Treatment of old Achilles’ tendon ruptures by means of twin fascia plasty

José Antonio Enríquez Castro; Miguel Cruz Cruz; Rolando E Zapata

2001, Number 5

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Acta Ortop Mex 2001; 15 (5)

Treatment of old Achilles’ tendon ruptures by means of twin fascia plasty

Enríquez CJA, Cruz CM, Zapata RE

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Language: Spanish
References: 32
Page: 221-226
PDF size: 86.38 Kb.

ABSTRACT

Objective. Resolving the problem of the 20 to 30% of all heel cord injuries that remain with no repair. Material and methods. A series of 19 patients, 13 male and 6 female, 34.6 years in average, had primary spontaneous rupture in 13 cases, as well as post-operative re-rupture when starting rehabilitation in 3 and by external wound in other 3. The period between rupture and surgical reconstruction was 3 months in average (33 to 202 days). Fibrotic ruptured extremes are sarpened without removing more than 2 mm of fibrous tissue and a Bunnell 00-nylon suture is applied while keeping ankle in equinus. A proximal 8-10 cm long and 1.5-2 cm wide proximal gastroc flap is transported over the repaired rupture and fixed by 00-nylon sutures all through. An equinus long-leg cast is bore for 3 weeks, followed by a sole less short leg for another 3 weeks. Rehabilitation is started but equinus weight-bearing exercise is allowed until 6 months. Results. After 2 to 20 months, overall results were good, except for 2 cases who otherwise still had 8 and 10 weeks of PO. Hyperplastic enlargement of the heel cord was observed in all cases, which is beneficial since it increases tendon tensile strenght. Superficial wound infection in one case was the only complication. Conclusion. Present technique is recommended for those cases of long lasting heel cord rupture, being important the slow timing for complete healing of tendon.

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