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Regeneration of tendo Achillis
A A H Parkar1, M Taylor, N Patel
1Broomfield Hospital, Chelmsford CM1 7ET,UK. drasifparkar@rediffmail.com
Insights
A child
Area of Science:
- Orthopedic Surgery
- Pediatric Traumatology
- Wound Healing
Background:
- Secondary infection following tendo Achillis (Achilles tendon) repair can lead to significant tendon loss.
- Management of extensive soft tissue and tendon defects in pediatric patients presents a challenge.
Observation:
- A pediatric patient experienced a 5 cm loss of the distal tendo Achillis and surrounding soft tissue due to secondary infection post-repair.
- Initial management involved a free skin flap for wound coverage and infection control, deferring tendon reconstruction.
Findings:
- Two years post-skin flap, the child demonstrated spontaneous, normal ankle function with equal strength in both lower extremities.
- Delayed reconstruction of the tendo Achillis was deemed unnecessary due to the patient's remarkable functional recovery.
Implications:
- This case suggests that spontaneous functional recovery of the tendo Achillis is possible even after substantial tendon loss and infection.
- It highlights the potential for non-operative management or delayed reconstruction in select pediatric cases with extensive Achilles tendon defects.
Abstract:
A child with traumatic laceration of the tendo Achillis developed secondary infection after primary repair. This resulted in the loss of 5 cm of the distal part of the tendon and overlying soft tissue. The patient was treated with a free skin flap to cover the wound and to control the infection leaving reconstruction for a second-stage procedure. However, when he was assessed two years after the skin-flap, delayed reconstruction proved to be unnecessary since he had regained normal ankle function spontaneously and could demonstrate equal function in both tendons.
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