scholarly journals Treatment of Achilles tendon rupture using different methods

2012 ◽  
Vol 69 (8) ◽  
pp. 663-668 ◽  
Author(s):  
Predrag Grubor ◽  
Milan Grubor
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Spinal Anaesthesia ◽  
Local Anaesthesia ◽  
Open Surgery ◽  
Achilles Tendon Rupture ◽  
Plaster Cast ◽  
Surgical Reconstruction ◽  
Orthopedic Procedures ◽  
Tendon Ruptures

Background/Aim. Today there are controversies about searching for the ideal surgical method (conservatively with plaster cast, with open and percutaneous tenorrhaphy) for repairing a ruptured Achilles tendon. The aim of this study study was to examine the results of treating Achilles tendon ruptures in patients by using the following methods: percutaneous suturing, open surgery technique and non-surgical treatment by plaster cast immobilisation. Methods. Forty two patients treated at our facility in the period August 2003 - September 2010 for Achilles tendon ruptures were included in the study. They were operated on by using different orthopedic procedures (percutaneous reconstruction of the Achilles tendon, open surgery, plaster cast only) and two anaesthesia technique (spinal aneasthesia and local infiltrational anaesthesia). The following parameters were monitored after interventions performed and compared: duration of hospital stay, postsurgical complications, incidence of the reruptures of the Achilles tendon and time for full leg functionality. Results. The patients sustained their respective injuries in the following manner: 8 of them while pursuing sports activities, 24 while pursuing recreational activities, 4 at workplace, 4 while performing everyday activities, and 2 of the patients did not know how they had sustained their injuries. The average age of the patients was 40.5, with 37 (88%) men and 5 (12%) women. Surgeries were performed under spinal anaesthesia in 29 (69%) patients, and in 5 (12%) patients tenorrhaphy was performed under local anaesthesia. Anaesthesia was not used in 8 (19%) patients treated with plaster cast. We performed percutaneous reconstruction of the Achilles tendon in 19 (45%) patients. A total of 14 (33%) patients were treated under spinal anaesthesia, and 5 (11.9%) under local infiltrational anaesthesia with 2% xylocain. We treated 15 (36%) patients with open surgery. The patients treated conservatively stayed in hospital on average for up to 5 hours. Those who underwent an percutaneous surgery stayed 2 days and those who underwent an open surgery stayed 9 days. A total of 28 (66%) patients from the given series experienced no complications. The patients treated with open surgical reconstruction experienced skin complications ranging from inflammatory changes on the skin in 6 (14%) patients to dehiscence and skin necrosis in 3 (7%). The 5 (11.9%) patients whose ruptured Achilles tendon was treated percutaneously experienced temporary redness and delayed healing of the incision(s) longer than 5 mm. A total of 3 (7%) patients treated with open surgery and 1 (2%) patient treated with percutaneous tenorrhaphy had temporary peroneal nerve prolapses. A total of 7 (16.6%) patients had reruptures: 4 were treated with plaster cast, 2 underwent open surgery, and 1 was treated percutaneously. Out of the 8 patients who were treated with plaster cast, 4 sustained reruptures and 3 of the 4 had diabetes. Conclusion. Surgical treatment, percutaneous tenorrhaphy, performed in a small operating theatre under local anaesthesia, should be preferred in cases of fresh ruptures of the Achilles tendon.

scholarly journals Bearing Weight at the Same Day in Conservatively Treated Acute Achilles Tendon Rupture Patients

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0020
Author(s):  
Murat Korkmaz ◽  
Sadiye Yolcu ◽  
Özlem Balbaloğlu ◽  
Zekeriya Öztemur ◽  
Fatih Karaarslan
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Treatment Protocol ◽  
Early Mobilization ◽  
Treated Group ◽  
Plaster Cast ◽  
Wound Complications ◽  
American Orthopaedic

