scholarly journals Treating Haglund's Deformity with percutaneous Achilles tendon decompression: a case series

2019 ◽  
Vol 08 (04) ◽  
pp. 488 ◽  
Author(s):  
F. Sergio ◽  
O. Catani ◽  
F. Fusini ◽  
F. Langella ◽  
G. Cautiero ◽  
...  
2019 ◽  
Vol 87 (September) ◽  
pp. 3451-3458 ◽  
Author(s):  
MAHMOUD T. ALLAM, M.Sc.; MOHEB EL-DEEN A. FADEL, M.D. ◽  
MOHAMED A. QUOLQUELA, M.D.; AHMED M. SAMY, M.D.

2021 ◽  
Vol 6 (2) ◽  
pp. 247301142110035
Author(s):  
Keisuke Tsukada ◽  
Youichi Yasui ◽  
Maya Kubo ◽  
Shinya Miki ◽  
Kentaro Matsui ◽  
...  

Background: The purpose of this retrospective study was to clarify the operative outcomes of the side-locking loop suture (SLLS) technique accompanied by autologous semitendinosus tendon grafting for chronic Achilles tendon rupture. Methods: A chart review was conducted of consecutive patients treated with the SLLS technique at our department from 2012 to 2017. Postoperatively, a below-knee splint was applied for 2 weeks in 20 degrees of plantar flexion and then active range of motion exercise was started. Partial weightbearing exercise was allowed at 4 weeks according to patient tolerance, and full weightbearing without crutches was allowed at 8 weeks. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale score and the Achilles tendon rupture score (ATRS) were used to evaluate clinical outcomes preoperatively and at the final follow-up. Results: Ten patients (6 men, 4 women) were included in the analysis. Mean AOFAS ankle-hindfoot scale score increased significantly from 64.2 ± 5.6 points preoperatively to 95.0 ± 5.3 points at the final follow-up ( P < .001). The mean ATRS also increased significantly from 29.8 ± 4.4 points to 86.2 ± 7.7 points, respectively ( P < .001). Mean time between surgery and ability to perform 20 continuous double-leg heel raises of the operated foot was 13.5 ± 3.4 (range 10-18) weeks. One patient complained of postoperative hypoesthesia in the foot, which had spontaneously resolved by 3 months after surgery. Conclusion: The SLLS technique accompanied by autologous semitendinosus tendon grafting provided successful operative outcomes for patients with chronic Achilles tendon rupture regardless of the size of the defect, and thus long-term orthotic use was not needed after surgery. Level of Evidence: Level IV, retrospective case series.


2021 ◽  
Vol 7 (1) ◽  
pp. e000979
Author(s):  
Håkan Alfredson ◽  
Lorenzo Masci ◽  
Christoph Spang

ObjectivesChronic painful insertional Achilles tendinopathy is known to be difficult to manage. The diagnosis is not always easy because multiple different tissues can be involved. The plantaris tendon has recently been described to frequently be involved in chronic painful mid-portion Achilles tendinopathy. This study aimed to evaluate possible plantaris tendon involvement in patients with chronic painful insertional Achilles tendinopathy.MethodsNinety-nine consecutive patients (74 males, 25 females) with a mean age of 40 years (range 24–64) who were surgically treated for insertional Achilles tendinopathy, were included. Clinical examination, ultrasound (US)+Doppler examination, and surgical findings were used to evaluate plantaris tendon involvement.ResultsIn 48/99 patients, there were clinical symptoms of plantaris tendon involvement with pain and tenderness located medially at the Achilles tendon insertion. In all these cases, surgical findings showed a thick and wide plantaris tendon together with a richly vascularised fatty infiltration between the plantaris and Achilles tendon. US examination suspected plantaris involvement in 32/48 patients.ConclusionPlantaris tendon involvement can potentially be part of the pathology in chronic painful insertional Achilles tendinopathy and should be considered for diagnosis and treatment when there is distinct and focal medial pain and tenderness.Level of evidenceIV case series.


2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Daniel Baumfeld ◽  
Fernando Raduan ◽  
Caio Nery ◽  
Benjamim Macedo ◽  
Thiago Silva ◽  
...  

