Management of chronic Achilles tendon ruptures—A review

Malagelada, Francesc; Clark, Callum; Dega, Raman

doi:10.1016/j.foot.2016.05.001

Cited by 28 publications

(43 citation statements)

References 48 publications

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“…The ankle plantar flexion can be partially strengthened with an ankle foot orthosis, however, the normal physiological gait cannot be restored. The prognosis of nonoperative treatment is poor compared to surgical options, and patient satisfaction is less than 55% [1].…”

Section: Discussionmentioning

confidence: 99%

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Flexor hallucis longus tendon transfer through a single incision in the treatment of chronic Achilles tendon rupture with large defect

Xu¹,

Li²,

Xiang³

et al. 2020

Preprint

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Background To evaluate the medium-to-long term clinical outcome of flexor hallucis longus tendon transfer through a single incision in the treatment of chronic Achilles tendon rupture with a defect greater than 5 cm. Methods Clinical data of patients treated with flexor hallucis longus tendon transfer due to chronic Achilles tendon rupture between January 2009 and December 2016 were reviewed retrospectively. All cases were presented with Achilles tendon rupture for more than 4 weeks after injury. The defect of the Achilles tendon was greater than 5 cm after debridement in all patients. Clinical outcomes were assessed with AOFAS Ankle-Hindfoot Scale (AOFAS-AH), Achilles tendon Total Rupture Score (ATRS) and AOFAS Hallux Metatarsophalangeal-lnterphalangeal Scale (AOFAS-HM). Results 18 patients were followed successfully for 24-83 months (mean follow-up time of 43.2 months) and 5 were lost. According to the complete datasets obtained from 18 patients, none of the tendons re-ruptured during the follow-up. The AOFAS-AH and ATRS at last follow-up visit was 94.4 ± 3.2 (87-100) and 89.6 ± 5.9 (72-98) respectively, which revealed statistically significant improvement from the preoperative score of 58.2 ± 6.3 (49-70) and 53.3 ± 7.3(42-68). The AOFAS-HM at last follow-up visit was 90.1 ± 5.2 (77-97). Conclusion The flexor hallucis longus tendon transfer through a single incision is a safe and simple method for chronic Achilles tendon rupture with minimal morbidity and complications.

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Section: Discussionmentioning

confidence: 99%

“…The Achilles tendon (AT) rupture is one of the most common tendon injuries following the rupture of patellar ligament and quadriceps femoris tendon [1,2]. It often occurs in people 30-39 years old especially the so called "weekend warrior".…”

Section: Introductionmentioning

confidence: 99%

Flexor hallucis longus tendon transfer through a single incision in the treatment of chronic Achilles tendon rupture with large defect

Xu¹,

Li²,

Xiang³

et al. 2020

Preprint

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“…Apesar de comum, a ruptura do Aquiles ainda apresenta uma taxa de falha no diagnóstico à primeira avaliação médica de 20 a 25%, ocasionando um atraso no seu diagnóstico e tratamento, concorrendo para um aumento na prevalência de casos crônicos. 31,32 Essa alta porcentagem é causada tanto pela falta de procura por atendimento desses pacientes (muitos creditam uma lesão muscular ou de menor gravidade), pela incapacidade de acesso de muitos indivíduos a serviços especializados de saúde e pela deficiência de profissionais em realizar o correto diagnóstico precoce. 33,34 Alguns critérios podem ser utilizados para a definição da lesão crônica como a existência de tecido fibrocicatricial interposto entre seus cotos, a presença de largo defeito com afastamento e retração dos mesmos, um período decorrido da lesão até o momento do diagnóstico > 6 semanas ou sintomas de fraqueza e dificuldade para caminhar e subir escadas.…”

Section: Epidemiologiaunclassified

Lesões do Aquiles – Parte 2: Rupturas

Mansur

Fonseca

Matsunaga

et al. 2020

Rev Bras Ortop (Sao Paulo)

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ResumoA crescente incidência de rupturas do tendão calcâneo tem impactado substancialmente o cuidado ortopédico e os custos relacionados ao seu tratamento e prevenção. Motivada principalmente pelo aumento da expectativa de vida, o crescimento do uso de drogas tenotóxicas e o acesso errático à atividade física, essa lesão gera morbidade considerável aos pacientes qualquer seja o desfecho a ser considerado. A evolução das técnicas cirúrgicas e de reabilitação permitiu que ortopedistas, nos últimos anos, tivessem melhores condições para decidir a conduta mais apropriada nas roturas agudas do tendão calcâneo. Por mais que ainda frequentes pela sua alta taxa de negligência, as rupturas crônicas do Aquiles hoje encontram opções operatórias biológicas mais simples e são amparadas por um novo paradigma que se debruça sobre a especialidade.