Objectives: Achilles tendon rupture (ATR) often occurs in 40- to 50-year-old men.. At treating there has been considerable research interest in attempting to identify the optimal treatment strategy, surgical or non-surgical, combined with functional early mobilisation or plaster cast immobilisation. Our aimed to compare the outcomes of bearing weight at the same day in conservatively treated and surgically treated groups of ATR patients. Methods: Thirty-two conservatively treated ATR patients and twenty nine surgically treated ATR patients were included to our study. Patients were over 18 years old who had been followed for 12 months by our clinic. All patients underwent knee supporting cast at four week and both group was asked for walking with bearing weight (%30-40) at same day. Results: In all groups 2nd and 12th months’ AOFAS (American Orthopaedic Foot and Ankle Society) scorings of the patients had significant differences (p<0.001). Return to work time results were significantly different and shorter in conservatively treated group (p= 0.035). This study founded a relatively high complication percentage of (6 patients) 20.6% in the surgically treated group. On the contrary the wound complications non-surgical group has not been be observed. Conclusion: In conclusion, this study adds to evidence that a well conducted non-surgical treatment protocol (early mobilization treatment regimen) gives a good clinical outcome and complication rate is not higher than after surgical treatment.

scholarly journals Patients with Achilles tendon injuries – how are function and quality of life affected?

2018 ◽  
Vol 12 (2) ◽  
pp. 130-135
Author(s):  
Bruno Mota Albuquerque ◽  
Vinícius Quadros Borges ◽  
Gabriel Ferreira Ferraz ◽  
Kelly Cristina Stéfani
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Surgical Treatment ◽  
Achilles Tendon ◽  
Open Surgery ◽  
Tendon Transfer ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
The Mean

Objective: To evaluate the late postoperative results for quality of life after surgical treatment of Achilles tendon rupture by open surgery and peroneus brevis tendon transfer. Methods: This prospective cohort study included patients who underwent surgical treatment for Achilles tendon rupture by open surgery andperoneus brevis tendon transfer and evaluated these patients in outpatient follow-up. Functional and quality-of-life scores were determined in the late postoperative period. Results: The sample consisted of 32 patients with spontaneous tendon rupture primarily caused by practising recreational sports (81.1%). The mean age was 44.6 years, and the mean body mass index was 28.1Kg/m2; most of the patients were men. The rate of complications related to suture dehiscence in the immediate postoperative period was 31%. The World Health Organization Quality of Life-Abbreviated (WHOQOL-BREF) score was 15.2±2.45, the Foot Function Index Revised (FFI-R) score was 42.59±0.16, the Short Musculoskeletal Function Assessment (SMFA) score was 15.60±16.74, and the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score was 80.16±15.08. Conclusion: The late postoperative functional results of open surgical treatment of tendon rupture were satisfactory using the AOFAS score and unsatisfactory using the FFI-R score. The quality-of-life outcomes were satisfactory using the WHOQOL-BREF score and unsatisfactory using the SFMA score. Both the FFI-R and SFMA scores indicated that the main patient complaints were stiffness of the affected limb and pain/ discomfort in the tendon that was surgically treated. Level of Evidence II; Prospective Cohort Study.

Surgical Repair of Achilles Tendon Ruptures Using Polypropylene Braid Augmentation

1994 ◽  
Vol 15 (7) ◽  
pp. 372-375 ◽  
Author(s):  
Giannini Sandro ◽  
Girolami Mauro ◽  
Ceccarelli Francesco ◽  
Catani Fabio ◽  
Susanna Stea
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Surgical Repair ◽  
Achilles Tendon Rupture ◽  
Plaster Cast ◽  
Test Evaluation ◽  
Level Of Activity ◽  
Significant Difference ◽  
Tendon Ruptures ◽  
Active Patients

Surgical repair in fresh rupture of the Achilles tendon should be considered in active patients and athletes to restore their preinjury level of activity. Fifteen cases of Achilles tendon rupture underwent surgical repair using interpositional augmentation. This technique provides an immediate mechanical strength of the repair, avoiding the need for a postoperative plaster cast and allowing immediate motion of the ankle. No wound infection, scar adherence of the skin to the tendon, or rerupture of the tendon is present in this series. All patients were subjectively satisfied with the results and returned to their preinjury level of activity. Objectively, isokinetic assessment revealed no significant difference, as per t-test evaluation ( P < .05), between the operated leg and the contralateral one.

scholarly journals The Influence of Diabetes on Acute Achilles Tendon Rupture Repair

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0028
Author(s):  
Jonathan Kaplan ◽  
Jeffery Hillam ◽  
Amiethab Aiyer ◽  
Niall Smyth
Keyword(s):  
Diabetes Mellitus ◽  
Postoperative Complications ◽  
Achilles Tendon ◽  
Power Analysis ◽  
Tendon Rupture ◽  
Surgical Repair ◽  
Achilles Tendon Rupture ◽  
The United States ◽  
Foot And Ankle ◽  
Tendon Ruptures