Category: Ankle, Arthroscopy, Hindfoot Introduction/Purpose: Background Achilles tendon chronic rupture lead to proximal retraction of the tendon and have a greater tendency to show poorer functional outcomes than acute ruptures. Numerous surgical procedures have been described to treat this pathology. The transfer of the flexor hallucis longus is a well-established treatment option, usually performed as an open procedure. The aim of this paper is to report a case series of six patients with chronic Achilles tendon rupture treated with endoscopic transfer of FHL. Methods: Six patients with Achilles tendon chronic injuries or re-ruptures were treated with endoscopic FHL transfer. There were four man and two women, average of 50 years, with four left and two right tendons involved, and no bilateral cases. All lesions were at zone 2 (between 2-6 cm proximal to insertion). We describe the surgical technique and report our results at an average of a nine-month follow-up. Results: The average follow-up of the series was 9 months (range, 5–12 months). Three patients had an associate procedure at the Achilles tendon to repair the pre-existent gap, using a minimally invasive technique. On average, we expend 56 minutes to perform the surgery, ranging from 45 to 70 minutes. All patients had a major increase in ATRS score values postoperatively, with an average of 17.8 preoperatively and 83,3 postoperatively No major complications or wound healing problems were noted. Tiptoe stance was possible for all patients without limitation. None of the patients noticed functional weakness of the hallux during daily life activity. Conclusion: Endoscopic FLH transfer is a reliable option for patients with higher skin risk and soft tissue complications. Other studies are needed to compare this technique with the open procedure, gold standard by now, to ensure its safety and efficacy.


2020 ◽  
Vol 14 (3) ◽  
pp. 269-273
Author(s):  
Vinicius Oliveira ◽  
Sérgio Prata

Objective: To assess the degree of postoperative satisfaction of patients with acute Achilles tendon rupture who underwent surgical reconstruction by a minimally invasive technique using Tenolig®. Methods: A retrospective observational study was conducted with 18 patients with acute Achilles tendon rupture diagnosed by a positive Thompson test who underwent surgery. Outcomes were assessed using the American  arthopaedic Foot and Ankle Society (AOFAS) score and the Foot Function Index (FFI). Furthermore, quantitative variables were descriptively treated, and patients’ age was correlated with FII and AOFAS score using Spearman’s correlation coefficient at a significance level of 5%. Results: Patients underwent surgery from one to six days after injury and were discharged one day later. Only one patient had a superficial postoperative infection. Patients’ AOFAS scores ranged from 75 to 100 points, and FFI ranged from 0 to 20%. The patient withsuperficial postoperative infection had an AOFAS score and a FFI of 75 points and 20%, respectively. Conclusion: Percutaneous repair of complete Achilles tendon rupture with Tenolig® resulted in high functional scores and a low rate of complications. Level of Evidence IV; Therapeutic Studies; Case Series.


2021 ◽  
Vol 53 (8S) ◽  
pp. 200-200
Author(s):  
Daniel Chen ◽  
Matthew Beran ◽  
Molly Duncan ◽  
Julie Young ◽  
James MacDonald

2020 ◽  
Vol 55 (2) ◽  
pp. 176-180 ◽  
Author(s):  
Lucas Maciel Rabello ◽  
Iris Sophie Albers ◽  
Mathijs van Ark ◽  
Ron L. Diercks ◽  
Inge van den Akker-Scheek ◽  
...  

Context Several studies have been conducted to better understand the effect of load on the Achilles tendon structure. However, the effect of a high cumulative load consisting of repetitive cyclic movements, such as those that occur during the running of a marathon, on Achilles tendon structure is not yet clear. Clinicians, coaches, and athletes will benefit from knowledge about the effects of a marathon on the structure of the Achilles tendon. Objective To investigate the short-term response of the Achilles tendon structure to running a marathon. Design Case series (prospective). Setting Sports medicine centers. Patients or Other Participants Ten male nonelite runners who ran in a marathon. Main Outcomes Measure(s) Tendon structure was assessed before and 2 and 7 days after a marathon using ultrasound tissue characterization (UTC), an imaging tool that quantifies tendon organization in 4 echo types (I–IV). Echo type I represents the most stable echo pattern, and echo type IV, the least stable. Results At 7 days postmarathon, both the insertional and midportion structure changed significantly. At both sites, the percentage of echo type II increased (insertion P &lt; .01; midportion P = .02) and the percentages of echo types III and IV decreased (type III: insertion P = .01; midportion P = .02; type IV: insertion P = .01; midportion P &lt; .01). Additionally, at the insertion, the percentage of echo type I decreased (P &lt; .01). Conclusions We observed the effects of running a marathon on the Achilles tendon structure 7 days after the event. Running the marathon combined with the activity performed shortly thereafter might have caused the changes in tendon structure. This result emphasizes the importance of sufficient recovery time after running a marathon to prevent overuse injuries.


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