Achilles tendon ruptures are prevalent among physically active adults and can lead to sural nerve injuries (SNIs) due to the anatomical proximity of the sural nerve to the Achilles tendon. While SNIs are well-recognized in surgical contexts, their occurrence following nonoperative treatments, which are often preferred for their lower risk of surgical complications, remains less documented and poorly understood. This report describes a case of a 30-year-old active male who developed chronic traction sural neuropathy after opting for nonoperative treatment of an acute complete Achilles tendon rupture. Despite adhering to a rehabilitation protocol, he experienced persistent symptoms of sural nerve damage, which were confirmed as chronic sensory neuropathy through nerve conduction studies. Here, we discuss the proposed pathophysiology and review the literature on SNIs in Achilles injuries. This case highlights the importance for clinicians to accurately diagnose and remain aware of the potential for SNIs in the nonoperative management of Achilles tendon ruptures.
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http://dx.doi.org/10.7759/cureus.74420 | DOI Listing |
Cureus
December 2024
Trauma and Orthopaedics, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, GBR.
Introduction Achilles tendon rupture (ATR) represents a significant musculoskeletal injury that can affect many patients' mobility and quality of life. Treatment of ATR consists of both conservative and surgical options, with the traditional belief being that surgical intervention reduces the risk of re-rupture. However, with the introduction of physiotherapy-led functional rehabilitation strategies with early mobilization, it has been shown that re-rupture rates are equal among surgical and non-surgical patients.
View Article and Find Full Text PDFJ Orthop Case Rep
January 2025
Department of Orthopaedics, Vinayaka Mission's Medical College and Hospital, Vinayaka Mission's Research Foundation (DU), Karaikal , Puducherry, India.609609.
Introduction: Extreme beak calcaneal fractures (Type 2 Lee's tuberosity avulsion fractures) are rare injuries, accounting for only 1.3-3% of all calcaneal fractures. These injuries are considered as surgical emergency as they can lead to significant functional impairment and soft-tissue compromise if not promptly managed.
View Article and Find Full Text PDFJ Orthop Res
January 2025
Graduate School of Health, Medicine, and Welfare, Saitama Prefectural University, Koshigaya, Saitama, Japan.
Incomplete tendon healing and postponed muscle weakness after Achilles tendon rupture and surgical repair lead to poor performance in patient activities. Although the effectiveness of postoperative early functional rehabilitation has been proven, the priority and each effect of specific methods in early rehabilitation remain unclear. We hypothesized early muscle contraction exercises without joint motion would promote tendon healing and prevent calf muscle atrophy; in contrast, early static stretching after surgical repair would not contribute to tendon healing and induce calf muscle atrophy.
View Article and Find Full Text PDFActa Biomater
January 2025
Department of Biomedical Engineering, Lund University, Box 118, 221 00 Lund, Sweden.
While the number of studies investigating Achilles tendon pathologies has grown exponentially, more research is needed to gain a better understanding of the complex relation between its hierarchical structure, mechanical response, and failure. At the microscale, collagen fibers are, with some degree of dispersion, primarily aligned along the principal loading direction. However, during tension, rearrangements and reorientations of these fibers are believed to occur.
View Article and Find Full Text PDFFoot Ankle Int
January 2025
Department of Foot Surgery, Schulthess Klinik, Zurich, Switzerland.
Background: Operative management of chronic Achilles tendinopathy with large defects can be surgically challenging. Concerns exist regarding transosseous transfer of the flexor hallucis longus (FHL) tendon because of the shortened lever arm of flexion and weakening of the big toe. The aim of this study was to demonstrate the 2-year outcome of transosseous FHL transfer for the treatment of large Achilles tendon defects.
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