Chronic Achilles tendon rupture augmented by transposition of the fibularis brevis and fibularis longus muscles

Abstract

A 1 year and 8 months old castrated male Pyrenean mountain dog was presented with an Achilles tendon rupture at least 5 weeks old. The defect between the two tendon ends was 2 cm in full extension of the tarsal joint. A new technique was successfully applied; a transposition and tenodesis of the fibularis brevis and fibularis longus muscles, combined with a 3 loop pulley suture and a tensor fascia lata graft. A transarticular external fixator was used for the first 3.5 weeks after surgery and a splint for the two following weeks. A 3 years follow-up shows the dog walking without any lameness.

Treatment of Common Calcaneal Tendon Rupture Using a Central Gastrocnemius Turnover Aponeurotic Flap Technique in a Dog

“…Methods used in dogs include autogenous tissue flaps derived from the semitendinosus muscle, fascia lata, fibularis brevis, fibularis longus and flexor digitorum lateralis tendons. 6,16,[18][19][20][21] Allogeneic grafts of porcine small intestinal submucosa have also been used to augment primary calcaneal tendon repair. 19 Synthetic implants such as polyethylene terephthalate, synthetic gastrocnemius tendon, carbon fibre mesh and poly-4-hydroxybutyrate (P4HB) mesh, as well as application of bone plates have been described for tendon repair.…”

Augmented Repair of an Achilles Tendon Rupture Using the Flexor Digitorum Lateralis Tendon in a Toy Poodle

“…It is commonly caused by acute trauma, such as laceration of the tendon, resulting in a typical plantigrade stance in dogs with a complete rupture . In large breed dogs, partial tendon ruptures with an intact superficial digital flexor tendon are considered more common due to repetitive stress during exercise . Various surgical techniques have been reported and most involve primary suture repair with secondary immobilization of the tibiotarsal joint .…”

“…Augmentation of the repair is strongly preferred to shorten the postoperative immobilization period while maintaining the strength of the repair site. Augmentation with autologous grafts has been advocated to strengthen repaired tendons in dogs, including free fascia lata grafts, peroneus brevis or longus tendon transposition, semitendinosus muscle transposition, and fibularis brevis and fibularis longus muscle transposition . Although synthetic carbon fiber and polypropylene mesh implants have been used in dogs and people, they may incite foreign body reactions …”

“…1 In large breed dogs, partial tendon ruptures with an intact superficial digital flexor tendon are considered more common due to repetitive stress during exercise. [2][3][4][5] Various surgical techniques have been reported and most involve primary suture repair with secondary immobilization of the tibiotarsal joint. 6 Postoperative immobilization is recommended for at least 6 weeks to prevent failure of the primary repair, due to the relatively poor blood supply to the repaired tendon.…”

“…Augmentation with autologous grafts has been advocated to strengthen repaired tendons in dogs, including free fascia lata grafts, 7,8 peroneus brevis or longus tendon transposition, 9 semitendinosus muscle transposition, 10 and fibularis brevis and fibularis longus muscle transposition. 3 Although synthetic carbon fiber and polypropylene mesh implants have been used in dogs and people, they may incite foreign body reactions. 4,10-13 A bone plate can be applied to strengthen the repaired tendon but it must be removed after 8-10 weeks.…”