2015, Number 6
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Medisur 2015; 13 (6)
Tendon graft and platelet concentrate for chronic achilles tendon rupture. A case report
Ferrer LY, Oquendo VP, Morejón TY, Díaz TD
Language: Spanish
References: 16
Page: 785-794
PDF size: 433.12 Kb.
ABSTRACT
Achilles tendon is third most common tendon torn,
following the rotator cuff and the quadriceps
extensor mechanism. Ruptures can be partial or
complete and their etiology is multifactorial. We
present the case of a 63-year-old woman who
attended the Orthopedics service because of
discomfort when walking that had been present for
several months and persistent pain in his right heel
related to an acetonide triamcinolone injection into
the back of the calcaneus. The gap in the tendon
(hatchet strike defect) and a Thompson test
confirmed the Achilles tendon rupture. The tendon
was repaired using a peroneus brevis tendon graft
and the repair was reinforced with gastrocnemius
aponeurosis. The skin flap necrosis led to
conservative debridement, graft exposure, and daily
application of a platelet lysate, which was
subsequently alternated due to the successful
formation of the scar tissue. Epithelialization was
reached in the fourth postoperative week. Twelve
weeks after surgery, the patient began to resume
her normal life. The use of platelet concentrates as
adjuvant therapy is rare in these patients. For this
reason, we decided to publish this case.
REFERENCES
Yañez J, Del Vecchio J, Raimondi N. Rotura aguda del tendón de Aquiles Comparación biomecánica de tres técnicas de sutura con polietileno trenzado combinado en modelos cadavéricos. Rev Asoc Argent Ortop Traumatol. 2008 ; 73 (1): 68-75.
Pastrana F, Olivares J, Reyes J, Galaviz V, Enríquez JA, López A, et al. Ruptura crónica del tendón de Aquiles. Tratamiento quirúrgico. Acta Ortopédica Mexicana. 2003 ; 17 (2): 94-100.
Paton F, García M. Resultados en pacientes con rotura del tendón de Aquiles tratados quirúrgicamente con técnica convencional frente a pacientes tratados con técnica mínimamente invasiva. Evolución a dos años. Trauma Fund MAPFRE. 2012 ; 23 (3): 172-5.
Zwart J. Patología del tendón de Aquiles (II). Roturas del tendón y desinserciones musculares. JANO. 2003 ; 65 (1483): 314-22.
Delgado BH, Cristiani DG, Aspe ME. Ruptura del tendón de Aquiles: Incidencia y experiencia en su manejo. Acta Ortopédica Mexicana. 2003 ; 17 (5): 248-52.
Lelièvre J, Lelièvre JF. Patología del pie. 4ta. ed. Barcelona: Toray-Masson; 1982.
Bhandari M, Guyatt GH, Siddiqui F, Morrow F, Busse J, Leighton RK, et al. Treatment of acute Achilles tendon ruptures: a systematic overview and metaanalysis. Clin Orthop Relas Res. 2002 (400): 190-200.
Aviña JA, Guillén MA. Repair of acute Achilles tendon rupture. Comparative study of two surgical techniques. Acta Ortop Mex. 2009 ; 23 (3): 125-9.
Ozkaya U, Parmaksizoglu AS, Kabukcuoglu Y, Sokucu S, Basilgan S. Open minimally invasive Achilles tendon repair with early rehabilitation: functional results of 25 consecutive patients. Injury. 2009 ; 40 (6): 669-72.
Guerra P, García D, Cano J, San F. Sutura percutánea del tendón de Aquiles mediante la técnica de las cinco incisiones. Seguimiento a medio plazo. Tobillo y pie. 2010 ; 2 (2): 13-8.
Davis W, Singerman R, Labropoulos PA, Victoroff B. Effect of Ankle and Knee Position on Tension in the Achilles Tendon. Foot Ankle Int. 1999 ; 20 (2): 126-31.
Anitua E, Andia I, Ardanza J, Nurden P, Nurden AT. Autologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost. 2004 ; 91 (1): 4-15.
Marx RE, Carlson ER, Eichstaedt RM, Schimmele SR, Strauss JE, Georgeff KR. Platelet-rich plasma: growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998 ; 85 (6): 638-46.
Fernández Barbero JE, Galindo-Moreno P, Avila-Ortiz G, Caba O, Sánchez Fernández E, Wang HL. Flow cytometric and morphological characterization of platelet-rich plasma gel. Clin Oral Implant Res. 2006 ; 17 (6): 687-93.
López-Gavito E, Gómez Carlín LA, Parra Téllez P, Vázquez Escamilla J. Plasma rico en plaquetas para el manejo de tendinopatía del tendón calcáneo y fascitis plantar. Acta Ortopédica Mexicana. 2011 ; 25 (6): 380-5.
Calder JD, Saxby TS. Early, active rehabilitation following mini-open repair of Achilles tendon rupture: a prospective study. Br J Sports Med. 2005 ; 39 (11): 857-9.