运动性跟腱损伤的临床流行病学特点  

Analysis of clinical epidemiology in achilles tendon injury due to exercise

作　　者：赵立君[1] 杨小玉[2] 李红群[2] 付凯[1] 殷赵阳[2] 张善永[2] 

机构地区：[1]吉林大学体育学院,吉林省长春市130012 [2]吉林大学中日联谊医院骨科,吉林省长春市130012

出　　处：《中国临床康复》2006年第28期10-12,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:分析运动性跟腱损伤患者的临床资料,探讨如何防治运动性跟腱损伤发生,降低其发生率。方法:对运动性跟腱损伤的临床资料进行回顾性分析。于1994-08/2005-11选择吉林大学中日联谊医院骨科、解放军第四六一医院骨科收治运动性跟腱损伤患者64例为研究对象。保守治疗10例,分别采取屈膝跖屈石膏固定4～6周。手术治疗54例,其中进行直接缝合术41例,局部肌腱瓣成形术11例,异体肌腱移植2例。术后屈膝40°,足跖屈30°位长腿石膏固定,6周后改为膝下石膏固定,8周后拆除石膏,改穿高跟鞋,练习踝关节跖背屈活动。10周后去高跟鞋,逐步适应性练习全足落地下蹲,12周后练习双足提踵,并逐渐过渡到单足提踵。20周后踝关节活动加大加强,可室内工作,24周后恢复正常工作和剧烈活动。随访6个月,按照Arner-Lindholm评定标准评估疗效。建立运动性跟腱损伤患者数据库,对每例患者伤前所从事的运动项目、损伤原因、损伤机制、损伤特点及治疗效果等内容逐一输入数据库,汇总分析。结果:①患者伤前所从事运动项目:篮球运动21例,跳远运动9例,足球运动8例,长跑运动5例,体操运动3例,排球运动13例,武术3例,散打2例。②与运动性跟腱损伤受伤相关因素:伸膝负重状态下突然弹跳离地动作34例(53%);不经常锻炼者41例(64%);未做准备活动与准备活动不充分者51例(80%);由跟腱原始基础病引起的37例(58%)。③运动性跟腱损伤特点:跟腱似有撞击感或被踢感60例(94%);可听到跟腱断裂声47例(73%);伤后局部麻胀、酸感者60例(94%);无痛觉者12例(19%),有不同程度疼痛者15例(23%)。④疗效分析:随访6～30个月,随访52例,手术治疗患者43例,全部恢复训练及活动,优25例,良16例,差2例;保守治疗患者9例,优3例,良5例,差1例,患肢疲劳、跛行、踝关节活动明显减小。结论:跟腱原发病存在是引发运动性跟腱损伤重要�AIM： To analyze the clinical data of patients with achilles tendon injury in athletics, and discuss how to prevent and cure the achilles tendeon injury in athletics and degrade its incidence. METHODS： The clinical data of patients with achilles tendon injury in athletics were retrospectively analyzed. Sixty-four patients with achilles tendon injury were selected from the Department of Orthopedics, China-Japan Friendship Hospital Affiliated to Jilin University and Department of Orthopedics, the 461 Hospital of Chinese PLA between August in 1994 and November 2005. Of them, 10 were cured by plaster immobilization with genuflex and plant flex for four to six weeks, and 54 patients received surgical operation, in which 41 received direct sutura, 11 were given partial tendon flap plasty, and 2 received variant tendon transplantation. Patients were immobilized by long leg cast with genuflex of 40° and planter flexion of 30° after operation. After six weeks, long leg casts were changed by BK casts, and the long leg casts were displaced at 8 weeks after that, and patients wore high-beel shoes, practiced plantar flexion of ankle. Ten weeks later, patients displaced the high-heel shoes and gradually practice to squat with whole-foot of affected extremity. Twelve weeks later, patients practiced to lift heels with both feet and gradually transit to lift heels with one foot. Twenty weeks later, patients reinforced the joint motion of ankle and worked inside the room. Twenty- four weeks later, patients took common jobs and aggravating activities. The therapeutic effects of cases in 6-month follow-up were evaluated by Arner- Lindholm evaluation criteria. The database of achilles tendon injury in athletics was established, and data of mode of exercise, reasons of injury, mechanism of injury, feature of injury and effect of treatment etc. in each patient before injury were input in the database for analysis. RESULTS：（1）Sports activities that patients took before injury： basketball （twenty-one cases）, broad ju

关 键 词：运动医学 跟腱/损伤 流行病学 

分 类 号：R339.4[医药卫生—人体生理学]