Open Achilles tendon lacerations

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• 作者：M. Nader Said ; Mohamed Al Ateeq Al Dosari…
• 关键词：Achilles tendon injuries ; Lacerations ; Heal wounds ; Wound management ; Complications
• 刊名：European Journal of Orthopaedic Surgery & Traumatology
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：25
• 期：3
• 页码：591-593
• 全文大小：423 KB
• 参考文献：1. Chatterjee, SS, Sarkar, A, Misra, A (2006) Management of acute open tendo-achilles injuries in Indian lavatory pans. Indian J Plast Surg 39: pp. 29-30 CrossRef
  2. Dar, TA, Sultan, A, Dhar, SA, Ali, MF, Wani, MI, Wani, SA (2011) Toilet seat injury of the Achilles tendon a series of twelve cases. Foot Ankle Surg 17: pp. 284-286 CrossRef
  3. Zhu, Y, Xu, Y, Li, J, Yag, J, Ouyang, Y, He, X, Chen, H, Fan, X (2009) Treatment of spoke heel injuries in children. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 23: pp. 1180-1182
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgical Orthopedics
  Traumatic Surgery
  
• 出版者：Springer Paris
• ISSN：1432-1068

文摘

In contrast to closed Achilles tendon ruptures, open injuries are rarely reported in the literature. This paper provides information about open Achilles tendon wounds that are eventually seen in the Middle East. The reporting unit, Hamad Medical Corporation, is one of the biggest trauma centers in the Gulf area and the major health provider in Qatar. This is a retrospective study including patients admitted and operated for open Achilles tendon injuries between January 2011 and December 2013. Two hundred and five cases of open Achilles tendon lacerations were operated in Hamad General Hospital in this period. Forty-eight cases showed partial injuries, and the remaining are complete tendons cut. In the same period, fifty-one closed ruptured Achilles tendons were operated in the same trauma unit. In the majority of cases, the open injury resulted from a slip in the floor-leveled traditional toilette seats. Local damage to the toilette seats resulted in sharp edges causing the laceration of the heel if the patient was slipping over the wet floor. This occurrence is the cause in the vast majority of the cases. Wounds were located 1-?cm proximal to tendon insertion. Standard treatment principles were applied. This included thorough irrigation in the emergency room, intravenous antibiotics, surgical debridement and primary repair within 24?h. Patients were kept in the hospital 1-?days for intravenous antibiotics and possible dressing changes. Postoperatively below knee slabs were applied in the majority of patients and were kept for about 4?weeks followed by gradual weight bearing and range of motion exercises. Outpatients follow up in 1-?weeks. Further follow-up visits at around 2-, 4-, 8- and 12-week intervals until complete wound healing and satisfactory rehabilitation outcome. Sixteen cases needed a second procedure. A high incidence of Achilles tendon open injuries is reported. This seems to be related to partially damaged floor-level toilettes in the typical Middle-East lavatory. The surgical treatment resulted in excellent outcome in the vast majority of the cases. Low incidence of complications resulted despite dramatic injury pattern.