The Incidence of Achilles Tendon Ruptures in Edmonton,                Canada

Background: The incidence of Achilles tendon ruptures specific to the North American population has not been previously reported and current epidemiological data are primarily reported from European communities. The purpose of this study was to determine the incidence of Achilles tendon ruptures in the city of Edmonton, Alberta, Canada, and to compare this data to those reported in European studies. Methods: A retrospective chart review from all five acute care hospitals in Edmonton from 1998 to 2002 (inclusive) were reviewed for Achilles tendon ruptures. Data such as gender, age, side, mechanism of injury, and season of injury were obtained. Results: The incidence of Achilles tendon ruptures ranged from an annual average of 5.5 ruptures to 9.9 ruptures per 100,000 inhabitants with an overall mean of 8.3 ruptures per 100,000 people. There was a statistically significant difference in Achilles tendon ruptures over the last two study years for both genders (women, p < 0.02; men, p < 0.03). The mean age for an Achilles tendon rupture was 40.6 years for men and 44.5 years for women. The Achilles tendon ruptures occurred most frequently in the 30 to 39 and 40 to 49 year old age groups in both men and women, respectively ( p < 0.02). Most ruptures occurred in the spring season, but there was no statistical difference in the incidence of Achilles tendon ruptures by season ( p > 0.05). Conclusions: The incidence of Achilles tendon ruptures in this community was comparable to those reported in European communities (range 6 to 37 ruptures per 100,000 people), although a bimodal age distribution of rupture previously reported was not observed in this study.

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Seasonal Variation of Achilles Tendon Injury

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00179 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0017

Author(s):

Jon-Michael Caldwell ◽

Harry Lightsey ◽

Hasani Swindell ◽

Justin Greisberg ◽

J. Turner Vosseller

Keyword(s):

Seasonal Variation ◽

Achilles Tendon ◽

Tendon Rupture ◽

Seasonal Pattern ◽

Achilles Tendon Rupture ◽

Tendon Injury ◽

Categorical Variables ◽

Continuous Variables ◽

Significant Difference ◽

Tendon Ruptures

Category: Sports Introduction/Purpose: Achilles tendon ruptures are increasingly common injuries. There are several known risk factors for Achilles tendon rupture, although little is reported on the seasonal variation of the incidence of these injuries. Of the few studies in the literature touching on this question, the results have been varied. We sought to determine if there is any seasonal pattern of Achilles tendon ruptures. Knowledge of such a seasonal pattern could be advantageous for patient education, risk assessment, and ultimately prevention of these injuries. Methods: We queried billing records for CPT codes 27650, 27652, and 27654 as well as ICD diagnosis codes 727.67, 845.09, and S86.01x pertaining to Achilles tendon injury, repair, and reconstruction. Charts were screened and included if the patient suffered an acute Achilles tendon rupture on a known date. Charts were excluded if the patient had a chronic Achilles tear or underwent reconstruction or debridement for tendonitis, Haglunds deformity, tendon laceration, or any other indication aside from acute rupture. Data was analyzed using a chi-squared test for categorical variables, binomial tests for dichotomous variables and Mann-Whitney-U or Welch t-test for continuous variables. Significance was set at p < 0.05. Results: Our search yielded 499 cases with 245 meeting inclusion criteria. Sixty-six percent (66%) of injuries were identified as sports-related while 34% were non-sports related. When stratified by month, significant peaks occurred in April and July (p = .036, .011 respectively) with significantly fewer injuries occurring in October through December (p = 0.049). The highest rate of injury was seen in Spring (p = .015) and the lowest was seen in Fall (p < .001). There was no significant difference between seasons when only the non-sports related injuries were considered. Basketball was the most common sport involved (n=78) accounting for 51% of injuries (p < .001), followed by soccer and tennis. There was no significant variation between seasons in any particular sport. Conclusion: There was significant seasonal variation in the incidence of Achilles tendon ruptures. Both sports and non-sports-related injuries followed a similar pattern, with most injuries occurring during the Spring and Summer and fewer during Fall and Winter. This increase corresponds to the increase in activity in the recreational athlete population in the region which is often preceded by a time of relative inactivity. Our study confirms that the deconditioned athlete is at particularly elevated risk for Achilles tendon rupture during the Spring season when abrupt increases in sporting activity are common. Targeted education and prevention efforts could help mitigate this risk.

