Achilles Tendon Trephination Versus Peroneus Brevis Tendon Transfer in Total Avulsion Injuries in a Tertiary Hospital
Journal Title: Journal of Surgery Research and Practice - Year 2025, Vol 6, Issue 1
Abstract
Introduction: Complete avulsion of Achilles tendon is common and treatment is challenging which can be trephination with suturing anchoring technique or peroneus brevis tendon transfer. The aim of the study was to evaluate the functional outcomes of ankles following Achilles tendon repair by comparing trephination with peroneus brevis tendon transfer in total avulsion injury. Methods: A single center prospective randomized study that consisted of 31 patients with Achilles tendon injuries who presented between April, 2019 and December, 2021 on account of complete avulsion injury of the Achilles tendon. Thirty-one (31) patients were randomized into two groups: Group A consisted of 16 patients who had trephination with suture anchoring technique while group B, consisted of 15 patients who had peroneus brevis tendon transfer. Achilles tendon injuries transected at least 10 mm above the calcaneus were excluded and repaired with conventional techniques. The inclusion criteria involved those patients that had complete avulsion injury. The socio-demographic data such as sex, age, occupation, mechanism of injury was documented. The outcome parameters were Endurance test and Proprioceptive evaluation. Results: Eighteen patients (58.1%) had right heel injuries while 13 patients (41.9%) had left leg injuries. About 16[51.6%] patients had trephination while 15[48.4%] patients had peroneus brevis tendon transfer. The age range was 3.2 and 8 years, with a mean age of 5.7years and a follow-up period of 10.4 and 14.8 months. All patients had open wounds. Seventeen males [63.6%] and fourteen females [36.4%] paediatric age group were studied. Complications were re-rupture in 1 patient with tendon transfer (3.2%), superficial surgical site infection in 3 patients (9.7%) and two sural nerve damage in peroneus brevis transfer (6.5%), stiff ankle joint 2 patients (6.2%) and post operative ankle pains up to 2 years was (1) 3.2%. The probability of damaging sural nerve was higher in peroneus brevis transfer as shown in Table 2, Achilles tendon rupture 1(3.2%) and stiff ankle joint in trephination 1 (3.2%). There was no significant statistical difference between the groups with p-value ≥ 0.06. Endurance test and proprioceptive evaluations were satisfactory at 8-10 weeks post- surgery. Conclusion: Achilles tendon trephination was simpler with less structural injury compared with peroneus brevis tendon transfer in total Achilles tendon transfer.
Authors and Affiliations
MBA Okpan Ozinko1*, Samuel E Urom2, Izuchkwu Arinze2
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Achilles Tendon Trephination Versus Peroneus Brevis Tendon Transfer in Total Avulsion Injuries in a Tertiary Hospital
Introduction: Complete avulsion of Achilles tendon is common and treatment is challenging which can be trephination with suturing anchoring technique or peroneus brevis tendon transfer. The aim of the study was to evalua...