Extensor Tendon Injuries of the Foot and Ankle Caused by Agricultural Trauma: Clinical Characteristics, Complications, and Functional Outcomes.

Abstract

Chainsaw- and brush hook-related agricultural injuries may cause extensor tendon injuries, particularly on the dorsal aspect of the foot. Due to frequent occupational exposure, these injuries are commonly encountered in agricultural regions. This study aimed to evaluate demographic characteristics, associated injuries, complications, treatment strategies, and factors affecting functional outcomes in patients with foot extensor tendon injuries caused by these mechanisms. Retrospective cohort study. A retrospective analysis was conducted between 2016 and 2023, including patients with foot extensor tendon injuries secondary to chainsaw or brush hook trauma. Demographic data, injury characteristics, associated fractures, complications, and functional outcomes were evaluated. Functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) and Foot and Ankle Ability Measure-Activities of Daily Living (FAAM-ADL) scores. Regression analysis was performed to identify factors affecting outcomes. A total of 126 patients were included, with a mean age of 45.9 ± 11.3 years; 87.3% were male. The extensor hallucis longus tendon was the most commonly injured tendon, and zone III was the most frequent injury location. Complications occurred in 31.7% of patients, most commonly neuropraxia. Chainsaw-related injuries resulted in significantly lower AOFAS and FAAM-ADL scores (p < 0.05). Multivariate regression analysis demonstrated that age independently affected AOFAS scores, whereas age, chainsaw use, and injury region significantly influenced FAAM-ADL scores. Agricultural tool-related foot extensor tendon injuries are associated with considerable morbidity. Functional outcomes are influenced by patient age, injury mechanism, and injury location. III, retrospective cohort study.