DOS 2016

DOS Kongressen 2016 ·

221

Re-rupture rate of conservatively treated Achilles

tendon ruptures

Linea Holck Lundholm, Kim Hegnet Andersen, Jeannette Østergaard Penny

Faculty of Health and Medical Sciences, stud.med., University of Copenhagen;

Department of Orthopedic Surgery, Hvidovre Hospital; Department of

Orthopedic Surgery, Hvidovre Hospital

Background:

Recently the algorithms for treating primary closed Achilles ten-

don ruptures (ATR) have drifted towards non operative treatment. After suba-

cute foot and ankle surgery was appointed to one person, he noted more re-

ruptures than expected.

Purpose / Aim of Study:

Our primary aim was to investigate the re- rupture

rate of conservatively treated ATR in the year since the treatment was referred

to a dedicated foot and ankle surgeon (year A), to describe the reconstructions

and patient demographics. Secondary aims were to compare it to the previous

year (B), and if any difference was found, to investigate if a difference was to be

found in the treatment algorithms or demographics.

Materials and Methods:

A search on DS860 and DT935B was performed on

ER and outpatients. Age, sex, primary treatment, re-ruptures and type of re-

constructions was registered. Summary statistics and 2 group proportion tests

used.

Findings / Results:

We treated 107 true ATR in year B. Of those, 3 had an

open rupture, 34 were not primarily treated at HVH and 3 had primary surgery.

In year A, 133 had ATR, 39 not primarily treated at HVH and 2 had primary

surgery. Leaving 67 and 92 for analysis (78% men/ 22% women, mean age 46

). No difference between A and B. Weight bearing details on conservative treat-

ment were lacking. In year B, 2 patients had a re-rupture following conservative

treatment, corresponding to 3% and 12 patients in year A=13% which was sig-

nificant with p=0.03. The re-rupture surgery needed 6 elongations, 1 flex hall

transfers, 4 vendebro plasties.

Conclusions:

We found re-rupture rates in line with the literature but higher in

year A. Comparable patient demographics but conservative regime will require

further investigation to explain the increased re-rupture rate. Generally re-rup-

ture surgery required more extensive surgical interventions than an end-to-end.

No conflicts of interest reported

172.