A clinical study of surgical management of tendoachilles rupture by various modalities

Banna Kiran Kumar, Shenkeshi Sirish Kumar, Bolloju Keshava Rao, K Kishore Kumar, J Venkateswarlu

Abstract


Background: Acute injuries to Achilles tendon with open wounds in Tendo Achilles region is more common unlike the west, where the chronic ruptures and sport injury are more common. This is because most Indians use Indian squatting type of toilets which are common cause of open injury to Achilles tendon (closet injury).
Aim & Objective: This study aims to evaluate the outcomes of surgical management of Tendo Achilles rupture.
Materials and Methods: It is a prospective observational study, of 21 patients with Achilles tendon ruptures treated in the Department of Orthopaedics, Mahatma Gandhi Memorial Hospital, Kakatiya Medical College, Warangal, Telangana, India, between June 2019 to December 2020.
Results: Achilles tendon ruptures are more common in males. In elderly people, Tendo Achilles ruptures occurred most commonly due to trivial trauma. Most ruptures occur 2-6cm proximal to the calcaneal insertion of the tendon. Risk factors for Tendo Achilles rupture are usage of quinolone antibiotics, steroid, and are also seen in patients with diabetes, gout and rheumatoid arthritis. Primary surgical management if done well, produces good functional outcome without any functional deficit and chronic pain. Raghuram
technique is safe and good method for chronic ruptures. Post operative evaluation is necessary in assessing final outcome with various scoring system including ultrasound and dynamometric studies.
Conclusion: 6 months after surgery following adequate immobilization and effective physiotherapy, unrestrained activity can be done. Patients can stand on tip toes and complete plantar flexion is achieved. Inadequate paratenon closure leads to delayed wound healing and increased rate of infection.

Keywords: Achilles tendon, Paratenon, Raghu ram technique.


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