Open AccessManagement of Missed Traumatic Achilles Tendon Rupture in a Pediatric Patient: A Case Report
Author(s) -
Saad Andaloussi
Publication year - 2021
Publication title -
ortopediâ, travmatologiâ i vosstanovitelʹnaâ hirurgiâ detskogo vozrasta
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.157
H-Index - 4
eISSN - 2410-8731
pISSN - 2309-3994
DOI - 10.17816/ptors77113
Subject(s) - achilles tendon , medicine , achilles tendon rupture , surgery , asymptomatic , tendon , physical examination , plantaris muscle , anatomy , skeletal muscle , soleus muscle
BACKGROUND: Missed traumatic Achilles tendon ruptures in children are rarely reported in the literature. Various techniques have been described to reconstruct delayed Achilles tendon ruptures for adults, but the long-term consequences in the growing child are unknown.
CLINICAL CASE: The article presents a clinical observation of a 8-year-old girl with missed rupture of the Achilles tendon operated 7 weeks after the trauma by end-to-end Kessler-type sutures augmented with the plantaris tendon. At 2-year follow-up, the patient was completely asymptomatic.
DISCUSSION: A review of the literature shows that this is the third neglected pediatric case of post-traumatic Achilles tendon rupture. The first case concerns a 10-year-old boy treated successfully six weeks after the traumat by open surgical repair using the Bunnell sutures technique. The second patient was a 7-year-old girl, she was operated 8 weeks after the trauma with a termino-terminal tenorrhaphy using the Bunnell technique augmented with the plantaris tendon.
CONCLUSIONS: Using the plantaris tendon to reinforce the Achilles tendon repair offers satisfactory results with minimal morbidity. Prognosis depends on the extent of tendon defect which determines the long-term functional outcome. Any skin wound that sits on the back of the leg requires a systematic and careful physical examination to check the integrity of the Achilles tendon.