Abstract
Purpose of the study: Wounds of the calcaneal tendon are common, but less well documented compared with tears of the same tendon. We performed a retrospective analysis of the epidemiological, therapeutic and prognostic features of this injury.
Material and method: The series included 70 patients collected from 1992 to 2002; 56 male and 14 female. Mean age was 22 years (range 4–70 years). The right ankle was involved in 42 cases. Causes were broken glass injury (44%), automobile accidents (22%), aggressions (18%) and motorcycle wheel injuries (10%).
Results: The diagnosis was obvious at admission. A surgical exploration was systematic to determine the partial or complete nature of the injury. Surgical treatment involved tendon repair with a cage or frame in 65 patients. A plantar plasty was needed in three patients. Bosworth tendinoplasty was performed in two other patients. The three cases with skin loss were treated by directed wound healing (n=2) and MacFarlane flap (n=1). Postoperative complications were: infection (n=11) and functional (n=10, shoe conflict). The scar remained disgraceful in 20 patients. Outcome was good or very good according to the Schmitt criteria in 92% of patients.
Discussion: Wounds of the calcaneal tendon are common, and are generally observed in young male patients. The diagnosis is clinical. The goal of treatment, either by simple suture or by pasty, is to restore normal ankle function. Because of the risk of infection, as well as the risk of a poorly healed scar preventing proper use of shoes, any surgical procedure must be as minimally traumatic as possible and performed under rigorous conditions. Adequate immobilisation and rehabilitation are required for good outcome. The prognosis is generally good.
Correspondence should be addressed to Ghislaine Patte at sofcot@sofcot.fr
