Long-Term Functional Outcome of Bilateral Spontaneous and Simultaneous Achilles Tendon Ruptures

2012 ◽  
Vol 5 (5) ◽  
pp. 318-320
Author(s):  
Prasad Ellanti ◽  
Nikos Davarinos ◽  
Thomas E. Burke ◽  
Lester G. D’Souza
Keyword(s):  
Risk Factors ◽  
Achilles Tendon ◽  
Functional Outcome ◽  
Chronic Diseases ◽  
Therapeutic Level ◽  
Level Of Evidence ◽  
Good Functional Outcome ◽  
Tendon Ruptures

Bilateral simultaneous ruptures are rare comprising less than 1% of all Achilles tendon ruptures. Risk factors for bilateral ruptures include chronic diseases and medications such as corticosteroids and fluoroquinolones. There is little in the literature on the long-term functional outcome of bilateral Achilles tendon ruptures. This article present a series of 3 cases of simultaneous and spontaneous bilateral Achilles tendon ruptures with a minimum of 5-year follow up suggesting a good functional outcome. Level of Evidence: Therapeutic Level IV

Long-Term Effects of Decompressive Craniectomy on Functional Outcomes after Traumatic Brain Injury: A Multicenter Study

2018 ◽  
Vol 84 (8) ◽  
pp. 1314-1318 ◽  
Author(s):  
Eliza Moskowitz ◽  
Claudia I. Melendez ◽  
Julie Dunn ◽  
Abid D. Khan ◽  
Richard Gonzalez ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Confidence Interval ◽  
Functional Outcome ◽  
Decompressive Craniectomy ◽  
Functional Outcomes ◽  
Structured Interview ◽  
Good Functional Outcome

Decompressive craniectomy (DC) is a surgical modality sometimes used in the management of elevated intracranial pressure. Questions remain as to its long-term benefits in traumatic brain injury patients. The extended Glasgow Outcome Scale (eGOS) is a scoring system based on a structured interview that allows for consistent and reproducible measurement of long-term functional outcomes. The purpose of this study was to determine the eGOS score of post-craniectomy patients after discharge and stratify survivors based on outcome. A multicenter review of patients who underwent DC was performed. Survivors underwent a phone survey at which time the eGOS was calculated. Patients with an eGOS ≥ 5 were considered to have a good functional outcome. Fifty-four patients underwent DC. Age (OR 1.038; confidence interval 1.003–1.074) and Glasgow Coma Scale (OR 0677; confidence interval 0.527–0.870) were predictors of mortality. Patients who were available for follow-up (n = 13) had poor functional outcomes at discharge (eGOS = 3); however, this improved at the time of follow-up survey (eGOS = 5; P = 0.005). DC is a controversial operation with high mortality and uncertain benefit. Among our cohort, the eGOS score was significantly higher at follow-up survey than it was at discharge. Although the mortality was high, if patients survived to discharge, most had a good functional outcome at follow-up survey.

Retrospective Analysis of Mini-Open Repair Versus Open Repair for Acute Achilles Tendon Ruptures

2012 ◽  
Vol 6 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Erin E. Klein ◽  
Lowell Weil ◽  
Jeffrey R. Baker ◽  
Lowell Scott Weil ◽  
Wenjay Sung ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Open Repair ◽  
Surgical Intervention ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Level Of Evidence ◽  
Tendon Ruptures ◽  
Return To Activity ◽  
Mini Open

Purpose: Debate exists over optimal treatment for acute Achilles tendon ruptures. Recent literature suggests the mini-open technique may provide the reliability of the open repair with the decreased complication rate of non-operative treatment. This retrospective review compares acute tendon ruptures treated with one of two techniques: open repair (TO) or mini-open repair (MOA). Methods & Results: Records were reviewed and 34 patients were found to meet the inclusion criteria for open or mini-open repair of an acute Achilles tendon rupture with follow up of at least 12 months. TO (n=16) and MOA (n=18) had no statistically significant differences in age at time of injury [TO: 41 + 2.5 years (range 20 – 68); MOA: 46 + 2.5 years (range 33 – 73)] or time between injury and surgical repair [TO: 15 + 2 days (range 2 – 30); MOA: 15 + 2 days (range 2 – 30)]. Post-operative VISA-A scores were 82 + 10 (range 42 – 98) and 92 + 5 (range 66 – 100) for TO and MOA, respectively. Significant differences were found in the time between surgical intervention and beginning of rehabilitation [TO: Post op day 37 + 5 (range 21 – 46); MOA: Post op day 19 + 2 (range 7 – 32)] and the time between surgical intervention and full return to activity [TO: Post op month 7 + 1 (range 4 – 11); MOA: Post op month 5 + 0.6 (range 4 – 11)]. Conclusion: These results suggest that the mini-open repair provides acceptable surgical outcomes while optimizing patient function after Achilles tendon repair. Level of Evidence: Therapeutic, Level III: Retrospective Comparative

scholarly journals Management and Outcome of Hindfoot Trauma With Concomitant Talar Head Injury

