Suspected Achilles Tendon Ruptures and the Course of Action: Assessing Compliance With Local Protocols.

Area of Science:

• Orthopedic surgery
• Sports medicine
• Trauma care

Background:

• Achilles tendon rupture is a debilitating injury common in active adults.
• Effective management is crucial for optimal healing and return to function.
• Clinical pathways standardize care but adherence can vary, impacting outcomes.

Purpose of the Study:

• To assess compliance with a local Achilles tendon rupture care pathway using a closed-loop audit.
• To evaluate the impact of targeted interventions on pathway adherence.
• To identify areas for improvement in managing Achilles tendon ruptures.

Main Methods:

• A closed-loop audit assessed compliance with a 10-point Achilles tendon rupture pathway.
• Two audit cycles were conducted before and after interventions (pathway dissemination, dedicated ultrasound form).
• Standards included VTE prophylaxis, immobilisation, weight-bearing advice, ultrasound timing, and VFC referral.

Main Results:

• Initial compliance varied, with ultrasound imaging at 43% and VTE prophylaxis at 80%.
• Post-intervention, compliance improved significantly for immobilisation (80% to 86%) and ultrasound within 14 days (43% to 59%).
• VFC referral compliance reached 100%, but VTE prophylaxis remained unchanged; no re-ruptures or VTE events occurred.

Conclusions:

• Targeted interventions can enhance adherence to specific elements of Achilles tendon rupture care pathways.
• Consistent VTE prophylaxis prescribing requires further attention and education.
• Sustained improvements necessitate ongoing education, structured pathways, and regular re-audits.