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Achillis tendon rupture

C J Lever, H A Bosman, A H N Robinson
Aims Flexor hallucis longus (FHL) tendon transfer is a well-recognized technique in the treatment of the neglected tendo Achillis (TA) rupture. Patients and Methods We report a retrospective review of 20/32 patients who had undergone transtendinous FHL transfer between 2003 and 2011 for chronic TA rupture. Their mean age at the time of surgery was 53 years (22 to 83). The mean time from rupture to surgery was seven months (1 to 36). The mean postoperative follow-up was 73 months (29 to 120). Six patients experienced postoperative wound complications...
May 1, 2018: Bone & Joint Journal
Nicola Maffulli, Francesco Oliva, Gayle D Maffulli, Angelo Del Buono, Nikolaos Gougoulias
BACKGROUND: Surgical management of chronic Tendo Achillis (TA) ruptures usually requires tendon grafting procedures. Several techniques have been described. We examined the outcome of three different less invasive (incisions length less than 3 cm) tendon transfer techniques in the management of patients with a chronic rupture of the TA. METHODS: Of 62 patients (39 males and 23 females; mean age 44.8 years; range 29.3-62 years) with chronic TA ruptures managed operatively, 21 patients had a ≥6cm gap and underwent free ipsilateral semitendinosus (ST) graft (21 patients), whereas patients with smaller gaps had either ipsilateral peroneus brevis (PB) (20 patients) or ipsilateral flexor hallucis longus (FHL) transfer (21 patients)...
April 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Ben J Ollivere, Hilary A Bosman, Philip W P Bearcroft, Andrew H N Robinson
Repair of acute Achilles tendon rupture is a common procedure. There are many accepted surgical techniques; suture selection is largely due to surgeon preference. We present a case report of a granulomatous reaction to suture material following Achilles tendon repair. 'Fiberwire(®)' is an increasingly popular suture material for the repair of tendons and ligamentous structures; the polyethelene braided structure with silicone and polyester coating provides high tensile strengths and good handling characteristics...
June 2014: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
E Domeij-Arverud, A Latifi, F Labruto, G Nilsson, P W Ackermann
We hypothesised that adjuvant intermittent pneumatic compression (IPC) beneath a plaster cast would reduce the risk of deep-vein thrombosis (DVT) during post-operative immobilisation of the lower limb. Of 87 patients with acute tendo Achillis (TA) rupture, 26 were prospectively randomised post-operatively after open TA repair. The treatment group (n = 14) received two weeks of IPC of the foot for at least six hours daily under a plaster cast. The control group (n = 12) had no additional treatment. At two weeks post-operatively all patients received an orthosis until follow-up at six weeks...
September 2013: Bone & Joint Journal
Stephane Guillo, Angelo Del Buono, Marion Dias, Vincenzo Denaro, Nicola Maffulli
Minimally invasive repair of acute traumatic ruptures of the tendo Achillis may produce lower complications compared to open repair. Twenty-three active patients underwent percutaneous repair of an acute rupture of the tendo Achillis. Post-operatively, the ATRS score was administered to assess the functional status. The maximum calf circumference, isometric plantar flexion strength of the gastrocsoleus muscle complex, ankle dorsiflexion, and return to sport activity were assessed in all patients at an average post-operative follow-up of 25...
February 2013: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Bing-Ju Xie, Wei-Liang Wang, Guo-Jing Yang, Guang-Mao Lin, Zhan-Peng Pan, Liang-Le Liu
OBJECTIVE: To compare the curative effects of newly suture anchors and traditional steel wire for the reconstruction of near distal tendo achillis rupture. METHODS: The clinical data of 56 patients with near distal tendo achillis rupture from June 2007 to February 2011 were retrospectively analyzed. Among 31 patients receiving reconstruction by suture anchors, 22 patients were male and 9 patients were female, with a mean age of 35.5 years (ranging from 16 to 52 years )...
