Surgical Management of Neglected Achilles Tendon Rupture

This retrospective study concerns 40 cases of neglected rupture of the Achilles tendon listed in the Traumatology-Orthopedics department of the Avicenne Military Hospital in Marrakech over a period of 7 years, between 2017 and 2022. Our patients are 34 men and 6 women, the average age was 37 years (between 27 and 59 years). The average consultation time was 8 weeks. The causes of the delay in diagnosis are, on the one hand, the negligence of the patients (85%) and, on the other hand, the error of initial diagnosis and the traditional practice. The clinical examination was sufficient to make the diagnosis, although all patients received standard x-ray and ultrasound to eliminate other differential diagnosis. The treatment was surgical in all cases. Three surgical techniques were performed; V-Y plasty as described by Abraham, Bosworth plasty and the transfer with tendon of the flexor hallucis longus muscle. The long-term results were evaluated according to the score of AOFAS (American Orthopaedic Foot & Ankle Society) with a follow-up between a minimum of 2 years and a maximum of 7 years. The aim of our work is to describe the epidemiological, clinical and diagnostic profiles of patients and to evaluate the value of surgery in neglected ruptures of the Achilles tendon, by studying the indications of the different surgical techniques used.