2021 ◽  
pp. 107110072098002
Author(s):  
Esmee Wilhelmina Maria Engelmann ◽  
Olivier Wijers ◽  
Jelle Posthuma ◽  
Tim Schepers
Keyword(s):  
Functional Outcome ◽  
Case Series ◽  
Ankle Injuries ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Long Term Outcome ◽  
Talar Head ◽  
The Mean

Background: Talar head fractures account for 2.6% to 10% of all talar fractures and are often associated with concomitant musculoskeletal injuries. The current literature only describes a total of 14 patients with talar head fractures and, with that, guidelines for management are lacking. The aim of the current study was to evaluate the management and long-term outcome of patients who have hindfoot trauma with concomitant talar head fractures. Methods: This study includes a retrospective cohort of patients with talar head fractures. Patient characteristics, trauma mechanism, fracture characteristics, treatment, follow-up, and complications were reported. Functional outcome was assessed using the Foot Function Index (FFI) and the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score. Quality of life was measured by the EuroQol-5D (EQ-5D). Twenty-one patients with acute fractures of the talar head were identified. The mean follow-up time was 4.9 years. Results: All patients sustained additional ipsilateral foot and/or ankle injuries. Fifteen patients had operative management of their talar head fracture. There were no postoperative wound infections and no cases of avascular necrosis. All fractures united, and 29% of patients developed posttraumatic osteoarthritis. The overall mean FFI score index was 34.2, and the mean AOFAS score was 70.7. The mean EQ-5D index score was 0.74. Conclusion: Talar head fractures always coincided with other (foot) fractures. Management and long-term functional outcome were affected by the extent of associated injuries. Due to the low incidence and high complexity of talar head fractures, early referral to dedicated foot surgeons and centralization of complex foot surgery is recommended. Level of Evidence: Level IV, retrospective case series.

Reconstruction of neglected achilles tendon ruptures with gastrocnemius flaps: excellent results in long-term follow-up

2016 ◽  
Vol 136 (10) ◽  
pp. 1417-1423 ◽  
Author(s):  
Ali Seker ◽  
Adnan Kara ◽  
Raffi Armagan ◽  
Yunus Oc ◽  
Ali Varol ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Long Term Follow Up ◽  
Tendon Ruptures

scholarly journals Functional Effects of the Adams Procedure: A Retrospective Intervention Study

2018 ◽  
Vol 07 (04) ◽  
pp. 331-335 ◽  
Author(s):  
Thomas Kootstra ◽  
Margriet van Doesburg ◽  
Arnold Schuurman
Keyword(s):  
Functional Outcome ◽  
Grip Strength ◽  
Distal Radioulnar Joint ◽  
Healthy Population ◽  
Short Term ◽  
Level Of Evidence ◽  
Unaffected Side ◽  
Initial Procedure

Background Injury to the distal radioulnar joint (DRUJ) causes swelling and ulnar-sided wrist pain. The Adams procedure stabilizes the DRUJ and shows promising short-term results. Purpose We studied the long-term functional outcome in patients who underwent the Adams procedure. We also tested the null hypothesis that there would be no difference in range of motion (ROM) and grip strength between the operated wrist compared to the unaffected side. Patients and Methods We identified 74 consecutive patients that were operated from March 2005 to February 2014. Twenty-three patients responded to our invitation and underwent clinical follow-up. Three patients had a re-do of the Adams procedure after presenting with postoperative DRUJ instability, one was excluded due to additional wrist surgery not related to the initial procedure. Wrist functionality in the remaining 22 patients was examined by measuring ROM in all planes and grip strength of the operated and non-operated hand. Functional outcome was measured by asking patients to complete the Disabilities of the Arm, Shoulder, and Hand (DASH) outcome measure and the Patient-Rated Wrist and Hand Evaluation (PRWHE). Results After a mean follow-up time of 5.0 years (standard deviation [SD] 2.0), we found that supination, pronation, and grip strength were significantly decreased in the operated wrist. Postoperative DASH and PRWHE-scores averaged 13.1 (SD 18.6) and 20.3 (SD 15.1), respectively. Conclusion The Adams procedure affects, but largely restores pronation and supination, and clinical examination, DASH, and PRWHE scores indicate that the Adams procedure leaves patients with upper extremity functionality comparable to a healthy population. Level of Evidence Level IV.