Category: Sports Introduction/Purpose: Diabetes Mellitus (DM) is an epidemic affecting millions of individuals in the United States. Multiple studies have demonstrated an increase in complications in foot and ankle surgery in patients with DM, including wound healing complications, surgical site infections (SSI), or surgical failure. The goal of this study was to retrospectively review outcomes data from the National Surgical Quality Improvement Program (NSQIP) to determine the impact of DM on operative treatment of achilles tendon ruptures. Methods: Using the NSQIP from 2006-2015, patients were identified using common procedure terminology (CPT) for Achilles tendon ruptures. Diabetic and non-diabetic cohorts were evaluated to compare demographics, comorbidities, perioperative details and 30-day outcomes. Statistical evaluation included a power analysis for the primary outcome measure of wound disruption as well as univariate analysis was performed using chi-squared or Fisher’s exact and Wilcoxon signed-rank tests. Results: A total of 2,014 patients were identified having sustained an Achilles tendon rupture. There were 1,981 patients without DM and 33 patients with DM. There were no significant differences in postoperative complications, including SSI, medical complications, and 30-day outcomes between patients with DM and non-DM patients undergoing surgical repair of acute Achilles tendon ruptures. The power analysis for wound disruption showed a P=0.9 with an alpha of 0.05, sample size of n=2014, and Pearson correlation coefficient of r=0.0721 Conclusion: While DM has been shown to have an increase in complications in various foot and ankle procedures, this study demonstrates that there is no significant difference in postoperative complications and 30-day outcomes between patients with DM and non-DM patients undergoing surgical repair of acute Achilles tendon ruptures using the NSQIP database from 2006-2015. Based on this data, patients with diabetes mellitus can be considered adequate surgical candidates for acute Achilles tendon rupture repair.

scholarly journals Achilles Tendon Ruptures: Comparison between the Clinical Results of Classical Versus Mini-Invasive or Percutaneous Surgical Treatment

2015 ◽  
Vol 20 (3) ◽  
pp. 135-138
Author(s):  
Obada B. ◽  
Serban Al. O.
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Functional Results ◽  
Clinical Results ◽  
Needle Insertion ◽  
Invasive Technique ◽  
Percutaneous Technique ◽  
Degree Of Satisfaction ◽  
Invasive Techniques

Abstract The aim of the study is to evaluate the surgical treatment comparing the results obtained with different techniques. We revised 68 cases with acute Achilles tendon rupture who underwent surgical correction between 2004 and 2011, with a 40 month average follow-up. 34 of these were submitted to a classical open repair using the Kessler or Krakow technique, 25 to a mini-invasive technique (Achilon) and 9 to a percutaneous technique (Tenolig). We report a 29% rate of complications when using the classical technique: the major complications were one re-rupture, two surgical wound dehiscences, one infection and one sural nerve injury. In the mini-invasive/percutaneous techniques, two re-ruptures occurred (5.9% total, one in each technique) and one fistula at the needle insertion location. In regards to the percutaneous and mini-invasive techniques, the functional results and degree of satisfaction were higher, with fewer complications, reflecting a trend that has been expressed in the international literature.

scholarly journals Knotless Reconstruction of Chronic Achilles Tendon Ruptures With <3-cm Defects: Technique Tip

2021 ◽  
Vol 6 (4) ◽  
pp. 247301142110505
Author(s):  
Justin C. Haghverdian ◽  
Christopher E. Gross ◽  
Andrew R. Hsu
Keyword(s):  
Achilles Tendon ◽  
Skin Incision ◽  
Surgical Reconstruction ◽  
Fixation Strength ◽  
Level Of Evidence ◽  
Functional Deficits ◽  
Tendon Lengthening ◽  
Soft Tissue Dissection ◽  
Tendon Ruptures ◽  
Gait Abnormalities

Chronic Achilles tendon ruptures can result in tendon lengthening and significant functional deficits including gait abnormalities and diminished push-off strength. Surgical intervention is typically required to restore Achilles tension and improve ankle plantarflexion strength. A variety of surgical reconstruction techniques exist depending on the size of the defect and amount of associated tendinosis. For smaller tendon defects 2 to 3 cm in size, primary end-to-end repair using an open incision and multiple locking sutures is an established technique. However, a longer skin incision and increased soft tissue dissection is required, and failure at the suture-tendon interface has been reported that can result in postoperative tendon elongation and persistent weakness. In this report, we describe a novel technique to reconstruct chronic midsubstance Achilles tendon ruptures using a small incision with knotless repair of the tendon secured directly to the calcaneus. This technique minimizes wound healing complications, increases construct fixation strength, and allows for early range of motion and rehabilitation. Level of Evidence: Level V, Expert Opinion.

