Endoscopic adhesiolysis for extensive tibialis posterior tendon and Achilles tendon adhesions following compound tendon rupture

Abstract

SUMMARYTendon adhesion is one of the most common causes of disability following tendon surgery. A case of extensive peritendinous adhesions of the Achilles tendon and tibialis posterior tendon after compound rupture of the tendons was reported. This was managed by endoscopic adhesiolysis of both tendons. The endoscopic approach allows early postoperative mobilisation which can relieve the tendon adhesion. BACKGROUND

A Case of Heel Cord Pain After Repair of Acute Achilles Tendon Rupture

“…19,20 Severe crush injury with involvement of the flexor hallucis longus muscle and rupture of the fascia covering the muscle, compound tendon rupture with prolonged air exposure, presence of bulky sutures as nidus for fibrosis and prolonged postoperative immobilization contribute to the development of symptomatic peritendinous adhesion. 21 Although flexor hallucis longus transfer has been proposed to stimulate regeneration of a degenerated Achilles tendon, adhesion of the Achilles tendon to the muscle can be part of the cause of the postrepair tendon pain as the muscle can become fibrotic and inelastic after crush injury. 21…”

Arthroscopic and Endoscopic Management of Posttraumatic Hindfoot Stiffness

“…Endoscopic adhesiolysis of the peroneal tendons and the posterior tibial, FDL and FHL tendons can be performed via the respective tendoscopic approaches. 18 19 20 21 22 23 Tendoscopy should be started from the normal nonscarred part of the tendon, the interface between the tendon and the peritendinous adhesions at the scarred zone can be identified. This can assure correct plane of adhesiolysis.…”

“…It is important to make sure complete circumferential release along the whole span of the scarred zone. Fibrous adhesion of the Achilles tendon following hindfoot trauma can follow a severe crush injury 18 or open reduction and internal fixation of avulsion fracture of the Achilles tendon. 12 This can be treated by endoscopic adhesiolysis of the Achilles tendon with or without endoscopic calcaneoplasty.…”

“… 12 This can be treated by endoscopic adhesiolysis of the Achilles tendon with or without endoscopic calcaneoplasty. 18 24 25 26 27 …”

Retrocalcaneal Pain After Open Reduction and Internal Fixation of Avulsion Fracture of the Achilles Tendon Treated by Endoscopic Adhesiolysis and Endoscopic Calcaneoplasty

“…The patient suffered from persistent heel pain, which was successfully treated by endoscopic adhesiolysis and endoscopic calcaneoplasty. [5][6][7][8] Case Report…”