Revision Surgery for the Achilles Tendon

Shane, Amber M.; Reeves, Christopher L.; Nguyen, Garrett B.; Sebag, Joshua A.

doi:10.1016/j.cpm.2020.03.005

Cited by 5 publications

(3 citation statements)

References 61 publications

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“…Median height was 164 (150-180) cm with a median BMI 23.3 (17.3-39.7) kg/cm 2 . The surface reference line had a median length of 44 (36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48) cm. The medial-lateral location of the SN in relation to the traced points of the line was described according to a percentage (Table 3) and median distance (Table 4).…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, according to our series, incisions medial to the reference line with a minimum distance of 20 mm, 10 mm, 10 mm and 0 mm from Points 1, 2, 3 and 4, respectively, would be safe to perform (Table 4 ). Proximal zones and points may be useful in revision surgery or chronic Achilles tendon rupture surgery [ 16 , 31 , 41 , 44 ] or in some Achilles tendon lengthening techniques [ 7 , 10 , 19 , 41 ]. The central zones may be useful in acute Achilles pathology surgeries [ 12 , 22 , 35 , 47 ] and distal zones in arthroscopic surgeries [ 2 , 23 , 34 ] or ankle fractures [ 18 , 29 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound evaluation of a new surface reference line to describe sural nerve location and safe zones to consider in posterior leg approaches

Ruiz-Riquelme

Poggio-Cano

Sala‐Blanch

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose Several authors have described methods to predict the sural nerve pathway with non-proportional numerical distances, but none have proposed a person-proportional, reproducible method with anatomical references. The aim of this research is to describe ultrasonographically the distance and crossing zone between a surface reference line and the position of the sural nerve. Methods Descriptive cross-sectional study, performed between January and April 2022 in patients requiring foot surgery who met inclusion criteria. The sural nerve course in the posterior leg was located and marked using ultrasound. Landmarks were drawn with a straight line from the medial femoral condyle to the tip of the fibula. Four equal zones were established in the leg by subdividing the distal half of the line. This way, areas based on simple anatomical proportions for each patient were studied. The distance between the marking and the ultrasound nerve position was measured in these 4 zones, creating intersection points and safety areas. Location and distances from the sural nerve to the proposed landmarks were assessed. Results One-hundred and four lower limbs, 52 left and 52 right, assessed in 52 patients were included. The shortest median distance of the nerve passage was 2.9 mm from Point 2. The sural nerve intersection was 60/104 (57.7%) in Zone B, 21/104 (20.1%) in Zone C and 19/104 (18.3%) in Zone A. Safety zones were established. Average 80.5% of coincidence in sural nerve localization was found in the distal half of the leg, in relation to the surface reference line when comparing both legs of each patient. Conclusions This study proposes a simple, reproducible, non-invasive and, for the first time, person-proportional method, that describes the distance and location of the main areas of intersection of the sural nerve with points and zones (risk and safe zones) determined by a line guided by superficial anatomical landmarks. Its application when surgeons plan and perform posterior leg approaches will help to avoid iatrogenic nerve injuries. Level of evidence IV.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ultrasound evaluation of a new surface reference line to describe sural nerve location and safe zones to consider in posterior leg approaches

Ruiz-Riquelme

Poggio-Cano

Sala‐Blanch

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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“…Some studies have indicated that the risk of rerupture is highest following the termination of cast or orthosis treatment in nonoperative protocols. Other factors such as type of immobilization, time to treatment, cause of rupture, gender, sports involvement, non-sports individuals, and immunosuppressive treatment did not demonstrate an increased risk of rerupture in certain studies ( 6 ).…”

Section: Discussionmentioning

confidence: 93%

Successful restoration of failed Achilles tendon surgery with semitendinosus and gracilis tendon graft: a case report

Hung,

Alizargar,

Alizargar

et al. 2023

Front. Surg.

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ObjectiveThis case presentation aims to highlight the challenges and outcomes associated with a partial tear of the Achilles tendon (AT) in an elite marathon runner. The objective was to restore tendon anatomy and optimize strength recovery through surgical intervention.MethodWe present the case of a marathon runner who suffered a partial AT tear and underwent an initial surgery that failed. A revision surgery was then performed using a semitendinosus and gracilis tendon graft.ResultsThe patient underwent surgery 14 weeks after the initial AT injury, but unfortunately experienced a complete AT tear after 6 months. However, the novel aspect of this case is the successful restoration of the failed double-row suture technique through the utilization of a semitendinosus and gracilis tendon graft. Notably, the graft remained intact even under high tendon loading during the 2-year follow-up period.ConclusionDifferential diagnosis should consider partial tears of the AT as a possible diagnosis in the patients with heel pain. Furthermore, it is crucial to prioritize a well-paced post-surgical rehabilitation process in AT surgeries. In cases of failed AT surgery, the utilization of gracilis and semitendinosus tendon grafts can serve as viable options for repairing reruptures.

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43/m—sudden “blow” in the heel area

Baumbach

Polzer

2020

Unfallchirurg

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Revision Surgery for the Achilles Tendon

Cited by 5 publications

References 61 publications

Ultrasound evaluation of a new surface reference line to describe sural nerve location and safe zones to consider in posterior leg approaches

Ultrasound evaluation of a new surface reference line to describe sural nerve location and safe zones to consider in posterior leg approaches

Successful restoration of failed Achilles tendon surgery with semitendinosus and gracilis tendon graft: a case report

43/m—sudden “blow” in the heel area

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