Patient 11

A 48 year old male fell playing basketball and sustained an injury to his left leg. The magnitude of his injury was such that it limited his walking capabilities and he experienced pain. He opted for conservative management at first which failed. On examination at The Fracture and Orthopedic Clinic, he was limping and there was tenderness on the area of the left Achilles tendon. An ultrasound was immediately done that showed a complete tear of the left Achilles tendon at the musculo-skeletal junction. This patient was advised on the need for surgery to correct his injury.

An exploration and reconstruction of his ruptured left Achilles tendon was done. A longitudinal incision was made, the tendon sheath was opened and a chronic rupture of the Achilles tendon was found with minimal scarring. The scarred, minimally functional tendon was cut and re-stitched with two “Krackow” stitches and then a circumferential stitch (shown in pictures provided). The tendon sheath was also reconstructed using vicryl stitch. The patient was placed in a slab (cast) and ordered to not weight-bear on his left leg for three to four weeks. Two weeks post- op, the patient is doing self exercises with minimal pain, and his range of movement is improving and his wound healed. His sutures were removed and was advised to continue his self-directed exercises and to continue follow-up to monitor improvements.

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