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“…обсуждение как уже упоминалось ранее, все методы пласти-ческого замещения дефектов ахиллова сухожилия можно разделить на несколько основных групп: с использованием местных тканей, с сухожиль-ным трансфером, с применением свободных ауто-и аллотрансплантатов и синтетических материалов [2,9,13]. на данный момент не существует иссле-дований, статистически значимо выделяющих одну из методик как самую рациональную и безопасную [20]. практически в каждом из исследований по данной тематике число наблюдений не превышает 20-40, а оценка результатов проводится достаточно неоднородно, что также затрудняет анализ резуль-татов применения различных методик.…”

Section: Fig 2 Approach To Peroneus Brevis Tendonunclassified

“…замещения дефекта может образоваться избыток тканей, который тяжело укрыть при ушивании раны; кроме того, размер лоскута анатомически имеет ограничения по своим размерам [20].…”

Section: Fig 2 Approach To Peroneus Brevis Tendonunclassified

Our Approach to Treatment of Neglected Achilles Tendon Ruptures. Is There a Simple Solution?

Чугаев¹,

Konovalchuk²,

Сорокин³

et al. 2018

Traumatology and Orthopedics of Russia

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Introduction. Subcutaneous rupture of achilles tendon is a frequent trauma and most patients with such pathology are men of working age. Even though it is not difficult to diagnose such ruptures, especially those that need surgical treatment, there are numerous cases when patients come to a surgeon with a big delay. In such cases, the rupture becomes «chronic» or «neglected» and can be no longer treated as an acute rupture. There are many techniques of operative treatment of chronic achilles tendon ruptures, but still there is no consensus on which technique is to be considered the most simple, effective and safe.The aim of this study is to evaluate the effectiveness of using peroneus brevis tendon as a graft for treatment of achilles tendon defects type 3 in Kuwada classification. Will this technique bring good and excellent results that are comparable with end-to-end suture after acute achilles tendon ruptures?Materials and methods. The present study includes 13 patients in which peroneus brevis was used for treatment of neglected achilles tendon rupture (group I) and 18 patients after end-to-end suture after acute achilles tendon rupture (group II). Group I consisted of patients with neglected rupture of achilles tendon that was not previously treated due to various reasons and with a significant defect.Results. Mean surgery duration in group I was 91.9±6.6 (Me — 100) min, in group II — 43.2±2.2 (Me — 45) (p = 0.0001). damaged limb was evaluated using achilles Tendon Total Rupture Score, mean post-op follow up was around 1 year. The results were: group I — 86.6±2.28 (Me — 87), group II — 93.4±1.01 (Me — 94) (p = 0.04). This means, that despite quite high scores in group I, they are still statistically worse than scores after suture of acute rupture in group II. There was no difference in post-operative complication rate between the groups (p0.05). The most common complication for both groups was range of motion restriction in ankle joint. None of the patients had ankle joint instability after surgery.Conclusion. Management of neglected ruptures of achilles tendon type 3 (in Kuwada classification) with peroneus brevis autologous graft is an effective and safe technique, that achieves good and excellent results in treatment of this group of patients, in absolute numbers is comparable to functional outcomes after end-to-end suture of acute achilles tendon ruptures, but statistically demonstrates significantly worse results.

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Management of chronic Achilles tendon ruptures—A review

Cited by 28 publications

References 48 publications

Flexor hallucis longus tendon transfer through a single incision in the treatment of chronic Achilles tendon rupture with large defect

Flexor hallucis longus tendon transfer through a single incision in the treatment of chronic Achilles tendon rupture with large defect

Lesões do Aquiles – Parte 2: Rupturas

Our Approach to Treatment of Neglected Achilles Tendon Ruptures. Is There a Simple Solution?

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