Anatomic Reconstruction of Neglected Achilles Tendon Rupture With Autogenous Peroneal Longus Tendon by EndoButton Fixation

Wang, Chih Chien; Lin, Li‐Chen; Hsu, Chao Kuei; Shen, Pei; Lien, Shiu Bii; Hwa, Su Yang; Pan, Ru Yu; Lee, Chian Her

doi:10.1097/ta.0b013e3181a73f02

Cited by 19 publications

(18 citation statements)

References 13 publications

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“…The incidence of AT re-rupture after reconstruction in acute or chronic cases in the literature is 1.4-3.7% [27][28][29][30][31]. There was no case of re-rupture in our work through the follow up period.…”

Section: Discussionmentioning

confidence: 67%

Reconstruction of Chronic Achilles Tendon Rupture by V-Y Gastrocnemius Flap and Peroneus Brevis Transfer

Khira¹,

Gheith²

2016

Clin Res Foot Ankle

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Purpose: Reporting the outcome of the modified peroneus brevis (PB) transfertechnique in treating 26 patients with chronic rupture of Achilles tendon (AT). Methods: The diagnosis was neglected acute AT rupture in ten patients, ten with achronic rupture, re-rupture of the tendon in four cases, and Achilles xanthoma in two cases. The gap after debridement was 6 cm in average (range 4-8). The technique was V-Y gastrocnemius flaps of the ruptured AT in addition to peroneus brevis transfer. AOFAS score and isokinetic evaluation were used for functional assessment of ankle plantar flexion torque deficit in average 36 months follow up period (range 24-54 months). Results: Significant improvement of the AOFAS score at latest follow up. No re-rupture nor major complication, particularly of wound healing, was observed, isokinetic testing at 30 degrees/second and 120 degrees/second revealed a significant average decrease of 28 ± 11% and 36 ± 4%, respectively, in plantar flexion peak torque. Although strength deficit persisted at latest follow up, functional improvement was significant without morbidity due to (PB) harvesting. Conclusion: The surgical technique of V-Y myotendinous advancement of gastrosoleus tendon augmented by modified PB transfer for the treatment of chronic or neglected ruptures of AT with a gap of 6 cm length or more is a successful technique leading to high percentage of repair site healing and achieved excellent functional outcome.

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Section: Discussionmentioning

confidence: 67%

Reconstruction of Chronic Achilles Tendon Rupture by V-Y Gastrocnemius Flap and Peroneus Brevis Transfer

Khira¹,

Gheith²

2016

Clin Res Foot Ankle

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“…The branching point was located at 10% and 28% from the most proximal point of the head of the fibula in the PL and PB, respectively. Kerimoglu et al, 2008;Wang et al, 2009). Careful incision placement is required together with skin retraction to allow visualization of the tendon ends and to permit the reconstruction (Wang et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

“…Kerimoglu et al, 2008;Wang et al, 2009). Careful incision placement is required together with skin retraction to allow visualization of the tendon ends and to permit the reconstruction (Wang et al, 2009). An anatomic investigation regarding the location of the tendons and muscles of the PL and PB is necessary to minimize the incision site.…”

Section: Discussionmentioning

confidence: 99%

Anatomic localization of motor entry point of superficial peroneal nerve to peroneus longus and brevis muscles

Lee

et al. 2010

Clinical Anatomy

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This study examined the anatomic location of the motor entry point (MEP) and branching point at the proximal and distal points of the tendon of the peroneal muscle by visual observation. Forty-three fresh legs of 25 adult bodies which had been donated to science were investigated in this study. The mean length of the reference line between the most proximal point of the head of the fibula (PHF) and the most distal point of the malleolus of the fibula (DMF) was 33.4 ± 2.5 cm. The MEPs of the peroneus longus (PL) and peroneus brevis (PB) gathered from 20 to 40% (7.0-13.0 cm) and 40 to 60%, respectively. The branching point where the nerve was divided to innervate the PL and PB was 10% and 28% from the PHF, respectively. These anatomic results suggest appropriate areas where to inject phenol or other agents for a MEP block in the case of a spastic lower extremity as well as guidelines for an electromyography conduction test.

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“…1,2 If the diagnosis of acute rupture is missed, a conservative treatment fails, or the rupture turns into a chronic injury from severe degeneration, discomfort is caused by reduced plantarfl exion, 3,4 which can only be reversed by surgical treatment. 5,6 Chronic Achilles tendon ruptures are defi ned as those with a time period Ͼ4 to 6 weeks between injury and surgical management. 7 Patients with neglected Achilles tendon ruptures may recall a specifi c injury without prodromal symptoms such as pain or swelling, thus delaying diagnosis.…”

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confidence: 99%

Surgical Reconstruction of Chronic Achilles Tendon Ruptures Using Various Methods

Park

Sung²

2012

Orthopedics

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The purpose of this study was to evaluate the surgical outcomes of reconstruction of chronic Achilles tendon ruptures using various methods, including Achilles tendon allograft. Between October 2003 and March 2010, twelve patients with chronic Achilles tendon ruptures and a defect gap of >4 cm underwent surgical reconstruction with V-Y advancement, gastrocnemius fascial turn-down flap, flexor hallucis longus tendon transfer, or Achilles tendon allograft. The study group comprised 11 men and 1 woman. At last follow-up, all patients were assessed with regard to postoperative complications, self-reported level of satisfaction, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Achilles tendon Total Rupture Score, repetitive single-heel rises, single-leg hopping test, and ankle range of motion. The AOFAS scores increased from an average of 68.7 (range, 50-87) preoperatively to 98.0 (range, 88-100) postoperatively. All patients were able to perform 10 repetitive single-heel raises and single-leg hops at last follow-up. No patient experienced wound complications or deep infection. Seven patients were rated as excellent, 4 as good, and 1 as fair. Chronic Achilles tendon ruptures can be successfully treated by careful selection of the reconstruction method according to the length of defect gap and state of the remaining tissue. With an extensive defect, use of an Achilles tendon allograft can be a good option.

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Anatomic Reconstruction of Neglected Achilles Tendon Rupture With Autogenous Peroneal Longus Tendon by EndoButton Fixation

Cited by 19 publications

References 13 publications

Reconstruction of Chronic Achilles Tendon Rupture by V-Y Gastrocnemius Flap and Peroneus Brevis Transfer

Reconstruction of Chronic Achilles Tendon Rupture by V-Y Gastrocnemius Flap and Peroneus Brevis Transfer

Anatomic localization of motor entry point of superficial peroneal nerve to peroneus longus and brevis muscles

Surgical Reconstruction of Chronic Achilles Tendon Ruptures Using Various Methods

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