December 2011: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
R S Kearney, M L Costa
Rupture of the tendo Achillis is a common injury with a rising incidence. Traditionally the key question following this injury has been whether or not to operate. However a contemporary Cochrane review highlighted that the method of rehabilitation may also have an important contribution to the outcome. Since this review, various early weight-bearing rehabilitation protocols have been described. Currently evidence points to the use of early functional rehabilitation, regardless of operative or non-operative management...
January 2012: Journal of Bone and Joint Surgery. British Volume
R G H Wallace, G J Heyes, A L R Michael
Controversy surrounds the most appropriate treatment method for patients with a rupture of the tendo Achillis. The aim of this study was to assess the long term rate of re-rupture following management with a non-operative functional protocol. We report the outcome of 945 consecutive patients (949 tendons) diagnosed with a rupture of the tendo Achillis managed between 1996 and 2008. There were 255 female and 690 male patients with a mean age of 48.97 years (12 to 86). Delayed presentation was defined as establishing the diagnosis and commencing treatment more than two weeks after injury...
October 2011: Journal of Bone and Joint Surgery. British Volume
J F Keating, E M Will
A total of 80 patients with an acute rupture of tendo Achillis were randomised to operative repair using an open technique (39 patients) or non-operative treatment in a cast (41 patients). Patients were followed up for one year. Outcome measures included clinical complications, range of movement of the ankle, the Short Musculoskeletal Function Assessment (SMFA), and muscle function dynamometry evaluating dorsiflexion and plantar flexion of the ankle. The primary outcome measure was muscle dynamometry. Re-rupture occurred in two of 37 patients (5%) in the operative group and four of 39 (10%) in the non-operative group, which was not statistically significant (p = 0...
August 2011: Journal of Bone and Joint Surgery. British Volume
B Kocaoglu, I Agir, U Nalbantoglu, M Karahan, M Türkmen
We investigated the effect of mitomycin-C on the reduction of the formation of peritendinous fibrous adhesions after tendon repair. In 20 Wistar albino rats the tendo Achillis was cut and repaired using a modified Kessler technique. The rats were divided into two equal groups. In group 1, an injection of mitomycin-C was placed between the tendon and skin of the right leg. In group 2, an identical volume of sterile normal saline was injected on the left side in a similar fashion. All the rats received mitomycin-C or saline for four weeks starting from the day of operation...
June 2010: Journal of Bone and Joint Surgery. British Volume
Jean-Louis Rouvillain, Thomas Navarre, Octavio Labrada-Blanco, Emmanuel Garron, Wael Daoud
Conservative treatment of Achilles tendon ruptures may lead to re-rupture. Open surgical repair entails a risk of skin necrosis or infection. Several percutaneous techniques have been used, such as Tenolig or Achillon, but these techniques are costly and may be marred by wound healing problems. Ma and Griffith described a technique for percutaneous repair which left the suture and the knot under the skin, thus reducing the risk for infection. From January 2001 to September 2006, we used this percutaneous treatment for 60 acute ruptures of tendo Achillis...
April 2010: Acta Orthopaedica Belgica
Liang-Le Liu, Bing-Ju Xie, Wei-Liang Wang, Ming-Hai Dai, Guo-Jing Yang, Cheng-Xuan Tang
OBJECTIVE: To investigate the techniques and therapeutic effects of suture anchors for the reconstruction of distal tendo achillis rupture. METHODS: The clinical data of 16 patients of distal tendo achillis rupture repaired with suture anchors from June 2005 to August 2008 were retrospectively analyzed. Among them, there were 13 males and 3 females with a mean age of 33.5 years (ranged from 17 to 46 years). The postoperative rehabilitation was conducted for every patient...
March 2010: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Ali Dogan, Mahmut Korkmaz, Nurettin Cengiz, A Murat Kalender, M Ata Gokalp
BACKGROUND: Tendo Achillis lengthening is performed by means of Z-plasty in the classic treatment of clubfoot. In the Ponseti method for treating clubfoot, Achilles tenotomy is performed percutaneously for residual equine deformity. A randomized study was designed to compare tendon healing after tenotomy versus Z-plasty. METHODS: Thirty-six Sprague-Dawley rats were divided randomly into two groups. On the first day, while the right tendo Achillis of group 1 rats underwent tenotomy, those of group 2 rats underwent Z-plasty...
