Tendon lengthening after achilles tendon rupture–passive effects on the ankle joint in a cadaveric pilot study simulating weight bearing

Background: Although early accelerated rehabilitation is recommended for the treatment of acute Achilles tendon rupture, most traditional rehabilitation techniques require some type of brace. Methods: We retrospectively analyzed 44 feet of 44 patients (25 male and 19 female) with a mean age of 31.8 years who had an acute Achilles tendon rupture related to athletic activity. Patients had been treated by a double side-locking loop suture (SLLS) technique using double antislip knots between stumps and had undergone early accelerated rehabilitation, including active and passive range of motion exercises on the day following the operation and full weight-bearing at 4 weeks. No brace was applied postoperatively. The evaluation criteria included the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Scale (AOFAS) score; active plantar flexion and dorsiflexion angles; and the intervals between surgery and the time when patients could walk normally without any support, perform double-leg heel raises, and perform 20 continuous single-leg heel raises of the operated foot. Results: Despite postoperative early accelerated rehabilitation, the AOFAS score and active dorsiflexion angles improved over time (6, 12, and 24 weeks and 2 years). A mean of 4.3 ± 0.6 weeks was required for patients to be able to walk normally without any support. The mean period to perform double-leg heel raises and 20 continuous single-leg heel raises of the injured foot was 8.0 ± 1.3 weeks and 10.9 ± 2.1 weeks, respectively. All patients, except one who was engaged in classical ballet, could return to their preinjury level of athletic activities, and the interval between operation and return to athletic activities was 17.1 ± 3.7 weeks. Conclusion: The double SLLS technique with double antislip knots between stumps adjusted the tension of the sutured Achilles tendon at the ideal ankle position and provided good clinical outcomes following accelerated rehabilitation after surgery without the use of a brace. Level of Evidence: Level IV, retrospective case series.

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Achilles tendon rupture in camel (Camelus dromedarius): Radiographic and Ultrasonographic findings

JOURNAL OF CAMEL HEALTH ◽

10.37735/jch.11119 ◽

2019 ◽

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Soft Tissues ◽

Weight Bearing ◽

Achilles Tendon Rupture ◽

Clinical Decision ◽

Heterogeneous Structure ◽

Dromedary Camels ◽

Fracture Of The Calcaneus ◽

Calcaneal Tuberosity

This study describes the clinical presentation of Achilles tendon rupture and evaluates the utility of radiography and ultrasonography in the diagnosis of such disorder in dromedary camels. Seventeen camels were included in this study based on the clinical, radiographic and ultrasonographic evidence of Achilles tendon rupture. The clinical, radiographic and sonographic findings of studied camels differ according to the type, duration, and location of the tendon rupture. Complete and incomplete rupture of the Achilles tendon was precisely diagnosed in five (29.4%) and twelve (70.6%) camels respectively; ruptured deep and superficial parts of the Achilles tendon were recorded in 10 (58.8%) and 2 (11.8%) camels respectively. Clinically, the camels exhibited an acute non-weight-bearing lameness (second to fourth-grade lameness), with swelling in the tendon near the calcaneus. Radiographs revealed swelling of the soft tissues surrounding the Achilles tendon just proximal to the calcaneal tuberosity in most of the camels with the presence of avulsion fracture of the calcaneus in few cases (n=2). Ultrasonographically, the ruptured part was precisely diagnosed as swollen, oedematous, heterogeneous structure with the presence of anechoic or hypoechoic areas (core lesion). In conclusion, lateromedial radiographs and ultrasonography were helpful in diagnosis and differential diagnosis of different types of Achilles tendon rupture and subsequent clinical decision and surgical interference in dromedary camels.

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Achilles tendon rupture in camel (Camelus dromedarius): Radiographic and Ultrasonographic findings

JOURNAL OF CAMEL HEALTH ◽

10.37735/jch.00001 ◽

2019 ◽

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Soft Tissues ◽

Weight Bearing ◽

Achilles Tendon Rupture ◽

Clinical Decision ◽

Heterogeneous Structure ◽

Dromedary Camels ◽

Fracture Of The Calcaneus ◽

Calcaneal Tuberosity

This study describes the clinical presentation of Achilles tendon rupture and evaluates the utility of radiography and ultrasonography in the diagnosis of such disorder in dromedary camels. Seventeen camels were included in this study based on the clinical, radiographic and ultrasonographic evidence of Achilles tendon rupture. The clinical, radiographic and sonographic findings of studied camels differ according to the type, duration, and location of the tendon rupture. Complete and incomplete rupture of the Achilles tendon was precisely diagnosed in five (29.4%) and twelve (70.6%) camels respectively; ruptured deep and superficial parts of the Achilles tendon were recorded in 10 (58.8%) and 2 (11.8%) camels respectively. Clinically, the camels exhibited an acute non-weight-bearing lameness (second to fourth-grade lameness), with swelling in the tendon near the calcaneus. Radiographs revealed swelling of the soft tissues surrounding the Achilles tendon just proximal to the calcaneal tuberosity in most of the camels with the presence of avulsion fracture of the calcaneus in few cases (n=2). Ultrasonographically, the ruptured part was precisely diagnosed as swollen, oedematous, heterogeneous structure with the presence of anechoic or hypoechoic areas (core lesion). In conclusion, lateromedial radiographs and ultrasonography were helpful in diagnosis and differential diagnosis of different types of Achilles tendon rupture and subsequent clinical decision and surgical interference in dromedary camels.

