TITLE:
Surgical Outcomes of Traumatic Achilles Tendon Sections: A Study of 57 Patients from a West African Teaching Hospital
AUTHORS:
M’Bra Kouamé Innocent, Koua Abenan Grace Nieleny, Sery Bada Justin Léopold Niaoré, Yao Loukou Blaise, Kouassi Kouamé Jean-Eric, Soumahoro Ibrahim, Akobe Achié Jean-Regis, Soro Zolopigué Marcel, Kodo Michel
KEYWORDS:
Achilles Tendon, Traumatic Tendon Section, Open Tendon Injury, Surgical Repair, ATRS, Rehabilitation, Motorcycle Injury, Côte d’Ivoire
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.16 No.10,
October
20,
2026
ABSTRACT: Background: Traumatic Achilles tendon sections are serious injuries that may impair plantar-flexion strength, gait, and lower-limb function. Most contemporary literature concerns closed Achilles tendon ruptures, whereas data on traumatic open tendon sections remain limited, particularly in sub-Saharan Africa. Objective: To evaluate the clinical and functional outcomes of surgical treatment of traumatic Achilles tendon sections at Bouaké University Hospital and to identify factors associated with favorable functional recovery. Methods: We conducted a retrospective, observational, descriptive, and analytical study involving 57 patients treated for traumatic Achilles tendon section at Bouaké University Hospital between January 2020 and December 2024. Patients older than 15 years with an injury treated within 21 days and at least six months of follow-up were included. Functional outcome was assessed using the Achilles Tendon Total Rupture Score (ATRS). Factors associated with a favorable outcome, defined as ATRS ≥ 75, were assessed using binary logistic regression. Results: Fifty-seven patients were included. The mean age was 26.8 years (range, 15 - 60 years), with a sex ratio of 0.96. Motorcycle wheel-spoke trauma was the predominant mechanism, accounting for 70.17% of injuries. Complete tendon sections represented 85.96%. Treatment was performed within 24 hours in 77.19% of cases. All patients underwent open surgical repair. Normal gait without limping was observed in 94.73% of patients, while 75.44% resumed walking within 60 days. Normal ankle mobility was preserved in 96.50%. The re-rupture rate was 1.75%. No ankle stiffness, peritendinous fibrosis, or complex regional pain syndrome was observed. ATRS ranged from 55 to 100. An ATRS ≥75 was achieved by 92.98% of patients and ≥90 by 29.82%. Overall satisfaction was 98.25%, and all patients returned to occupational activities. In multivariable analysis, younger age was associated with a favorable functional outcome. For the absence of postoperative pain, the adjusted OR was 3.841 (reconstructed 95% CI, 1.01 - 14.56; p = 0.0478). Conclusion: Surgical treatment of traumatic Achilles tendon sections resulted in generally favorable clinical and functional outcomes in this series. Younger age and absence of postoperative pain were associated with better functional recovery. The predominance of motorcycle wheel-spoke injuries highlights the importance of prevention, early surgical management, and structured rehabilitation.