Department of Plastic & Reconstructive Surgery, Sheri Kashmir Institute of Medical Sciences, Srinagar, J&K, India.
Department of Plastic & Reconstructive Surgery, Sheri Kashmir Institute of Medical Sciences, Srinagar, J&K, India.
Injury. 2020 Oct;51(10):2316-2321. doi: 10.1016/j.injury.2020.06.051. Epub 2020 Jun 29.
Open traumatic tendoachilles injuries due to toilet seats are least reported. The exact mechanism of such injuries is debatable. None of the studies have reported associated neurovascular injuries and the need for microvascular tissue transfer.
It is a 5-year prospective observational study from Sep 2013 - Aug 2018 at a tertiary care center on 26 patients who had sustained foot injuries due to squatting type toilet seats. All the patients were managed by thorough wound irrigation and debridement followed by repair of cut tendoachilles, other tendons and neurovascular structures. All the complications and secondary procedures required were recorded. Functional outcome was assessed by Boyden clinical outcome score. Follow up ranged from 1 to 5 years.
All the 26 patients reported a particular mechanism of injury. Complete transection of tendoachilles was seen in 23 (88.5%) patients and partial transection in three (11.5%) patients. Microvascular repair of cut posterior tibial artery was undertaken in three and posterior tibial nerve in two cases and microvascular parascapular flap in one case for soft tissue reconstruction. Twenty-three (88.5%) patients had good to excellent Boyden score while three patients (11.5%) had fair to poor score at 1 year. Such severe injuries due to toilet seats have never been reported in literature.
Squatting toilet seats can cause devastating foot injuries involving tendons and neurovascular structures and may require microvascular tissue transfer for definitive wound management. The risk of such injuries will continue unless some modifications are undertaken in the design of the seat.
由于坐式马桶导致的开放性跟腱创伤较为少见。此类创伤的确切机制仍存在争议。目前尚无研究报道其相关的血管神经损伤和需要进行微血管组织移植的情况。
这是一项 2013 年 9 月至 2018 年 8 月在一家三级医疗中心进行的为期 5 年的前瞻性观察性研究，共纳入 26 例因蹲式马桶而足部受伤的患者。所有患者均行彻底的伤口冲洗和清创，然后修复切断的跟腱、其他肌腱和神经血管结构。记录所有并发症和需要的二次手术。采用 Boyden 临床结局评分评估功能结局。随访时间为 1 至 5 年。
所有 26 例患者均报告了特定的损伤机制。23 例（88.5%）患者出现完全性跟腱断裂，3 例（11.5%）患者出现部分性跟腱断裂。3 例患者行切断的胫后动脉显微修复，2 例患者行胫后神经显微修复，1 例患者行肩胛旁皮瓣显微修复用于软组织重建。23 例（88.5%）患者在 1 年时的 Boyden 评分良好至优秀，3 例（11.5%）患者评分一般至差。此类因马桶造成的严重创伤在文献中从未报道过。
蹲式马桶可导致足部严重损伤，累及肌腱和神经血管结构，可能需要进行微血管组织移植以进行确定性伤口管理。除非对马桶的设计进行某些改进，否则此类损伤的风险将持续存在。