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Prevalence of common phobias and their socio-demographic correlates in children and adolescents in a traditional developing society

European Psychiatry ◽

10.1016/s0924-9338(11)71978-2 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 268-268

Author(s):

A. Bener

Keyword(s):

Anxiety Disorders ◽

Social Phobia ◽

Children And Adolescents ◽

Age Distribution ◽

Age Groups ◽

Epidemiological Data ◽

Specific Phobia ◽

Cross Sectional ◽

Significant Difference ◽

Demographic Correlates

BackgroundEpidemiological data indicate that anxiety disorders are the most common childhood disorders and phobias are the most common form of anxiety disorders.AimTo identify the most common phobias in children and adolescents and to determine the prevalence, age distribution, and socio-demographic correlates of phobias.DesignA cross sectional studySettingPublic and Private schools of the Ministry of Education, State of QatarSubjectsA total of 2188 children and adolescents aged 6 to 18 years were approached and 1703 (77.8%) students participated in this study.MethodsThe questionnaire included socio-demographic information, extra curricular activities and hobbies, behaviour at home and various phobic fears. Psychiatrists determined the definitive diagnosis for various phobias by checking and screening their symptoms.ResultsOf the studied subjects, 44% were males and 56% were females. The overall prevalence of phobia in children and adolescents was 19.7%. Among children with phobia, females had higher rates of phobias (62.4% vs 37.6%) than males. Social phobia (12.7%) was the commonest phobia found followed by Agoraphobia (8.6%). Secondary school children were highly afflicted with social phobia (14.9%), agoraphobia (11.7%) and specific phobia (9.6%), while preparatory students (8.3%) were more likely to have’medical’ phobia (fear of physical illness, medical tests and procedures). A significant difference was observed between the age groups in children with agoraphobia (p = 0.002).ConclusionThe overall prevalence of phobia in children and adolescents in Qatar was higher, with the most common phobias observed being social phobia, agoraphobia and specific phobia.

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Surgical Repair of Achilles Tendon Ruptures Using Polypropylene Braid Augmentation

Foot & Ankle International ◽

10.1177/107110079401500705 ◽

1994 ◽

Vol 15 (7) ◽

pp. 372-375 ◽

Cited By ~ 8

Author(s):

Giannini Sandro ◽

Girolami Mauro ◽

Ceccarelli Francesco ◽

Catani Fabio ◽

Susanna Stea

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Surgical Repair ◽

Achilles Tendon Rupture ◽

Plaster Cast ◽

Test Evaluation ◽

Level Of Activity ◽

Significant Difference ◽

Tendon Ruptures ◽

Active Patients

Surgical repair in fresh rupture of the Achilles tendon should be considered in active patients and athletes to restore their preinjury level of activity. Fifteen cases of Achilles tendon rupture underwent surgical repair using interpositional augmentation. This technique provides an immediate mechanical strength of the repair, avoiding the need for a postoperative plaster cast and allowing immediate motion of the ankle. No wound infection, scar adherence of the skin to the tendon, or rerupture of the tendon is present in this series. All patients were subjectively satisfied with the results and returned to their preinjury level of activity. Objectively, isokinetic assessment revealed no significant difference, as per t-test evaluation ( P < .05), between the operated leg and the contralateral one.

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Short-term Outcomes of Open “Crown” Type v. Percutaneous Bunnell Type Repair of Acute Achilles Tendon Ruptures. Randomized Control Study

Lietuvos chirurgija ◽

10.15388/lietchirur.2020.19.29 ◽

2020 ◽

Vol 19 (3-4) ◽

pp. 101-108

Author(s):

Aleksas Makulavičius ◽

Giedrius Mazarevičius ◽

Povilas Masionis ◽

Matas Urmanavičius ◽

Mindaugas Klinga ◽

...

Keyword(s):

Patient Satisfaction ◽

Achilles Tendon ◽

Controlled Trial ◽

Achilles Tendon Rupture ◽

Deep Infection ◽

Percutaneous Technique ◽

Absorbable Suture ◽

Significant Difference ◽

Tendon Ruptures ◽

Group B

Background. The optimal treatment of acute Achilles tendon ruptures is still under debate. The purpose of this randomized controlled trial was to evaluate outcomes of open repair comparing with percutaneous procedure for Achilles tendon ruptures. Methods. 100 patients with acute Achilles tendon rupture were randomized in two groups: open “crown” type (group A) and percutaneous Bunnell type repair (group B). Absorbable suture was used in both groups. 87 patients were available for the mean follow up of 6 months. Results. No statistically significant difference was observed between groups in ATRS (Achilles Tendon Total Rupture Score), leg circumference, single heel rise, Achilles resting angle, time back to work and sports and overall patient satisfaction. Percutaneous technique was much faster. Overall 13 complications occurred in both groups (5 and 8 respectively). No deep infection occurred, no revisions were needed. Conclusions. Both techniques showed to be effective and safe when using absorbable suture material with a high patient satisfaction and a low complication rate, but percutaneous repair was significantly faster.