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Achilles tendon rupture in camel (Camelus dromedarius): Radiographic and Ultrasonographic findings

JOURNAL OF CAMEL HEALTH ◽

10.37735/jch.1.11111 ◽

2019 ◽

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Soft Tissues ◽

Weight Bearing ◽

Achilles Tendon Rupture ◽

Clinical Decision ◽

Heterogeneous Structure ◽

Dromedary Camels ◽

Fracture Of The Calcaneus ◽

Calcaneal Tuberosity

This study describes the clinical presentation of Achilles tendon rupture and evaluates the utility of radiography and ultrasonography in the diagnosis of such disorder in dromedary camels. Seventeen camels were included in this study based on the clinical, radiographic and ultrasonographic evidence of Achilles tendon rupture. The clinical, radiographic and sonographic findings of studied camels differ according to the type, duration, and location of the tendon rupture. Complete and incomplete rupture of the Achilles tendon was precisely diagnosed in five (29.4%) and twelve (70.6%) camels respectively; ruptured deep and superficial parts of the Achilles tendon were recorded in 10 (58.8%) and 2 (11.8%) camels respectively. Clinically, the camels exhibited an acute non-weight-bearing lameness (second to fourth-grade lameness), with swelling in the tendon near the calcaneus. Radiographs revealed swelling of the soft tissues surrounding the Achilles tendon just proximal to the calcaneal tuberosity in most of the camels with the presence of avulsion fracture of the calcaneus in few cases (n=2). Ultrasonographically, the ruptured part was precisely diagnosed as swollen, oedematous, heterogeneous structure with the presence of anechoic or hypoechoic areas (core lesion). In conclusion, lateromedial radiographs and ultrasonography were helpful in diagnosis and differential diagnosis of different types of Achilles tendon rupture and subsequent clinical decision and surgical interference in dromedary camels.

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Achilles tendon rupture in camel (Camelus dromedarius): Radiographic and Ultrasonographic findings

JOURNAL OF CAMEL HEALTH ◽

10.37735/jch.11118 ◽

2019 ◽

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Soft Tissues ◽

Weight Bearing ◽

Achilles Tendon Rupture ◽

Clinical Decision ◽

Heterogeneous Structure ◽

Dromedary Camels ◽

Fracture Of The Calcaneus ◽

Calcaneal Tuberosity

This study describes the clinical presentation of Achilles tendon rupture and evaluates the utility of radiography and ultrasonography in the diagnosis of such disorder in dromedary camels. Seventeen camels were included in this study based on the clinical, radiographic and ultrasonographic evidence of Achilles tendon rupture. The clinical, radiographic and sonographic findings of studied camels differ according to the type, duration, and location of the tendon rupture. Complete and incomplete rupture of the Achilles tendon was precisely diagnosed in five (29.4%) and twelve (70.6%) camels respectively; ruptured deep and superficial parts of the Achilles tendon were recorded in 10 (58.8%) and 2 (11.8%) camels respectively. Clinically, the camels exhibited an acute non-weight-bearing lameness (second to fourth-grade lameness), with swelling in the tendon near the calcaneus. Radiographs revealed swelling of the soft tissues surrounding the Achilles tendon just proximal to the calcaneal tuberosity in most of the camels with the presence of avulsion fracture of the calcaneus in few cases (n=2). Ultrasonographically, the ruptured part was precisely diagnosed as swollen, oedematous, heterogeneous structure with the presence of anechoic or hypoechoic areas (core lesion). In conclusion, lateromedial radiographs and ultrasonography were helpful in diagnosis and differential diagnosis of different types of Achilles tendon rupture and subsequent clinical decision and surgical interference in dromedary camels.

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One-Step Approach for Infections After Achilles Tendon Open Repair: The Distally Based Peroneus Brevis Muscle Flap

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734620951540 ◽

2020 ◽

pp. 153473462095154

Author(s):

Luca Vaienti ◽

Giuseppe Cottone ◽

Giovanna Zaccaria ◽

Emanuele Rampino Cordaro ◽

Francesco Amendola

Keyword(s):

Achilles Tendon ◽

Median Time ◽

Tendon Rupture ◽

Open Repair ◽

Weight Bearing ◽

Achilles Tendon Rupture ◽

Muscle Flap ◽

Full Weight Bearing ◽

Peroneus Brevis ◽

Distally Based

The aim of this single-center, retrospective study is to demonstrate the effectiveness of distally based peroneus brevis muscle flap as first therapeutic option for infections after Achilles tendon open repair. We retrospectively analyzed 14 consecutive patients with complete Achilles tendon rupture and developing surgical site infection after an attempt of open surgical repair. Every patient was reconstructed with distally base peroneus brevis muscle flap. The primary outcome was the return to work and the initiation of full weight-bearing. Secondary outcomes were complication rate and time needed to return to work. A review of the literature was conducted to better define the actual standard treatment. Each patient returned to work. No flap necrosis occurred. Two minor healing delays and one hematoma were reported. Median time to wound healing was 17 days (interquartile range [IQR] = 13-20). Median time to full weight-bearing was 52 days (IQR = 47-55). Median follow-up (FU) was 21 months. Distally based peroneus brevis flap is a safe treatment for surgical site infections after Achilles tendon rupture repair. Patients regained full weight-bearing after a median time of 52 days from the surgical reconstruction. No major complications were observed. This flap clearly emerges as first reconstructive option for complications after surgery of Achilles tendon region.

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