Incidents of Complications after Reconstruction of Neglected Achilles Tendon Injury by Baker's Procedure

Mohammad Sabbir Hossain, Md Shahiduzzaman, Md. Shahadat Hossain, Mohammad Anisur Rahman
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Abstract

Introduction: Neglected Achilles tendon ruptures present a significant challenge in orthopedic surgery, with varied outcomes and complications. This study aims to evaluate the effectiveness of Baker's Procedure in the reconstruction of neglected Achilles tendon ruptures and to analyze the associated postoperative outcomes and complications. Methods: This prospective interventional study was conducted from January 1, 2012, to May 31, 2013, at multiple centers in Dhaka, Bangladesh. It included 42 patients aged 18 to 60 years with neglected Tendo-Achilles ruptures, defined as injuries untreated for over 4 weeks. Baker's Procedure, involving gastrocnemius aponeurosis advancement, was employed for reconstruction. Result: Of the 42 participants, 71.43% were male, with a mean age of 30.7 years. Injuries predominantly occurred in the right Achilles tendon (57.14%) and were mainly caused by sharp-metal objects (57.14%) and toilet-pan accidents (35.71%). Postoperative complications included stitch or wound infections (21.43%), pain (14.29%), stiffness (28.57%), and calf-muscle weakness (35.71%). Excellent, good, and fair outcomes were achieved in 64.29%, 21.43%, and 14.29% of patients, respectively. Conclusion: Baker’s Procedure is effective in reconstructing neglected Achilles tendon ruptures, with a majority of patients achieving excellent or good outcomes. However, the relatively high rate of postoperative complications, particularly infections, calf muscle weakness and stiffness, highlights the need for improved surgical and postoperative strategies. These findings underscore the importance of tailored.
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采用贝克手术重建被忽视的跟腱损伤后的并发症事件
导言:被忽视的跟腱断裂是骨科手术中的一大难题,其结果和并发症各不相同。本研究旨在评估 Baker 手术在重建被忽视的跟腱断裂中的有效性,并分析相关的术后效果和并发症。研究方法这项前瞻性介入研究于 2012 年 1 月 1 日至 2013 年 5 月 31 日在孟加拉国达卡的多个中心进行。研究纳入了42名年龄在18至60岁之间、患有被忽视的腱索-跟腱断裂(定义为超过4周未治疗的损伤)的患者。重建手术采用贝克手术,包括腓肠肌肌腱前移。结果在 42 名参与者中,71.43% 为男性,平均年龄为 30.7 岁。损伤主要发生在右跟腱(57.14%),主要由尖锐金属物体(57.14%)和便盆事故(35.71%)引起。术后并发症包括缝合或伤口感染(21.43%)、疼痛(14.29%)、僵硬(28.57%)和小腿肌肉无力(35.71%)。分别有 64.29%、21.43% 和 14.29% 的患者获得了优、良和一般的疗效。结论贝克氏手术能有效重建被忽视的跟腱断裂,大多数患者都能获得极佳或良好的疗效。然而,术后并发症的发生率相对较高,尤其是感染、小腿肌肉无力和僵硬,这凸显了改进手术和术后策略的必要性。这些发现强调了量身定制的重要性。
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