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Open Repair of Acute Achilles Tendon Ruptures: Is the Incidence of Clinically Significant Wound Complications Overestimated?

Foot & Ankle Orthopaedics ◽

10.1177/2473011417699834 ◽

2017 ◽

Vol 2 (2) ◽

pp. 247301141769983 ◽

Cited By ~ 2

Author(s):

Meghan E. Bishop ◽

Carly D. Comer ◽

Justin M. Kane ◽

Mitchell G. Maltenfort ◽

Steven M. Raikin

Keyword(s):

Achilles Tendon ◽

Open Repair ◽

Local Treatment ◽

Retrospective Chart Review ◽

Additional Treatment ◽

Operative Intervention ◽

Wound Complications ◽

Level Of Evidence ◽

Significant Difference ◽

Tendon Ruptures

Background: Conflicting evidence exists regarding the optimal management of acute Achilles tendon ruptures. Operative repair is thought to afford patients a lower risk of rerupture, albeit at a higher overall risk of wound complications. Methods: A retrospective chart review of 369 consecutive patients undergoing open repair of acute Achilles tendon ruptures performed by a single foot and ankle fellowship-trained orthopedic surgeon was undertaken. Healing was classified as no complications, complications without prolonging treatment, complications requiring prolonged local treatment, and complications requiring operative intervention. A statistical analysis comparing the rates of complications in this cohort to that reported in the literature was conducted. Results: There were a total of 33 (8.94%) wound complications. Compared to the rates reported in the literature, no significant difference was detected ( P = .3943; CI 6.24-12.33). However, when the complications not requiring additional treatment or prolonged care were excluded, only 9 wound complications (2.44%) were identified—a significantly lower complication rate than that reported in the literature ( P < .0001; CI 1.12-4.58). There were only 2 (0.54%) major complications requiring operative intervention, also a significantly lower rate than in the literature ( P < .0001; CI 0.067-1.94). Conclusion: In the past, wound-healing complications have been cited as a concern when treating patients operatively. We found that when solely looking at healing complications prolonging the patients’ overall recovery, a significantly lower rate of complications existed compared to that reported in the literature. Level of Evidence: Level IV.

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Achilles Tendon Ruptures in Middle-Aged Rats Heal Poorly Compared With Those in Young and Old Rats

The American Journal of Sports Medicine ◽

10.1177/03635465211055476 ◽

2021 ◽

pp. 036354652110554

Author(s):

Thomas P. Leahy ◽

Courtney A. Nuss ◽

Mary Kate Evans ◽

Ashley K. Fung ◽

Snehal S. Shetye ◽

...

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Ex Vivo ◽

Achilles Tendon Rupture ◽

Age Groups ◽

Middle Aged ◽

Aged Patients ◽

Old Patients ◽

Tendon Ruptures

Background: Achilles tendon ruptures are painful and debilitating injuries and are most common in middle-aged patients. There is a lack of understanding of the underlying causes for increased rupture rates in middle-aged patients and how healing outcomes after a rupture might be affected by patient age. Therefore, the objective of this study was to define age-specific Achilles tendon healing by assessing ankle functional outcomes and Achilles tendon mechanical and histological properties after a rupture using a rat model. Hypothesis: Rats representing the middle-aged patient population would demonstrate reduced healing capability after an Achilles tendon rupture, as demonstrated by a slower return to baseline ankle functional properties and inferior biomechanical and histological tendon properties. Study Design: Controlled laboratory study. Methods: Fischer 344 rats were categorized by age to represent young, middle-aged, and old patients, and Achilles tendon ruptures were induced in the right hindlimb. Animals were allowed to heal and were euthanized at 3 or 6 weeks after the injury. In vivo functional assays and ultrasound imaging were performed throughout the healing period, and ex vivo tendon mechanical and histological properties were assessed after euthanasia. Results: Rats representing middle-aged patients displayed reduced healing potential compared with the other age groups, as they demonstrated decreased recovery of in vivo functional and ultrasound assessment parameters and inferior mechanical and histological properties after an Achilles tendon rupture. Conclusion: These findings may help explain the increased rupture rate observed clinically in middle-aged patients by suggesting that there may be altered tendon responses to daily trauma. Clinical Relevance: The results provide novel data on age-specific healing outcomes after an Achilles tendon rupture, which underscores the importance of considering a patient’s age during treatment and expectations for outcomes.

