Achilles Tendon Lengthening

Colen, Lawrence B.; Kim, Claudia Junghyun; Grant, William P.; Yeh, Jiun‐Ting; Hind, Baydoun

doi:10.1097/prs.0b013e3182729e0b

Cited by 52 publications

(12 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Operative lengthening of the Achilles tendon has been shown to be effective in healing and decreasing the recurrence rate of forefoot plantar ulcers in diabetic patients, especially when the contracture involves the entire gastrocsoleus unit as demonstrated by a negative Silfverskiöld test. 14,56 Posterior muscle group lengthening results in a temporary weakness of plantarflexion power, thus reducing the pressure applied to the forefoot. In the 2010 review, tendo-Achilles lengthening (TAL) received a Grade A recommendation based on Level I evidence.…”

Section: Achilles Tendon Lengtheningmentioning

confidence: 99%

Preventive and Therapeutic Strategies for Diabetic Foot Ulcers

et al. 2015

View full text Add to dashboard Cite

Section: Achilles Tendon Lengtheningmentioning

confidence: 99%

Preventive and Therapeutic Strategies for Diabetic Foot Ulcers

et al. 2015

View full text Add to dashboard Cite

“…Surgical options for recurrent or recalcitrant ulcers include Achilles tendon lengthening, [ 17 ] metatarsal osteotomies, debridement to metatarsal head resection, and limited amputations [ 18 – 20 ]. There are very few references relating to metatarsal osteotomies for off-loading-resistant and recurrent metatarsal plantar ulcers.…”

Section: Discussionmentioning

confidence: 99%

Mini-Invasive floating metatarsal osteotomy for resistant or recurrent neuropathic plantar metatarsal head ulcers

et al. 2016

View full text Add to dashboard Cite

BackgroundPatients with peripheral neuropathy and pressure under a relatively plantar deviated metatarsal head frequently develop plantar foot ulcers. When conservative management with orthotics and shoes does not cure the ulcer, surgical metatarsal osteotomy may be indicated to relieve the pressure and enable the ulcer to heal. The purpose of this study is to evaluate the use of a mini-invasive floating metatarsal osteotomy in treating recalcitrant ulcers or recurrent ulcers plantar to the metatarsal heads in patients with diabetes mellitus (DM) related neuropathy.MethodsComputerized medical files of patients with diabetic neuropathy treated with an osteotomy during 2013 and 2014 were retrospectively reviewed. There were 20 osteotomies performed on 17 patients (mean age 58 years). The patients had a diagnosis of DM for a mean of 17 years. All ulcers were University of Texas grade 1A; mean ulcer age was 19 months.ResultsAfter 17/20 operations, the ulcer completely resolved after 6 weeks and did not recur after a mean follow-up of 11.5 months. One patient developed an early post-operative infection with osteomyelitis at the osteotomy site (proximal shaft of the fifth metatarsal) that needed debridement and IV antibiotics. In the other 19 cases, the surgical wound healed within 1 week. Asymptomatic radiological non-union developed in six cases (30 %).ConclusionsMini-invasive floating metatarsal osteotomy can cure resistant and recurrent University of Texas grade 1A ulcerations plantar to the metatarsal heads in neuropathic patients.

show abstract

“…[ 9 ]In the foot, Achilles tendon (AT), plantar fascia (PF) andmetatarso-phalangeal joints (MPJs) represent a complex biomechanical unit[ 10 ]and interact in the distribution of plantar pressure on the foot[ 11 ]by means of the Windlass mechanism, a key component of the normal gait.Both AT and PF abnormalities[ 12 , 13 ]could contribute to the generation of augmented forefoot pressures observed in diabetic patients[ 14 ] thus increasing the risk of diabetic ulcerations. [ 15 ]For this reason, ATlengthening[ 16 ] and PF release[ 17 ]have been proposed for the management of recurrent diabetic ulcers.…”

Section: Introductionmentioning

confidence: 99%

Plantar fascia enthesopathy is highly prevalent in diabetic patients without peripheral neuropathy and correlates with retinopathy and impaired kidney function

et al. 2017

View full text Add to dashboard Cite

BackgroundAim of this study was to evaluate the prevalence of plantar fascia (PF) enthesopathy in Type 2 diabetes mellitus (T2DM) patients without distal peripheral neuropathy (DPN).MethodsWe recruited 50 T2DM patients without DPN and 50 healthy controls. DPN was excluded using the Michigan Neuropathy Screening Instrument (MNSI). All patients underwent a bilateral sonographicevaluation of the enthesealportion of the PF.ResultsPF thickness was significantly higher in T2DM patients (p<0.0001). T2DM patients presented a higher prevalence of entheseal thickening (p = 0.002), enthesophyte (p = 0.02) and cortical irregularity (p = 0.02). The overall sum of abnormalities was higher in T2DM patients (p<0.0001), as was the percentage of bilateral involvement (p = 0.005). In a logistic regression analysis, retinopathy predicted entheseal thickening (OR 3.5, p = 0.05) and enthesophytes (OR 5.13, p = 0.001); reduced eGFR predicted enthesophytes (OR 2.93, p = 0.04); body mass index (BMI) predicted cortical irregularity (OR 0.87, p = 0.05); mean glucose predicted enthesophyte (OR 1.01, p = 0.03); LDL cholesterol predicted cortical irregularity (OR 0.98, p = 0.02).ConclusionsOur data suggest that T2DM is associated with PF enthesopathyindependently of DPN.

show abstract

Achilles Tendon Lengthening

Abstract: Therapeutic, III.

Cited by 52 publications

References 17 publications

Preventive and Therapeutic Strategies for Diabetic Foot Ulcers

Preventive and Therapeutic Strategies for Diabetic Foot Ulcers

Mini-Invasive floating metatarsal osteotomy for resistant or recurrent neuropathic plantar metatarsal head ulcers

Plantar fascia enthesopathy is highly prevalent in diabetic patients without peripheral neuropathy and correlates with retinopathy and impaired kidney function

Contact Info

Product

Resources

About