Members do not see these Ads. Sign Up.

Hi

Had an interesting 26 year old male patient who 2 months ago stood on a piece of glass whilst wearing slops. He managed to get the glass to slice into the posterior aspect of his heel at the exact insertion of the achilles tendon (AT) to the calcaneus.

He had nil findings on xrays and the wound was cleaned and stitched. The ER doc felt that no orthpod/pod consult was nescessary as he felt the AT was not significantly damaged.
He now presents to me with a red, swollen and painful posterior heel.

New xray findings show nil of note but for soft tissue swelling adjacent to the AT insertion. The wound has healed fine. No other clinical findings of interest.

He experiences pain on ambulation and especially running. He doed not have any marked tightening of the AT.

There is no doubt some retro-calcaneal bursitis present due probably to the glass incising some of the AT.

I have put him into a silicone heel cup to lift the heel and line the posterior aspect and have sent him for physio to try and reduce the inflammation at the bursitis. I will follow him up in a 2 weeks to see his progress.

Generally, what is the long term prognosis of AT rupture (partial, as in this case) at its insertion into the calcaneus?

Any thoughts greatly appreciated.

Thank you

Brandon Maggen