Abstract
Objective: To assess the quality of life and functional status of patients subjected to debridement of ulcers in the posterior ankle who required complete Achilles tendon resection without any type of reconstruction or tendon transfer. Method: This is a case series of 5 (mostly diabetic) patients who underwent complete Achilles tendon resection due to an ulcer in the posterior ankle region. Preservation of the Achilles tendon was prevented due to tendon exposure, extensive degeneration and the need for infection control. Patients answered the Brazilian Portuguese version of the Achilles Tendon Total Rupture Score (ATRS-BR) questionnaire and the 36-item Short-Form Health Survey (SF-36) during the postoperative period, and follow-up varied between 6 and 24 months. The ATRS-BR ranges from 0 to 100, and higher scores indicate fewer symptoms and limitations. The SF-36 consists of 36 questions comprising 8 domains, which are independently assessed and given a score of up to 100 points, with higher scores indicating better health status. Results: The mean age of patients was 70 years. The mean score on the SF-36 physical functioning domain was 70 (50-95) points. The mean value of the ATRS-BR was 54.6 (31-88) points; however, the patients had few complaints about their functional status. Conclusion: Non-reconstruction of the Achilles tendon in predominantly diabetic elderly patients with posterior ankle ulcers presents encouraging functional outcomes. This study suggests that complete Achilles tendon resection is a viable option for ulcer treatment in this population. Level of Evidence IV; Therapeutic Studies; Cases Series.
Highlights
To assess the quality of life and functional status of patients subjected to debridement of ulcers in the posterior ankle who required complete Achilles tendon resection without any type of reconstruction or tendon transfer
The SF-36 consists of 36 questions comprising 8 domains, which are independently assessed and given a score of up to 100 points, with higher scores indicating better health status
J Am Podiatr Med Assoc. 2014 Jun 24. [Epub ahead of print]
Summary
Wrgelles Godinho Bordone Pires[1], Philipe Eduardo Carvalho Maia[1], Felipe Daniel Vasconcelos de Carvalho[1], Rodrigo Simões Castilho[1], Fernando Araújo Silva Lopes[1], Roberto Zambelli de Almeida Pinto[1]. RESUMO Objetivo: Avaliar a qualidade de vida e funcionalidade de pacientes submetidos ao desbridamento de úlceras na região posterior do tornozelo que evoluíram com a ressecção completa do tendão de Aquiles, sem a realização de qualquer tipo de reconstrução ou transferência tendínea. Métodos: Trata-se de uma série de casos de 5 pacientes, em sua maioria diabéticos, submetidos à ressecção completa do tendão de Aquiles, devido à úlcera na região posterior do tornozelo, sendo sua preservação impossibilitada pela exposição e degeneração extensa do tendão, além da necessidade de controle do processo infeccioso. Já o ATRS-BR apresentou uma média de 54,6 pontos (31-88), no entanto, com os pacientes pouco queixosos quanto à sua funcionalidade. Conclusão: A não reconstrução do tendão de Aquiles em pacientes em sua maioria diabéticos, idosos e com úlceras posteriores do tornozelo revela resultados funcionais encorajadores.
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