ABSTRACT
Introduction: Acute Achilles tendon ruptures in the pediatric population are an uncommon occurrence and there is currently limited literature with regard to this injury. Further, there is limited data evaluating traumatic lacerations of the distal substance of the Achilles tendon near the insertion site and its management, as opposed to the more common cited location of rupture at the mid-substance of the tendon. This case is the first known article to specifically address primary repair with non-absorbable sutures utilizing a Krackow configuration at this level in this patient population. Case Report: A case of a 10-year-old male who sustained a traumatic distal Achilles tendon laceration near the insertion site who was successfully treated with primary repair with non-absorbable sutures utilizing a Krackow configuration is presented. This repair technique demonstrated return to full functional ankle plantar and dorsiflexion with return to pre-injury level of activity. Conclusion: This case report highlights that primary repair with non-absorbable sutures utilizing a Krackow configuration on distal traumatic Achilles tendon lacerations near the insertion site in pediatric patients is a safe and effective method of repair for this uncommon injury presentation.
ABSTRACT
Background: Several reports have shown that shoulder stabilizing procedures lead to postoperative external rotation (ER) deficits. However, no study on arthroscopic Latarjet procedures has investigated the effect on ER when the arm is abducted at 0° (ER0) and 90° (ER90). This study examined the relationship between the arthroscopic Latarjet procedure and the subsequent effect on ER0 and ER90. Methods: Patients who underwent an arthroscopic Latarjet procedure from December 2015 to April 2021 were retrospectively evaluated. Preoperative ER0 and ER90 values were obtained from the contralateral shoulder. ER0 and ER90 values from the operative side were collected at both 3 and 6 months postoperatively. A repeated measures ANOVA was performed to assess the mean preoperative and postoperative values. Results: Forty-six patients met the inclusion criteria. Mean ER0 for the 3- and 6-month time frames measured 44.2° and 54.6°, respectively. Mean ER90 for the 3- and 6-month time frames measured 78.4° and 90.4°, respectively. Comparison to the contralateral arm at the 3-month follow-up period showed a deficit of 14.9° (P = .0001) and 17.2° (P = .0001) for ER0 and ER90, respectively. At the 6-month follow-up period, patients demonstrated an average decline in ER0 and ER90 of 4.57° (P = .063) and 5.11° (P = .008), respectively. Conclusion: A nominal deficit in ER occurred for both ER0 and ER90 status post arthroscopic Latarjet procedure. Despite loss of ER90 at 6 months achieving statistical significance, the clinical impact is arguably inconsequential. Such limited loss of ER provides more information regarding bony procedures being a more definitive treatment for glenohumeral instability and the ability to restore native motion.
