Background

The best choice of orthosis in the treatment of acute Achilles tendon rupture is still under debate.

Objective

To investigate if choice of orthosis in the first 3 weeks of treatment affected patient reported outcome (Achilles tendon Total Rupture Score (ATRS)), tendon elongation (Achilles Tendon Resting Angle (ATRA) and Heel Rise Height (HRH)) and re-rupture.

Methods

Registry study in the Danish Achilles tendon Database. Patients treated with cast and patients treated with walker in the first 3 weeks of treatment were compared using a linear mixed-effects model adjusted for potential confounders.

Results

1304 patients were included in the study. No clinically relevant difference was found: Adjusted mean difference (using walker the whole period as reference)(95% CI) ATRS after 1 year = 0.1(−3.0; 4.1), ATRS after 6 months = 2.0(−4.5; 5.8), ATRS after 2 years = 3.0(−0.7; 7.0), HRH difference = 0.6(−6.6; 8.2), ATRA difference = 0.03°(−1.5; 1.6), re-rupture(odds ratio) = 0.812(0.4; 1.61).

Conclusion

Patients treated with cast the first 3 weeks after acute Achilles tendon rupture did not have better treatment outcome than patients treated with walker.

中文翻译：

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急性跟腱断裂后前 3 周使用石膏或助行器的 1 年治疗结果没有差异。来自丹麦跟腱数据库的 1304 名患者的注册研究

背景

治疗急性跟腱断裂矫形器的最佳选择仍在争论中。

客观的

调查治疗前 3 周内矫形器的选择是否影响患者报告的结果（跟腱总断裂评分 (ATRS)）、肌腱伸长（跟腱静止角 (ATRA) 和足跟抬高 (HRH)）和再断裂.

方法

丹麦跟腱数据库中的注册研究。使用针对潜在混杂因素调整的线性混合效应模型比较在治疗的前 3 周内接受石膏治疗的患者和接受助行器治疗的患者。

结果

1304 名患者被纳入研究。未发现临床相关差异：调整后的平均差异（整个期间使用沃克作为参考）（95% CI）1 年后 ATRS = 0.1（-3.0；4.1），6 个月后 ATRS = 2.0（-4.5；5.8）， 2 年后 ATRS = 3.0（-0.7；7.0），HRH 差异 = 0.6（-6.6；8.2），ATRA 差异 = 0.03°（-1.5；1.6），再破裂（优势比）= 0.812（0.4；1.61） .

结论

急性跟腱断裂后前 3 周接受石膏治疗的患者的治疗结果并不优于接受助行器治疗的患者。