May 2009: Journal of the American Podiatric Medical Association
C J Pearce, S Sexton, D Gerrard, A Hatrick, M Solan
Chronic infections and ulceration around the tendo Achillis are difficult to manage. Split-skin grafts do not survive even on healthy exposed tendon. Refractory cases may require plastic surgical intervention with the use of free flaps. Patients with significant vascular disease are not suitable for such techniques. Flexor hallucis longus tendon transfer is an established treatment for chronic ruptures of the tendo Achillis. We report the successful treatment of an infected tendo Achillis with excision and reconstruction with flexor hallucis longus transfer...
February 2008: Journal of Bone and Joint Surgery. British Volume
Nicola Maffulli, Adam Ajis, Umile Giuseppe Longo, Vincenzo Denaro
The Achilles tendon is the most commonly ruptured tendon in the human body. About 20% of complete ruptures of the Achilles tendon are diagnosed late. The management of chronic ruptures of tendo Achillis is usually different from that of acute rupture, as the tendon ends normally will have retracted. As clinical diagnosis of chronic ruptures can be problematic, imaging can be useful. Most investigators counsel operative management, and the possibility of undertaking a tendon transfer should be kept in mind. Local tendons, such as the flexor digitorum longus, the flexor hallucis longus, and the tendon of peroneus brevis, can be used, and some investigators have reported the use of a free gracilis tendon graft...
December 2007: Foot and Ankle Clinics
Miguel A Ramirez, Lars C Richardson
Bilateral Achillies tendon ruptures are a rare occurrence that usually occur in patients with chronic systemic disease. Many cases are also associated with corticosteroid or fluoroquinolone use. Nonoperative treatment is generally indicated in this patient population, as the patients are often considered poor surgical candidates. Nonoperative immobilization, however, conveys the risk of developing deep venous thrombosis and pulmonary embolism. Such risks are even greater in patients displaying bilateral Achilles tendon ruptures...
July 2007: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
L Klenerman
No abstract text is available yet for this article.
April 2007: Journal of Bone and Joint Surgery. British Volume
Jiwan Lal Bassi, Pankaj Mahindra
OBJECTIVE: Repair of acute and remote ruptures of the tendo Achillis by a modified open technique to reduce wound healing complications and the incidence of reruptures. INDICATIONS: Acute and remote ruptures of the tendo Achillis in diabetic patients and those with any underlying local or systemic conditions that may delay skin healing or predispose to wound dehiscence. This technique is also helpful in instances of a large dehiscence of the ruptured tendon stumps...
June 2006: Operative Orthopädie und Traumatologie
M L Costa, K MacMillan, D Halliday, R Chester, L Shepstone, A H N Robinson, S T Donell
We performed two independent, randomised, controlled trials in order to assess the potential benefits of immediate weight-bearing mobilisation after rupture of the tendo Achillis. The first trial, on operatively-treated patients showed an improved functional outcome for patients mobilised fully weight-bearing after surgical repair. Two cases of re-rupture in the treatment group suggested that careful patient selection is required as patients need to follow a structured rehabilitation regimen. The second trial, on conservatively-treated patients, provided no evidence of a functional benefit from immediate weight-bearing mobilisation...
January 2006: Journal of Bone and Joint Surgery. British Volume
M L Costa, D Kay, S T Donell
One of the factors that influence the outcome after rupture of the tendo Achillis is abnormality of gait. We prospectively assessed 14 patients and 15 normal control subjects using an in-shoe plantar pressure measurement system. There was a significant reduction in peak mean forefoot pressure in the early period of rehabilitation (p < 0.001). There was a concomitant rise in heel pressure on the injured side (p = 0.05). However, there was no difference in cadence, as determined by the duration of the terminal stance and pre-swing phases as a proportion of total stance...
August 2005: Journal of Bone and Joint Surgery. British Volume
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