In the treatment of acute Achilles tendon rupture, recent studies demonstrate that conservative treatment with functional rehabilitation provides good results, with nearly identical postoperative rerupture rates when compared with surgical treatment. Surgical treatment is indicated in patients with particular conditions, such as patients who are young active athletes who require early return to play or those who wish to avoid the muscle atrophy associated with conservative methods. If surgery is the selected option for treatment, the postoperative complications of each type of surgery must be considered. In conventional open repair, the most common complication is soft-tissue infection due to the high tension of soft tissue affected from the bowstring of the repaired tendon being kept in the equinus position of the ankle. For percutaneous methods, sural nerve entrapment and injury are the most commonly reported complications. Other methods, including endoscopy, require technical expertise as well as special equipment. Several types of combination approaches have been explored in the literature. We describe a combined open and percutaneous technique to repair the Achilles tendon, called the hybrid Achilles tendon repair. This technique has been developed to provide a simplified and reproducible method of hybrid repair in which the complications of previous methods are avoided and which can be done without special equipment.

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Purpose: Geriatric hip fractures are common. Surgical treatment is generally required to achieve a good quality of life. It was reported that a delayed time from injury to treatment leads to poor outcomes. We aimed to determine the time interval from injury to hospital admission in patients with geriatric hip fractures and explore the reasons for delay. Methods: Information on geriatric hip fracture patients who received treatment at our hospital from November 2016 to October 2020 was extracted from medical records. The average delay time was analyzed and reported. The reasons for delay were collected from patients who were not referred from other hospitals and had a time interval from injury to admission of more than 24 h. Results: The median time interval was 0.38 days, and 127 (32%) visited the hospital more than 24 h later. In patients not referred from other hospitals, the most common cause of delay was that patients overlooked the possibility of bone fractures (58%). Other reasons included unavailable transportation (20%), missed diagnosis from other hospitals (11%), inability to afford the transportation cost (7%), and inability to talk and/or caregivers did not notice the injury (4%). Conclusions: Almost one-third of geriatric hip fracture patients had a time from injury to admission of more than 24 h. Knowing the reason for delay and determining a solution to minimize this time interval may improve treatment quality. This information demonstrates that public and healthcare providers should pay attention to elderly patients with a history of fall injury.

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