scholarly journals Repair of the Chronic Rupture of tendo Achilles Tendon using Peroneus Brevis Tendon

2017 ◽  
Vol 4 (1) ◽  
pp. 30-34
Author(s):  
Manjit Singh ◽  
Hari O Aggarwal ◽  
Sanjeev Sareen ◽  
Deepak Vashisht
Keyword(s):  
Achilles Tendon ◽  
Functional Outcome ◽  
Tendon Transfer ◽  
Skin Grafting ◽  
Asia Pacific ◽  
Chronic Rupture ◽  
Good Functional Outcome ◽  
Superficial Skin ◽  
Peroneus Brevis

ABSTRACT Aim To report 20 patients who underwent repair of chronic rupture of tendo Achilles tendon with peroneus brevis tendon. Materials and methods Records of 6 women and 14 men aged 26 to 58 (mean, 36) years who underwent repair of chronic rupture of tendo Achilles tendon with peroneus brevis tendon transfer were reviewed. Patients were evaluated at 3, 9, and 12 months using the foot and ankle outcome score (FAOS) questionnaire. Results Out of 20 patients, 4 developed superficial skin complications which healed gradually in 3 patients, and 1 patient underwent skin grafting surgery. No patient had a re-rupture of the tendo Achilles tendon. At the 1-year follow-up, all patients achieved good functional outcome in terms of the FAOS. Conclusion Repair of chronic rupture of tendo Achilles tendon with peroneus brevis tendon transfer achieved good functional outcome. How to cite this article Aggarwal HO, Singh M, Sareen S, Vashisht D. Repair of the Chronic Rupture of tendo Achilles Tendon using Peroneus Brevis Tendon. J Foot Ankle Surg (Asia-Pacific) 2017;4(1):30-34.

Immediate, Full Weightbearing Cast Treatment of Acute Achilles Tendon Ruptures: A Long-Term Follow-up Study

2003 ◽  
Vol 24 (10) ◽  
pp. 775-779 ◽  
Author(s):  
Robert A. Josey ◽  
John V. Marymont ◽  
Kevin E. Varner ◽  
Dan O'Connor ◽  
Andy Borom ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Follow Up Study ◽  
Full Weightbearing ◽  
Long Term Follow Up ◽  
Tendon Ruptures

Endoscopic Flexor Hallucis Longus Transfer for Chronic Noninsertional Achilles Tendon Rupture

2018 ◽  
Vol 39 (12) ◽  
pp. 1464-1472 ◽  
Author(s):  
Jordi Vega ◽  
Jesus Vilá ◽  
Jorge Batista ◽  
Francesc Malagelada ◽  
Miki Dalmau-Pastor
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Case Series ◽  
Flexor Hallucis Longus ◽  
Level Of Evidence ◽  
Wound Breakdown ◽  
Tendon Ruptures

Background: Operative management of chronic Achilles tendon ruptures is challenging, and numerous techniques have been described. Risk of infection and wound breakdown have been described after open techniques, and minimally invasive methods have been proposed to avoid them. The aim of this study was to describe the clinical and radiological results obtained after endoscopic flexor hallucis longus (FHL) tendon transfer in patients with chronic Achilles tendon rupture. Methods: Between 2012 and 2015, a total of 22 patients were endoscopically treated for chronic Achilles tendon rupture. Mean age was 69 years (range, 59-84 years). Mean follow-up was 30.5 months (range, 18-46 months). Preoperative magnetic resonance imaging (MRI) was obtained and tendon gap measured. An MRI was obtained at 9 to 12 months following surgery to evaluate Achilles tendon changes. Results: Preoperative MRI examination showed a mean tendon gap of 6.3 cm (range, 3-10.7 cm). The MRI control was obtained only in 12 patients, and a normal or close to normal Achilles tendon was observed in all but 1 patient. The mean American Orthopaedic Foot & Ankle Society score increased from 55 preoperatively (range, 26-75) to 91 (range, 74-100) at final follow-up. All patients returned to their daily activities without difficulties. No patients reported complaints or symptomatic deficits of great toe flexion strength. No major complications were encountered. Conclusion: Chronic Achilles tendon ruptures were successfully treated by an all-endoscopic procedure. The endoscopically assisted FHL transfer provided excellent results while benefiting from the minimally invasive procedure advantages. However, it entailed some technical challenges and may not be suitable for less experienced surgeons. Level of Evidence: Level IV, retrospective case series.

scholarly journals FUNCTIONAL OUTCOMES FOLLOWING SYNDESMOTIC SCREW FIXATION- A COMPARISON OF SCREW REMOVAL VERSUS RETENTION.

