Abstract
Achilles tendon rupture is an injury associated with significant morbidity. It is a common injury in adults and has been well studied in this age group. However, pediatric Achilles tendon ruptures are considered rare and have not been well described. PURPOSE: To describe cases of pediatric Achilles tendon rupture seen at a large pediatric center over a 10 year period. METHODS: A retrospective chart review was conducted over a 10 year period (2010-20) at a single, large pediatric center. Potential cases of Achilles tendon rupture were identified through database searches of EPIC and Orthopedic Surgery schedules, using relevant ICD9/10 and CPT codes. Additional cases were identified by correspondence from treating physicians. Cases were included if an acute injury to the Achilles tendon was identified in an individual 19 years or younger. Qualitative data including medical history, mechanism of injury, physical exam, and treatment were identified from the medical record. RESULTS: A total of 25 acute Achilles tendon ruptures were identified that met inclusion criteria. 10 of these were spontaneous ruptures, while 15 were laceration injuries. Of the 10 spontaneous ruptures, 9 were complete ruptures (Table 1). 5 injuries occurred during basketball, with football and volleyball being next most common. An abnormal Thompson’s test was documented in 8/10 spontaneous cases. Of note, one subject was on minocycline at the time of injury. Another had a history of clubfoot surgery on the injured side. All 15 laceration injuries were treated surgically. 6 injuries were partial lacerations. Patients were younger than those with spontaneous ruptures (mean: 10 vs 16 years). No advanced imaging was done in most cases of laceration. CONCLUSION: Achilles tendon ruptures are uncommon, but do occur in the pediatric population. Accidental laceration of the tendon is more common than spontaneous injury during sports. A positive Thompson test is suggestive of an Achilles tendon rupture.
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