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Updated Incidence of Thyroid Cancer in the North East Region of Romania after 35 Years of Chernobyl Fallout. Is There a Link between?

Diagnostics ◽

10.3390/diagnostics11050907 ◽

2021 ◽

Vol 11 (5) ◽

pp. 907

Author(s):

Laura Teodoriu ◽

Maria Christina Ungureanu ◽

Letitia Leustean ◽

Cristina Preda ◽

Delia Ciobanu ◽

...

Keyword(s):

Thyroid Cancer ◽

Age Distribution ◽

Age Groups ◽

Chernobyl Fallout ◽

Statistical Correlations ◽

North East ◽

The North ◽

East Region ◽

Radioactive Cloud ◽

The Moment

Thyroid cancer (TC) represents a worldwide problem, the consistent growth of the incidence increment issues about management of risk factors and curative treatment. Updated statistical data are not complete in the North East region of Romania and need to be improved. Therefore, through this study, we aim to renew the existing data on thyroid cancer. We conducted a retrospective study covering a period of 10 years. Data were collected from a hospital information system (InfoWorld) between 2009 and 2019. Patients’ age groups were stratified in relation with the age at the moment of the Chernobyl event. A database was obtained (Microsoft Excel) and statistical correlations were applied. In the studied period, 1159 patients were diagnosed: 968 females and 191 males, distributed by region, with the highest addressability in Iasi (529), followed by neighboring counties. Age distribution displayed that most of the thyroid cancers were in the range 4060 years old (50.94%), followed by 60–80 years old (32.41%). Most patients were diagnosed with papillary carcinoma 63.10%, then follicular 14.7%, medullary 6.74% and undifferentiated 1.02%. Romania was in the vicinity of the radioactive cloud at Chernobyl fallout, so we must deliberate whether the increased incidence of thyroid cancer in the age group 40–60 years is associated with radiogenicity (iodine 131) given the fact that over has 35 years and the half-life of other radioisotopes like Caesium-137 and Strontium -90 is completed.

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The Percutaneous Surgical Approach for Repairing Acute Achilles Tendon Rupture

Journal of the American Podiatric Medical Association ◽

10.7547/1000270 ◽

2010 ◽

Vol 100 (4) ◽

pp. 270-275 ◽

Cited By ~ 7

Author(s):

Shay Tenenbaum ◽

Niv Dreiangel ◽

Ayal Segal ◽

Amir Herman ◽

Amnon Israeli ◽

...

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Demographic Data ◽

Achilles Tendon Rupture ◽

Treatment Modalities ◽

Main Concern ◽

Complication Rates ◽

Percutaneous Surgery ◽

Significant Difference ◽

The Mean

Background: Treatment modalities for acute Achilles tendon rupture can be divided into operative and nonoperative. The main concern with nonoperative treatment is the high incidence of repeated ruptures; operative treatment is associated with risk of infection, sural nerve injury, and wound-healing sequelae. We assessed our experience with a percutaneous operative approach for treating acute Achilles tendon rupture. Methods: The outcomes of percutaneous surgery in 29 patients (25 men; age range, 24–58 years) who underwent percutaneous surgery for Achilles tendon rupture between 1997 and 2004 were retrospectively evaluated. Their demographic data, subjective and objective evaluation findings, and isokinetic evaluation results were retrieved, and they were assessed with the modified Boyden score and the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale. Results: All 29 patients demonstrated good functional outcome, with no- to mild-limitations in recreational activities and high patient satisfaction. Mean follow-up was 31.8 months. Changes in ankle range of motion in the operated leg were minimal. Strength and power testing revealed a significant difference at 90°/sec for plantarflexion power between the injured and healthy legs but no difference at 30° and 240°/sec or in dorsiflexion. The mean modified Boyden score was 74.3, and the mean Ankle-Hindfoot Scale score was 94.5. Conclusions: Percutaneous surgery for Achilles tendon rupture is easily executed and has excellent functional results and low complication rates. It is an appealing alternative to either nonoperative or open surgery treatments. (J Am Podiatr Med Assoc 100(4): 270–275, 2010)

