RESUMEN
BACKGROUND: While Achilles tendon rupture is a common injury sustained especially in sporting events, distal Achilles tendon rupture is less common. Even rarer is a bilateral traumatic distal Achilles tendon sleeve rupture, with outcomes of such injury unknown. The following case report describes this rare injury, not reported to date elsewhere. CASE: A 57-year-old Finnish man with no predisposing medical history had a traumatic bilateral distal Achilles tendon sleeve avulsion injury. Clinical and radiological evaluation confirmed the diagnosis. Treatment included suture anchors in a modified suture bridge style with customized rehabilitation protocol postoperatively. Symptoms continued to be relieved at 1 year postoperatively. CONCLUSION: A modified suture bridge style and meticulous rehabilitation protocol including motivated patient contributed to very satisfying results in this very rare bilateral injury.
Asunto(s)
Tendón Calcáneo , Traumatismos de los Tendones , Masculino , Humanos , Persona de Mediana Edad , Tendón Calcáneo/diagnóstico por imagen , Tendón Calcáneo/cirugía , Tendón Calcáneo/lesiones , Rotura/diagnóstico por imagen , Rotura/cirugía , Técnicas de Sutura , Traumatismos de los Tendones/diagnóstico por imagen , Traumatismos de los Tendones/cirugía , Procedimientos NeuroquirúrgicosRESUMEN
With the increasing burden of metastatic spinal disease there is ever-more pressure on the health system to provide optimal management. Multiple treatment modalities, including surgical intervention, are available. Multiple prognostic scoring systems have been developed to aid both clinician and patient in making the best decision for each individual. The modified Frailty Index (mFI) has not been assessed for its correlation with survival in patients treated for metastatic spine disease. A retrospective review of a patients undergoing surgery for metastatic spine disease at a tertiary referral centre was performed and a comparison was made between the mFI and previously established disease-specific prognostic scores (revised Tokuhashi, modified Bauer and Tomita scores and the Oswestry Spine Risk Index). 41 patients were included over a 5-year period. 38 deceased by the end of the study period with a 30-day mortality of 14.6% and a 1-year mortality of 73.2%. The mFI poorly correlated with survival. Out of the four established scoring system, the OSRI had the best correlation. The mFI did not correlate with survival in this cohort of surgically treated patients with metastatic spinal disease and is best used as a selection tool for surgery. Dedicated prognostic tools can be selected appropriate to the institution experience and set-up.