Outcome of a Simple Novel Technique to Reduce Soft Tissue Complications in Open Tendoachilles Injury: A Series of 20 Patients

Mohd J; Bhat NA; Lone ZA; Bhat TA; Afzal T; Dev B; Butt MF; Gupta S

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Outcome of a Simple Novel Technique to Reduce Soft Tissue Complications in Open Tendoachilles Injury: A Series of 20 Patients

Author: Mohd J ¹ ; Bhat NA ¹ ; Lone ZA ² ; Bhat TA ² ; Afzal T ² ; Dev B ² ; Butt MF ² ; Gupta S ²
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1. Department of Orthopaedics, Government Medical College Anantnag, Anantnag, India
2. Department of Orthopaedics, Government Medical College Jammu, Jammu, India
Publication Type:Journal Article
Keywords: open tendoachilles injury, lavatory pan toilet injury, primary end to end repair, AOFAS hindfoot score
From:Malaysian Orthopaedic Journal 2023;17(No.2):49-56
CountryMalaysia
Language:English
Abstract: Introduction: Open tendoachilles injuries are rare and associated with significant soft tissues complications. The objective of the present study was to assess the clinical outcome and safety of a simple and minimally invasive technique, with a goal to assess if it may help minimise flap and wound related complications in open tendoachilles injuries. Materials and methods: This prospective study of four years duration included 20 patients with open tendoachilles injuries managed with a simple minimally invasive tunnel technique. The primary outcome variable was occurrence of a major soft tissue complication. The secondary outcome variables included functional outcome measured using AOFAS Ankle hind foot score, re-rupture of tendoachilles and need for revision surgery. Results: None of the patients in the present series developed a serious soft tissue complication. Based upon the AOFAS hind foot scoring system, good to excellent outcome was achieved in 19 (95%) patients. All the patients were able to perform tip toe walking at six months post-surgery. None of the patients had a re-rupture of the tendoachilles and no patient needed a revision surgery. The complications encountered include thickening of the tendon at the repair site (15%), superficial wound infection (5%), stitch granuloma (5%) and hypertrophic scar (5%). Conclusion: This technique seems to be promising in reducing the soft tissue complications associated with the surgical management of open tendoachilles injuries. Most patients had a good final clinical outcome. The technique is safe, simple and reproducible. However, further randomised control studies with a larger sample size assessing the technique are recommended.