Abstract
The subjective functional outcome and factors affecting patient satisfaction were assessed following tendo Achilles injury which was treated either by conservative (42.4%) or surgical (57.6%) methods.
This is a retrospective study on 35 patients treated for tendo Achilles injury at Airedale General Hospital with a mean follow up time of 2 years (range nine months to four years). A questionnaire ascertained pre and post injury leisure time activity level, occupational change and overall satisfaction with treatment. Case-notes were reviewed for mechanism of injury, time of referral to specialist,previous tendon pathologies,treatment details and complications. Fifty-two patients were contacted and 35 responded. The mean age was 52.7 years (range 33 to 90); 27.3% are involved in office work, 27.3% doing manual work, 15.2% doing job which involves standing most of their time (teacher), 27.2% were leading a retired life and remaining were house wives.
Nobody has changed their occupation. Seventy percent were very satisfied with treatment (analogue score 7–10). The remaining patients complained of pain, stiffness and weakness of ankle and they could not fully get back to their previous leisure time activities. Statistically the operative and conservative groups did not show any difference in the level of satisfaction. The age, sex, occupation and level of sports activities undertaken did not have any significant bearing on satisfaction level. Decreased post injury leisure time activities significantly affected the satisfaction score (p=0.003). Sixty percent of subjects took less than six months to reach there pre-injury activity level. Another significant finding was that the group who presented late for treatment (range 15 days to 1.4 years) was less satisfied (p=0.015). There was some evidence (p=0.034) from regression analysis that physiotherapy intervention increased post injury activity and the satisfaction level. There were 2 reruptures in the conservative group but no other major complications.
To conclude, there were no differences in satisfaction following surgical or conservative management. The reduced post injury leisure time activities, delay in treatment and physiotherapy determined the final outcome.
The abstracts were prepared by Mr J. L. Barrie. Correspondence should be addressed to Mr J. L. Barrie, BOFSS Editor, Department of Orthopaedic Surgery, Blackburn Royal Infirmary, Blackburn, Lancashire BB2 3LR.
