Evaluation of Suspected Achilles Tendon Rupture Managed Through Virtual Fracture Clinic Pathway in Busy Major Trauma Centre

TL;DR

This study evaluates how virtual fracture clinics manage suspected Achilles tendon ruptures in a busy trauma center, finding it effective and safe.

Contribution

Demonstrates the effectiveness of virtual fracture clinics in managing suspected Achilles tendon injuries in a major trauma center.

Findings

Virtual fracture clinics effectively manage suspected Achilles tendon ruptures without missing injuries.

Most patients had complete tears, with a majority being male and right-sided.

Management through virtual clinics is safe, effective, and reproducible.

Abstract

Introduction

Achilles tendon rupture is one of the most common tendon injuries, affecting both males and females at a young age in athletic populations. These injuries can be best managed through the virtual fracture clinic once these patients present in the emergency department with suspected Achilles tendon ruptures. This study aims to evaluate the management of patients with Achilles tendon ruptures who are referred to virtual fracture clinics in the emergency department of a busy major trauma centre.

Materials and methods

This retrospective study reviewed all the patients referred from the emergency department to the virtual fracture clinic with suspected Achilles tendon ruptures. Data were collected through the electronic medical record system and by reviewing the patient's notes, which were analysed using SPSS Statistics version 20.0 (IBM Corp., Armonk, NY, USA). Data were reviewed in terms of age, gender, side affected, ultrasound findings for full tear or partial tear of Achilles tendon, gastrocnemius tear, chronic tendinosis, and no tear of Achilles tendon. Data were reviewed in terms of management of the injury, whether conservative management or surgical management was adopted as a treatment option.

Results

A total of 170 patients were identified through the electronic records. In 10 patients, no ultrasound studies were performed, and three patients did not attend; therefore, they were excluded from the study according to our exclusion criteria. The patient's mean age in our study was 46.69 years. Out of 157 patients, 119 (75.8%) were male and 38 (24.2%) were female. The right side was involved in 89 (56.7%) of cases, and the left side was involved in 68 (43.3%). According to the ultrasound results, 94 patients (59.9%) had a complete tear of the Achilles tendon, 41 patients (26.1%) had a partial tear, two patients (1.3%) had chronic tendonitis, three patients (1.9%) had a gastrocnemius tear, and 17 patients (10.8%) showed no tears or problems.

Conclusion

The suspected Achilles tendon ruptures can be effectively managed through the virtual fracture clinic after referral from the emergency department. This decreases the chances of missing any injuries and is found to be safe, effective, and reproducible.

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