scholarly journals Management of Missed Traumatic Achilles Tendon Rupture in a Pediatric Patient: A Case Report

2021 ◽  
Vol 9 (4) ◽  
pp. 465-470
Author(s):  
Saad Andaloussi
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Skin Wound ◽  
Plantaris Tendon ◽  
First Case ◽  
Tendon Ruptures ◽  
Post Traumatic

BACKGROUND: Missed traumatic Achilles tendon ruptures in children are rarely reported in the literature. Various techniques have been described to reconstruct delayed Achilles tendon ruptures for adults, but the long-term consequences in the growing child are unknown. CLINICAL CASE: The article presents a clinical observation of a 8-year-old girl with missed rupture of the Achilles tendon operated 7 weeks after the trauma by end-to-end Kessler-type sutures augmented with the plantaris tendon. At 2-year follow-up, the patient was completely asymptomatic. DISCUSSION: A review of the literature shows that this is the third neglected pediatric case of post-traumatic Achilles tendon rupture. The first case concerns a 10-year-old boy treated successfully six weeks after the traumat by open surgical repair using the Bunnell sutures technique. The second patient was a 7-year-old girl, she was operated 8 weeks after the trauma with a termino-terminal tenorrhaphy using the Bunnell technique augmented with the plantaris tendon. CONCLUSIONS: Using the plantaris tendon to reinforce the Achilles tendon repair offers satisfactory results with minimal morbidity. Prognosis depends on the extent of tendon defect which determines the long-term functional outcome. Any skin wound that sits on the back of the leg requires a systematic and careful physical examination to check the integrity of the Achilles tendon.

scholarly journals Ultrasonographic Classification of Achilles Tendon Ruptures as a Rationale for Individual Treatment Selection

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Michael H. Amlang ◽  
Hans Zwipp ◽  
Adina Friedrich ◽  
Adam Peaden ◽  
Alfred Bunk ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Individual Treatment ◽  
Reliable Instrument ◽  
Tendon Ruptures ◽  
Selection For ◽  
Sonographic Classification

Purpose. This work introduces a distinct sonographic classification of Achilles tendon ruptures which has proven itself to be a reliable instrument for an individualized and differentiated therapy selection for patients who have suffered an Achilles tendon rupture. Materials and Methods. From January 1, 2000 to December 31, 2005, 273 patients who suffered from a complete subcutaneous rupture of the Achilles tendon (ASR) were clinically and sonographically evaluated. The sonographic classification was organized according to the location of the rupture, the contact of the tendon ends, and the structure of the interposition between the tendon ends. Results. In 266 of 273 (97.4%) patients the sonographic classification of the rupture of the Achilles tendon was recorded. Type 1 was detected in 54 patients (19.8%), type 2a in 68 (24.9%), type 2b in 33 (12.1%), type 3a in 20 (7.3%), type 3b in 61 (22.3%), type 4 in 20 (7.3%), and type 5 in 10 (3.7%). Of the patients with type 1 and fresh ASR, 96% () were treated nonoperative-functionally, and 4% () were treated by percutaneous suture with the Dresden instrument (pDI suture). Of the patients classified as type 2a with fresh ASR, 31 patients (48%) were treated nonoperatively-functionally and 33 patients (52%) with percutaneous suture with the Dresden instrument (pDI suture). Of the patients with type 3b and fresh ASR, 94% () were treated by pDI suture and 6% () by open suture according to Kirchmayr and Kessler. Conclusion. Unlike the clinical classification of the Achilles tendon rupture, the sonographic classification is a guide for deriving a graded and differentiated therapy from a broad spectrum of treatments.

scholarly journals Different Sutures in the Surgical Treatment of Acute Closed Achilles Tendon Rupture

2014 ◽  
Vol 77 (S3) ◽  
pp. 936-940 ◽  
Author(s):  
Yunhan Ji ◽  
Xin Ma ◽  
Xu Wang ◽  
Jiazhang Huang ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture
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