1.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
Malaysian Orthopaedic Journal 2023;17(No.2):49-56
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.