Management of acute Achilles tendon ruptures: a survey of Army orthopaedic surgeons
Abstract Background Despite the literature on acute Achilles tendon ruptures, there remains a lack of consensus regarding the optimal treatment. The purpose of this survey study was to investigate treatment preferences among Army orthopaedic surgeons when presented with a standardized case of an acu...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-021-04121-y |
| _version_ | 1818456966387728384 |
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| author | Nischal Nadig Thomas Dowd Jeannie Huh |
| author_facet | Nischal Nadig Thomas Dowd Jeannie Huh |
| author_sort | Nischal Nadig |
| collection | DOAJ |
| description | Abstract Background Despite the literature on acute Achilles tendon ruptures, there remains a lack of consensus regarding the optimal treatment. The purpose of this survey study was to investigate treatment preferences among Army orthopaedic surgeons when presented with a standardized case of an acute Achilles rupture and determine if surgeon factors correlated with treatment preference. Methods A hypothetical case of a 37-year-old male with history, physical exam, and imaging consistent with an Achilles rupture was sent to board-certified Army orthopaedic surgeons to determine their preferred management. Demographic data was collected to include: practice setting, years from residency graduation, and completion of fellowship. Correlations analyzed between demographics and treatment preferences. Results Sixty-two surgeons responded. 62% of respondents selected surgical intervention. Of these, 59% chose a traditional open technique. 50% of respondents were general orthopaedic. There was a correlation between fellowship training and operative management (P = 0.042). Within the operative management group there was no statistical difference (P > 0.05) in need for further imaging, technique used, post-operative immobilization, length of immobilization, weight-bearing protocol, and time to release to running. The majority of non-operative responders would splint/cast in plantarflexion or CAM boot with heel lift for < 3 weeks (50%) and keep non-weight bearing for < 4 weeks (63%). Only 38% of respondents would use DVT chemoprophylaxis. Conclusion When provided with a hypothetic case of an acute Achilles tendon rupture, queried Army orthopaedic surgeons would more often treat with a surgical procedure. This difference in treatment is secondary to training, fellowship or other. This propensity of surgical management, likely stems from the highly active population and the desire to return to duty. |
| first_indexed | 2024-12-14T22:35:04Z |
| format | Article |
| id | doaj.art-92bb7017c54f465888a29640735c1a1d |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-14T22:35:04Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-92bb7017c54f465888a29640735c1a1d2022-12-21T22:45:10ZengBMCBMC Musculoskeletal Disorders1471-24742021-03-012211710.1186/s12891-021-04121-yManagement of acute Achilles tendon ruptures: a survey of Army orthopaedic surgeonsNischal Nadig0Thomas Dowd1Jeannie Huh2Department of Orthopaedic Surgery, Dwight D. Eisenhower Army Medical CenterDepartment of Orthopaedics & Rehab., San Antonio Military Medical CenterDepartment of Orthopaedics & Rehab., Womack Army Medical CenterAbstract Background Despite the literature on acute Achilles tendon ruptures, there remains a lack of consensus regarding the optimal treatment. The purpose of this survey study was to investigate treatment preferences among Army orthopaedic surgeons when presented with a standardized case of an acute Achilles rupture and determine if surgeon factors correlated with treatment preference. Methods A hypothetical case of a 37-year-old male with history, physical exam, and imaging consistent with an Achilles rupture was sent to board-certified Army orthopaedic surgeons to determine their preferred management. Demographic data was collected to include: practice setting, years from residency graduation, and completion of fellowship. Correlations analyzed between demographics and treatment preferences. Results Sixty-two surgeons responded. 62% of respondents selected surgical intervention. Of these, 59% chose a traditional open technique. 50% of respondents were general orthopaedic. There was a correlation between fellowship training and operative management (P = 0.042). Within the operative management group there was no statistical difference (P > 0.05) in need for further imaging, technique used, post-operative immobilization, length of immobilization, weight-bearing protocol, and time to release to running. The majority of non-operative responders would splint/cast in plantarflexion or CAM boot with heel lift for < 3 weeks (50%) and keep non-weight bearing for < 4 weeks (63%). Only 38% of respondents would use DVT chemoprophylaxis. Conclusion When provided with a hypothetic case of an acute Achilles tendon rupture, queried Army orthopaedic surgeons would more often treat with a surgical procedure. This difference in treatment is secondary to training, fellowship or other. This propensity of surgical management, likely stems from the highly active population and the desire to return to duty.https://doi.org/10.1186/s12891-021-04121-yAchilles ruptureAcute ruptureUnited states armyTendon rupture |
| spellingShingle | Nischal Nadig Thomas Dowd Jeannie Huh Management of acute Achilles tendon ruptures: a survey of Army orthopaedic surgeons BMC Musculoskeletal Disorders Achilles rupture Acute rupture United states army Tendon rupture |
| title | Management of acute Achilles tendon ruptures: a survey of Army orthopaedic surgeons |
| title_full | Management of acute Achilles tendon ruptures: a survey of Army orthopaedic surgeons |
| title_fullStr | Management of acute Achilles tendon ruptures: a survey of Army orthopaedic surgeons |
| title_full_unstemmed | Management of acute Achilles tendon ruptures: a survey of Army orthopaedic surgeons |
| title_short | Management of acute Achilles tendon ruptures: a survey of Army orthopaedic surgeons |
| title_sort | management of acute achilles tendon ruptures a survey of army orthopaedic surgeons |
| topic | Achilles rupture Acute rupture United states army Tendon rupture |
| url | https://doi.org/10.1186/s12891-021-04121-y |
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