months after surgery (early single heel raise group), and fortyfive patients could perform a single heel raise after 3 month postoperatively. The age, gender, body mass index, smoking, and operation delay were similar in the two groups. In addition, the defect size and distance between the calcaneal osteotendinous junction and rupture site as measured by preoperative ultrasound were similar (p=0.379 and p=0.631, respectively). On the other hand, when the rupture site was divided into the hypovascular zone (4~7 cm from calcaneal osteotendinous junction) and non-hypovascular zone, the hypovascular zone rupture rate was significantly lower in the early single heel raise group (60.9%, 14/23; 91.1%, 41/45; p=0.003). In logistic regression analysis, the odds of the hypovascular zone rupture group being capable of early single heel raise were 0.189 (p=0.017). The ATRS score at 3 months and 1 year after surgery were significantly higher in the early single heel raise group (p<0.001). Conclusion: Achilles tendon rupture at the hypovascular zone is a poor prognostic factor for early single heel raise and might affect the prognosis significantly after an Achilles tendon rupture operation.

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References

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