scholarly journals Conservative, minimally invasive and open surgical repair for management of acute ruptures of the Achilles tendon: a clinical and functional retrospective study

2017 ◽  
Vol 7 (1) ◽  
pp. 46 ◽  
Author(s):  
G Maffulli
Keyword(s):  
Retrospective Study ◽  
Minimally Invasive ◽  
Achilles Tendon ◽  
Surgical Repair ◽  
Open Surgical Repair

scholarly journals Neuromechanical activation of triceps surae muscle remains altered at 3.5 years following open surgical repair of acute Achilles tendon rupture

2021 ◽  
Author(s):  
Markus Wenning ◽  
Marlene Mauch ◽  
Albrecht Heitner ◽  
Johannes Lienhard ◽  
Ramona Ritzmann ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Gait Analysis ◽  
Tendon Rupture ◽  
Surgical Repair ◽  
Achilles Tendon Rupture ◽  
Triceps Surae ◽  
Median Frequency ◽  
Open Surgical Repair ◽  
Neuromuscular Activation ◽  
Injured Side

Abstract Purpose To assess whether the neuromuscular activation pattern following Achilles tendon rupture and repair may contributes to the observable functional deficits in this severe and increasingly frequent injury. Methods In this study, the neuromuscular activation using surface EMG of n = 52 patients was assessed during a battery of functional performance tasks to assess potential alterations of muscular activation and recruitment. We analyzed the injured leg vs. the contralateral healthy leg at a mean of 3.5 years following open surgical repair. The testing battery included isokinetic strength testing, bipedal and single-legged heel-rise testing as well as gait analysis. Results During isokinetic testing, we observed a higher activation integral for all triceps surae muscles of the injured side during active dorsiflexion, e.g., eccentric loading on the injured leg, while concentric plantarflexion showed no significant difference. Dynamic heel-rise testing showed a higher activation in concentric and eccentric loading for all posterior muscles on the injured side (not significant); while static heel-rise for 10 sec. revealed a significantly higher activation. Further analysis of frequency of fast Fourier-transformed EMG revealed a significantly higher median frequency in the injured leg. Gait analysis revealed a higher pre-activation of the tibialis anterior before ground contact, while medial and lateral gastrocnemius muscles of the injured leg showed a significantly higher activation during push-off phase. Conclusions The results of this study provide evidence on the neuromuscular changes 3.5 years following open surgical Achilles tendon repair. These complex neuromuscular changes are manifested to produce the maximum force output whilst protecting the previously injured tendon. The observed alterations may be related to an increased recruitment of type II muscle fibers which could make the muscles prone to fatigue. Level of evidence III.

scholarly journals Calf muscle functional deficit 1-year after Achilles tendon rupture repair surgery

2016 ◽  
Vol 2 (6) ◽  
pp. 172
Author(s):  
Vaida Aleknavičiūtė Ablonske ◽  
Albertas Skurvydas ◽  
Sigitas Balčiūnas ◽  
Vilma Juodžbalienė
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Surgical Repair ◽  
Plantar Flexion ◽  
Achilles Tendon Rupture ◽  
Open Surgical Repair ◽  
Biomechanical Behavior ◽  
Physiological Properties ◽  
Calf Muscles

The primary muscles responsible for plantar flexion movement are soleus and gastrocnemius which connects to the calcaneus by the Achilles tendon. Achilles tendon rupture is managed most often with open surgical repair in which the affected limb is immobilized. Understanding the effects of long-term immobilization, how these lead to changes in the physiological properties of the calf muscles changes, may help to improve rehabilitation. Investigating the biomechanical behavior of the calf muscles may provide a better understanding of how the inferior material properties of a scarred Achilles tendon may influence the more global structural properties of the intact muscles

scholarly journals Transthoracic minimally invasive closure for the treatment of arch penetrating aortic ulcer: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shixiong Wang ◽  
Debin Liu ◽  
Yongnan Li ◽  
Bingren Gao
Keyword(s):  
Computed Tomography ◽  
Minimally Invasive ◽  
Aortic Arch ◽  
Septal Defect ◽  
Surgical Repair ◽  
Acute Aortic Syndrome ◽  
Descending Thoracic Aorta ◽  
Open Surgical Repair ◽  
Penetrating Aortic Ulcer ◽  
Novel Method

