Retrospective analysis of complications after treatment of acute Achilles tendon rupture by Kessler technique.

INTRODUCTION: Open surgical treatment of Achilles tendon rupture comes with high ratio of complications. We have retrospectively evaluated those complications to find patients that would benefit from the mini-invasive technique. METHODS: We analysed all patients after surgical treatment of acute Achilles tendon rupture between the years 2014 and 2020. Information about the surgery, the following complications and patients characteristics were extracted from our documentation. Statistical analysis was concluded to evaluate their significance. We have included 134 patients with the Achilles tendon rupture in our analysis. The majority of patients were men (83.6%) and left-sided injuries were more common (51.5%). The average age was 45 years. RESULTS: Our results show that the most common complications after the treatment of Achilles tendon rupture in our clinic are wound dehiscence, thrombosis and infection. On the other hand, paresthesia and rupture are rare. We have confirmed that most complications occur in smoking patients. Our data show that age is a risk factor as well. Contrary to the previous study, our data did not show the female sex to be a risk factor. CONCLUSION: Open surgical treatment of Achilles tendon rupture in our clinic is accompanied with relatively high complication rate. Mini-invasive techniques could improve the outcomes in the cohort of smoking older patients with acute Achilles tendon rupture. Please kindly refer to the corresponding author to obtain full data in English.

Management of bone defects using the Masquelet technique of induced membrane.

INTRODUCTION: Extensive bone defects are mostly caused by trauma, bone infection or bone tumours. The treatment is one of the most challenging issues of musculoskeletal surgery. Nowadays we have several techniques to deal with this problem. One of them is a two staged procedure described by Alain Masquelet, based on the principle of a foreign body-induced membrane with an autologous bone graft. The membrane, induced by a cement spacer, closes the defect and prevents resorption of the bone graft. In this paper we share our experience with this method. METHODS: We retrospectively analysed 10 patients who had been treated at our department between years 2012 and 2020. In addition to basic epidemiological data, we also collected data concerning the mechanism of injury, size of the defect, presence of infection and the infectious agent, type of spacer used and its retention, type of bone stabilization, time to full load, and time of full consolidation. RESULTS: We evaluated 10 patients with bone defects (5 of traumatic and 5 of infectious origin) operated at our department. Optimal healing free of complications was achieved in 50% of patients, and together with those where the 2nd phase had to be repeated, the success rate was 70%. Observed complications included two refractures, two cases of infection and one case of prolonged healing. CONCLUSIONS: Bone defect management using the modified Masquelet technique has an important place in reconstructive surgery. If the indication criteria and correct procedures are observed, combined with motivated and cooperating patients, the results are favourable, particularly in the group of non-infectious defects. Compared to other options of bone defect management, this technique is less demanding both for the patient and the surgeon.