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The Influence of Diabetes on Acute Achilles Tendon Rupture Repair

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00282 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0028

Author(s):

Jonathan Kaplan ◽

Jeffery Hillam ◽

Amiethab Aiyer ◽

Niall Smyth

Keyword(s):

Diabetes Mellitus ◽

Postoperative Complications ◽

Achilles Tendon ◽

Power Analysis ◽

Tendon Rupture ◽

Surgical Repair ◽

Achilles Tendon Rupture ◽

The United States ◽

Foot And Ankle ◽

Tendon Ruptures

Category: Sports Introduction/Purpose: Diabetes Mellitus (DM) is an epidemic affecting millions of individuals in the United States. Multiple studies have demonstrated an increase in complications in foot and ankle surgery in patients with DM, including wound healing complications, surgical site infections (SSI), or surgical failure. The goal of this study was to retrospectively review outcomes data from the National Surgical Quality Improvement Program (NSQIP) to determine the impact of DM on operative treatment of achilles tendon ruptures. Methods: Using the NSQIP from 2006-2015, patients were identified using common procedure terminology (CPT) for Achilles tendon ruptures. Diabetic and non-diabetic cohorts were evaluated to compare demographics, comorbidities, perioperative details and 30-day outcomes. Statistical evaluation included a power analysis for the primary outcome measure of wound disruption as well as univariate analysis was performed using chi-squared or Fisher’s exact and Wilcoxon signed-rank tests. Results: A total of 2,014 patients were identified having sustained an Achilles tendon rupture. There were 1,981 patients without DM and 33 patients with DM. There were no significant differences in postoperative complications, including SSI, medical complications, and 30-day outcomes between patients with DM and non-DM patients undergoing surgical repair of acute Achilles tendon ruptures. The power analysis for wound disruption showed a P=0.9 with an alpha of 0.05, sample size of n=2014, and Pearson correlation coefficient of r=0.0721 Conclusion: While DM has been shown to have an increase in complications in various foot and ankle procedures, this study demonstrates that there is no significant difference in postoperative complications and 30-day outcomes between patients with DM and non-DM patients undergoing surgical repair of acute Achilles tendon ruptures using the NSQIP database from 2006-2015. Based on this data, patients with diabetes mellitus can be considered adequate surgical candidates for acute Achilles tendon rupture repair.

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Intraoperative Ultrasonography assistance for minimally invasive repair of the acute Achilles Tendon Rupture

10.21203/rs.3.rs-16380/v1 ◽

2020 ◽

Author(s):

Yongliang Yang ◽

Honglei Jia ◽

Wupeng Zhang ◽

Shihong Xu ◽

Fu Wang ◽

...

Keyword(s):

Minimally Invasive ◽

Achilles Tendon ◽

Nerve Injury ◽

Saphenous Vein ◽

Sural Nerve ◽

Tendon Rupture ◽

Achilles Tendon Rupture ◽

Intraoperative Ultrasonography ◽

Medial Side ◽

Significant Difference

Abstract Background: Minimally invasive repair is a better option for Achilles tendon rupture with low re-rupture and wound-related complications than conservative treatment or traditional open repair. The major problem is sural nerve injury. The purpose of this study was to evaluate the effect and advantage of the intraoperative ultrasonography assistance for minimally invasive repair of the acute Achilles tendon rupture.Methods: A retrospective study was performed on 36 cases of acute Achilles tendon rupture treated with minimally invasive repair assisted with intraoperative ultrasonography from January 2015 to December 2017. The relationship of the sural nerve and small saphenous vein was confirmed on the preoperative MRI. The course of the small saphenous vein and sural nerve were identified and marked by intraoperative ultrasonography. The ruptured Achilles tendon was repaired with minimally invasive Bunnell suture on the medial side of the SSV.Results: All patients were followed up for at least 12 months. No sural nerve injury or other complications was found intraoperatively and postoperatively. All the patients returned to work and light sporting activities at a mean of 12.78±1.40 weeks and 17.28±2.34 weeks, respectively. The Mean AOFAS scores improved from 59.17±5.31 preoperatively to 98.92±1.63 at the time of 12 months follow-up. There was statistically significant difference (P<0.001). No patient complained a negative effect on their life.Conclusions: The minimally invasive repair assisted with intraoperative ultrasonography can yield good clinical outcomes, less surgical time and less complications, especially sural nerve injury. It is an efficient, reliable and safe method for acute AT rupture.

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