Achilles Tendon Injuries in the Pediatric Population

Area of Science:

• Orthopedic Surgery
• Pediatric Sports Medicine
• Musculoskeletal Trauma

Background:

• Achilles tendon injuries are prevalent in adults but rare in pediatric populations.
• Limited research exists on pediatric Achilles tendon injuries, necessitating characterization of injury patterns, treatment, and outcomes.
• This study aims to fill this knowledge gap by analyzing pediatric Achilles injuries.

Purpose of the Study:

• To characterize the presentation, treatment, and outcomes of pediatric Achilles tendon injuries.
• To differentiate injury mechanisms and patient demographics in children and adolescents.
• To provide insights into the management and recovery of pediatric Achilles tendon injuries.

Main Methods:

• Retrospective chart review of patients aged 0-18 years treated for Achilles tendon injuries between 2008 and 2021 at two tertiary institutions.
• Data included demographics, injury characteristics, and treatment course, categorizing injuries into traumatic (open/closed) and muscular contraction ruptures.
• Descriptive analyses were used to summarize findings, with a Level-IV evidence rating.

Main Results:

• Thirty-nine pediatric patients (median age 15 years) were identified, with 74.4% experiencing complete tears.
• Traumatic injuries (64.1%) were more common, particularly open lacerations (68.0%), predominantly in patients ≤12 years.
• Older adolescents (≥14 years) were more likely to have ruptures from muscular contraction (35.9%). Most patients (89.7%) had surgical open repair, with a median return to activity at 6 months.

Conclusions:

• Age influences Achilles tendon injury mechanisms in pediatrics: trauma in younger children, muscular contraction in older adolescents.
• Surgical intervention is the primary treatment, leading to successful return to normal activities for most patients.
• Further prospective studies are recommended to refine treatment protocols and outcomes for pediatric Achilles tendon injuries.