2020 ◽  
pp. 68-71
Author(s):  
Rahul Thampi ◽  
Balu C Babu ◽  
Melvin J George ◽  
Druvan Shaji ◽  
V K Bhaskaran ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Screw Fixation ◽  
Weight Bearing ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Syndesmotic Screw

BACKGROUND: - The incidence of distal tibiofibular syndesmotic injury in ankle fractures is about 13%. The integrity of syndesmosis is a critical factor which stabilizes ankle mortise during weight-bearing besides load transmission. The primary purpose of the study was to assess the functional outcome in patients with Weber B and C fractures and to decide whether the syndesmotic screws are to be removed or not before weight-bearing. MATERIALS AND METHODS: - This was a prospective observational study involving patients (>18 years of age) who had undergone open reduction and internal fixation of an ankle fracture belonging to Weber B or C classification who had screw stabilization of a disrupted syndesmosis. The study period was three years commencing from August 2014. They were divided into two groups based on the syndesmotic screw retention or removal before weight-bearing. The patients were then regularly followed up with American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot score and Visual Analogue Score-Foot and Ankle (VAS-FA) score were used to assess the functional outcome. Clinical and radiographic evaluations were done with each follow-up at 4,6,9,12 months. RESULTS: - We identified 32 fractures in 32 patients. Treatment undertaken was open reduction and internal fixation for the malleolli and syndesmotic screw fixation in all patients, and syndesmotic screws were removed in 17 and retained in 15. None of the patients were managed conservatively. We lost a patient to long-term follow-up. The AOFAS score was seen to be progressively increasing (92.3 – 96.75) and higher in the removed group as compared to retained. The VAS-FA score was also seen to be increasing besides being higher in the removed group (160.17 to 187). None of the patients failed the operative stabilization. Also, none of the patients had long-term complications like non-union, mal-union or screw back out excepting one patient who had persistent pain in the retained group. CONCLUSION: It is safe and better to remove the syndesmotic screw prior to weight bearing, when compared to retaining them insitu. Level of evidence IV-prognostic

scholarly journals Long-term follow-up of conservative treatment of Charcot feet

2021 ◽  
Author(s):  
Viviane Gratwohl ◽  
Thorsten Jentzsch ◽  
Madlaina Schöni ◽  
Dominik Kaiser ◽  
Martin C. Berli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Conservative Treatment ◽  
Major Amputation ◽  
Limb Loss ◽  
Ulcer Recurrence ◽  
Level Of Evidence ◽  
Increased Risk ◽  
Charcot Feet

Abstract Background Charcot arthropathy (CN) can ultimately lead to limb loss despite appropriate treatment. Initial conservative treatment is the accepted treatment in case of a plantigrade foot. The aim of this retrospective study was to investigate the mid- to long-term clinical course of CN initially being treated conservatively, and to identify risk factors for reactivation and contralateral development of CN as well as common complications in CN. Methods A total of 184 Charcot feet in 159 patients (median age 60.0 (interquartile range (IQR) 15.5) years, 49 (30.1%) women) were retrospectively analyzed by patient chart review. Rates of limb salvage, reactivation, contralateral development and common complications were recorded. Statistical analysis was performed to identify possible risk factors for limb loss, CN reactivation, contralateral CN development, and ulcer development. Results Major amputation-free survival could be achieved in 92.9% feet after a median follow-up of 5.2 (IQR 4.25, range 2.2–11.25) years. CN recurrence occurred in 13.6%. 32.1% had bilateral CN involvement. Ulcers were present in 72.3%. 88.1% patients were ambulating in orthopaedic footwear without any further aids. Presence of Diabetes mellitus was associated with reactivation of CN, major amputation and ulcer recurrence. Smoking was associated with ulcer development and necessity of amputations. Conclusions With consistent conservative treatment of CN with orthopaedic footwear or orthoses, limb preservation can be achieved in 92.9% after a median follow-up of 5.2 years. Patients with diabetic CN are at an increased risk of developing complications and CN reactivation. To prevent ulcers and amputations, every effort should be made to make patients stop smoking. Level of Evidence III, long-term retrospective cohort study

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