AbstractPenetrating aortic ulcer (PAU) is one of the three subtypes of acute aortic syndrome. PAUs occur at any point throughout the aorta, most commonly in the descending thoracic aorta and less frequently in the aortic arch. Open surgical repair and total/hybrid endovascular repair are currently available to treat aortic arch PAUs. Herein, we present a patient with aortic arch PAU who underwent transthoracic minimally invasive closure, which is a novel method for the treatment of PAU. We describe a 52-year old Asian man who presented with sudden chest and back pain for 8 h. Computed tomography angiography showed that the PAU occurred in the aortic arch and had a diameter of 16 mm and a depth of 6 mm. The opening was successfully closed via transthoracic minimally invasive closure with an atrial septal defect occluder.

A Method for Combined Percutaneous and Open Surgical Repair of Achilles Tendon Ruptures: A Report of Three Cases

1996 ◽  
Vol 17 (4) ◽  
pp. 217-220 ◽  
Author(s):  
Behiç Tanil Esemenli ◽  
Hakan Gündeş ◽  
Mete Mecikoğlu
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Surgical Repair ◽  
Functional Results ◽  
Wound Complication ◽  
Wound Complications ◽  
Distal Stump ◽  
Open Surgical Repair ◽  
Tendon Ruptures

Surgical treatment of Achilles tendon ruptures provides excellent functional results in active individuals, although it carries an incidence of wound complications. After experiencing a 25% wound complication rate with the traditional techniques in Achilles tendon ruptures, we modified the Bosworth technique by passing the gastrocsoleus flap percutaneously through the distal stump. This modification eliminated one third of the distal incision, which appears to be the most vulnerable part. We performed the operation in three consecutive cases. At 2-year follow-up there were no wound complications and no reruptures.

Effect of Complications After Minimally Invasive Surgical Repair of Acute Achilles Tendon Ruptures

2011 ◽  
Vol 39 (4) ◽  
pp. 820-824 ◽  
Author(s):  
Roderik Metz ◽  
Geert J. M. G. van der Heijden ◽  
Egbert-Jan M. M. Verleisdonk ◽  
Nicky Kolfschoten ◽  
Michiel H. J. Verhofstad ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Surgical Repair ◽  
Minimally Invasive Surgical ◽  
Tendon Ruptures

scholarly journals Midterm functional performance following open surgical repair of acute Achilles tendon rupture

2021 ◽  
Author(s):  
Markus Wenning ◽  
Marlene Mauch ◽  
Albrecht Heitner ◽  
Paul Streicher ◽  
Ramona Ritzmann ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Surgical Repair ◽  
Functional Performance ◽  
Achilles Tendon Rupture ◽  
Anatomical Reconstruction ◽  
Open Surgical Repair ◽  
Functional Deficits ◽  
Post Surgery ◽  
Patient Reported

Abstract Introduction Various impairments such as soleus atrophy and consecutive functional deficits in end-range plantarflexion have been described in surgical repair of acute Achilles tendon rupture. The aim of this study was to assess the functional performance at midterm following open surgical repair. Materials and Methods This cross-sectional study includes n = 52 patients which were tested on average 3.5 ± 1.4 years postoperatively using three different functional performance tests and patient-reported outcome measures. Two different surgical techniques (anatomical repair = AR vs. conventional repair = CR) were compared in a subanalysis. The testing included isokinetic strength testing, a novel setup of heel-rise testing using a marker-based 3D motion analysis system and a gait analysis. Results At an average 3.5 years post-surgery, there is a persisting deficit in plantarflexion strength of 10.2%. Moreover, analysis of maximum peak torque angle and strength deficits according to the plantarflexion angle revealed that these deficits are not equally distributed across the range of motion. AR results in a significantly smaller deficit at 10° of plantarflexion compared to CR (13.9 vs. 29.9%, p < 0.05). This reflects into the functional performance during different modalities (static vs. dynamic) in this novel method of heel-rise testing. Conclusion In summary, there are persisting functional deficits at > 3 years following Achilles tendon repair which range from strength deficits to specific impairments of functional performance e.g. during heel rise. Anatomical reconstruction is associated with an improved functional performance potentially due to a more symmetric strength during end-range plantarflexion which transfers into a higher satisfaction during athletic activities. Level of evidence III, retrospective cohort study

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