Management of commode injuries of Achilles tendon: a newly established tertiary care hospital-based study

Wajahat Ahmad Mir, Javaid Ahmad Ganaie, Rasiq Rashid, Imran Khan, Ab Hai Qureshi


Background: The Achilles tendon is the largest and strongest tendon in the body, formed by the union of gastrocnemius and soleus. Despite its strength, the Achilles tendon is vulnerable to injury, due to its subcutaneous position and the high tensions placed on it. Common mode of Achilles tendon injury nowadays in India is slipping of the foot in Indian type of commode and is often fraught with complications due to the potential contamination of wound at the time of injury. The purpose of this study was to assess the clinical outcome and complications of open Achilles tendon injury with an Indian type commode.

Methods: 30 patients who presented with open Achilles tendon injury between the ages of 10 to 55 years were included. All the patients were treated with emergency debridement, thorough washing and primary repair within 24 hours using Krackow technique.

Results: Out of the 30 patients meeting the inclusion criteria, there was 1 case of superficial infection which resolved with antibiotics and serial dressings. Foreign body sensation was present in 3 patients at final follow-up. Hypertrophic scar formation was seen in one patient. There were no cases of re-rupture in our study. Mean ROM at ankle in saggital plane at final follow-up was 66.13 degrees.

Conclusions: Commode injury is the most common cause of open Achilles tendon injury in Indian population. The complications can be minimized by early primary repair and should only be undertaken after thorough washing and debridement under proper antibiotic cover to contain the infection.


Achilles tendon, Gastrocnemius, Soleus, Krackow technique, Saggital

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