INTRODUCTIONBoth conservative and operative management have been described in the literature for the management of chronic Achilles tendon ruptures with surgical management generally having more favourable results. In our institution, the favoured reconstructive technique was the use of 2 turndown tendon fl aps fashioned from the proximal Achilles tendon augmented by a tenomyodesis of the flexor hallucis longus. The purpose of this study was to assess the clinical outcome of all patients who underwent this procedure.

MATERIALS AND METHODSFrom the records, a total of 9 patients underwent the above-mentioned procedure of whom 6 patients had complete data collection sets [including SF-36, Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores, ankle range of motion (ROM), presence of residual symptoms and complications] at 2 years of follow-up.

RESULTSOur results showed an average AOFAS Ankle-Hindfoot score of 94.2, VAS of 0 in all but 1 patient, and generally high scores (75-96) in all 8 domains of the SF-36 questionnaire. Patient satisfaction was also rated to be high from the surgical procedure.

CONCLUSIONWe submit that the procedure adopted at our institution is able to reproduce satisfactory results with low morbidity in patients with this challenging condition.

Achilles Tendon ; injuries ; surgery ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; surgery ; Orthopedic Procedures ; methods ; rehabilitation ; Patient Satisfaction ; Recovery of Function ; Rupture ; surgery ; Suture Techniques ; Tendon Injuries ; surgery ; Tendons ; transplantation ; Transplantation, Autologous

INTRODUCTIONTendo Achilles (TA), which is the confluence of the gastrocnemius and soleus muscles, is one of the most commonly injured tendons. The surgical repair of TA ruptures is associated with a significant risk of infection. This study examined several factors (i.e. gender, age, body mass index, history of diabetes mellitus, steroid use, acute or chronic TA injuries, type of surgical incision and type of sutures used) that may be associated with postoperative wound infection after open TA repair.

METHODSThis was a retrospective study involving 60 patients who underwent open TA repair over an 18-month period. Patients who had prior TA surgery or open TA injuries, or who needed soft tissues flaps were excluded.

RESULTSAmong the patients, 7 (11.7%) developed superficial wound infections that were successfully treated with oral antibiotics, while 3 (5.0%) developed deep wound infections that required at least one debridement procedure. No significant association was found between the risk of postoperative wound infection and gender, age, the presence of diabetes mellitus, acute or chronic ruptures, site of surgical incision and type of deep or superficial sutures used.

CONCLUSIONWhile diabetes mellitus and age did not appear to be associated with postoperative wound infections after open TA repair, obese patients were found to be two times more likely to develop a wound infection than normal-weight patients. The incidence of superficial wound infections in this study was similar to previously published results (11.7% vs. 8.2%-14.6%), but the incidence of deep infections was higher (5% vs. 1%-2%).

Achilles Tendon ; surgery ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Body Mass Index ; Diabetes Complications ; Diabetes Mellitus ; pathology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Rupture ; surgery ; Surgical Wound Infection ; prevention & control ; Suture Techniques ; Tendon Injuries ; Wound Healing