Abstract：
BACKGROUND: Delayed treatment of Achilles tendon ruptures is generally due to either misdiagnosis or patient delay. When the treatment is delayed more than 4 weeks, the rupture is defined as \"chronic\", and almost always requires more invasive surgery and longer rehabilitation time compared with acute Achilles tendon ruptures. There is insufficient knowledge of patient experiences of sustaining and recovering from a chronic Achilles tendon rupture.
METHODS: To evaluate patients\' experiences of suffering a chronic Achilles tendon rupture, semi-structured group interviews were conducted 4-6 years after surgical treatment using a semi-structured interview guide. The data were analyzed using qualitative content analysis described by Graneheim and Lundman.
RESULTS: The experiences of ten patients (65 ± 14 years, 7 males and 3 females) were summarized into four main categories: (1) \"The injury\", where the patients described immediate functional impairments, following either traumatic or non-traumatic injury mechanisms that were misinterpreted by themselves or the health-care system; (2) \"The diagnosis\", where the patients expressed relief in receiving the diagnosis, but also disappointment and/or frustration related to the prior misdiagnosis and delay; (3) \"The treatment\", where the patients expressed high expectations, consistent satisfaction with the surgical treatment, and addressed the importance of the physical therapist having the right expertise; and (4) \"The outcomes\", where the patients expressed an overall satisfaction with the long-term outcome and no obvious limitations in physical activity, although some fear of re-injury emerged.
CONCLUSIONS: An Achilles tendon rupture can occur during both major and minor trauma and be misinterpreted by both the assessing health-care professional as well as the patient themselves. Surgical treatment and postoperative rehabilitation for chronic Achilles tendon rupture results in overall patient satisfaction in terms of the long-term outcomes. We emphasize the need for increased awareness of the occurrence of Achilles tendon rupture in patients with an atypical patient history.
METHODS: To evaluate patients\' experiences of suffering a chronic Achilles tendon rupture, semi-structured group interviews were conducted 4-6 years after surgical treatment using a semi-structured interview guide. The data were analyzed using qualitative content analysis described by Graneheim and Lundman.
RESULTS: The experiences of ten patients (65 ± 14 years, 7 males and 3 females) were summarized into four main categories: (1) \"The injury\", where the patients described immediate functional impairments, following either traumatic or non-traumatic injury mechanisms that were misinterpreted by themselves or the health-care system; (2) \"The diagnosis\", where the patients expressed relief in receiving the diagnosis, but also disappointment and/or frustration related to the prior misdiagnosis and delay; (3) \"The treatment\", where the patients expressed high expectations, consistent satisfaction with the surgical treatment, and addressed the importance of the physical therapist having the right expertise; and (4) \"The outcomes\", where the patients expressed an overall satisfaction with the long-term outcome and no obvious limitations in physical activity, although some fear of re-injury emerged.
CONCLUSIONS: An Achilles tendon rupture can occur during both major and minor trauma and be misinterpreted by both the assessing health-care professional as well as the patient themselves. Surgical treatment and postoperative rehabilitation for chronic Achilles tendon rupture results in overall patient satisfaction in terms of the long-term outcomes. We emphasize the need for increased awareness of the occurrence of Achilles tendon rupture in patients with an atypical patient history.
摘要：
背景：跟腱断裂的延迟治疗通常是由于误诊或患者延误。当治疗延迟超过4周时，破裂定义为“慢性”，与急性跟腱断裂相比，几乎总是需要更多的侵入性手术和更长的康复时间。对患者从慢性跟腱断裂中维持和恢复的经验了解不足。
方法：为了评估患者遭受慢性跟腱断裂的经历，手术治疗后4~6年,采用半结构化访谈指南进行半结构化小组访谈.使用Graneheim和Lundman描述的定性内容分析对数据进行分析。
结果：10例患者（65±14年，7名男性和3名女性)被总结为四大类：(1)“伤害”，患者描述了直接的功能障碍，遵循自身或医疗保健系统误解的创伤性或非创伤性损伤机制；(2)“诊断”，患者在接受诊断时表示放心，但也与先前的误诊和延误有关的失望和/或沮丧；(3)“治疗”，病人表达了很高的期望，对手术治疗的满意度一致，并阐述了物理治疗师拥有正确专业知识的重要性；和(4)“结果”，患者对长期结果表示总体满意，并且在身体活动方面没有明显的限制，尽管出现了一些对再次受伤的恐惧。
结论：跟腱断裂可发生在严重和轻微创伤期间，并被评估卫生保健专业人员和患者本身误解。慢性跟腱断裂的手术治疗和术后康复可提高患者的长期满意度。我们强调有非典型病史的患者需要提高对跟腱断裂发生的认识。
方法：为了评估患者遭受慢性跟腱断裂的经历，手术治疗后4~6年,采用半结构化访谈指南进行半结构化小组访谈.使用Graneheim和Lundman描述的定性内容分析对数据进行分析。
结果：10例患者（65±14年，7名男性和3名女性)被总结为四大类：(1)“伤害”，患者描述了直接的功能障碍，遵循自身或医疗保健系统误解的创伤性或非创伤性损伤机制；(2)“诊断”，患者在接受诊断时表示放心，但也与先前的误诊和延误有关的失望和/或沮丧；(3)“治疗”，病人表达了很高的期望，对手术治疗的满意度一致，并阐述了物理治疗师拥有正确专业知识的重要性；和(4)“结果”，患者对长期结果表示总体满意，并且在身体活动方面没有明显的限制，尽管出现了一些对再次受伤的恐惧。
结论：跟腱断裂可发生在严重和轻微创伤期间，并被评估卫生保健专业人员和患者本身误解。慢性跟腱断裂的手术治疗和术后康复可提高患者的长期满意度。我们强调有非典型病史的患者需要提高对跟腱断裂发生的认识。
