Percutaneous Achilles tendon lengthening: A cadaver-based study of failure of the triple hemisection technique

Hoefnagels, Eva M; Waites, Matthew D.; Belkoff, Stephen M.; Swierstra, Bart A

doi:10.1080/17453670710014590

Cited by 29 publications

(28 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…El nivel 1 se refiere a la zona de tendón de Aquiles en sí: alargamiento en Z o triple corte 27 . Se trata de una técnica que se puede realizar mediante cirugía abierta o percutánea aunque existen diferentes trabajos en cadáveres que han demostrado que las técnicas percutá-neas son poco fiables, pudiendo llegar a causar daños y riesgos a los nervios adyacentes, por lo que se recomienda la cirugía abierta 46 . Describieron además, complicaciones derivadas de esta técnica, como una mala cicatrización de las heridas o una debilidad muscular 27 .…”

Section: Alargamiento Del Tendón De Aquilesunclassified

Marcha en equino idiopática infantil: revisión sistemática

González¹

2017

Rev. Int. Cienc. Podol.

View full text Add to dashboard Cite

Recibido: 1 de febrero de 2015 / Aceptado: 1 enero de 2016 Resumen. La marcha en equino idiopática infantil se caracteriza por el apoyo único de la zona de antepié durante la marcha. Se trata de una patología desarrollada a partir de los 2 años de edad en niños sin ningún tipo de alteración neurológica u ortopédica. Esta revisión consiste en la comparación de estudios que incluyen diferentes tipos de tratamiento mediante yesos seriados, terapia física, toxina botulínica tipo-A o quirúrgicos; con el fin de esclarecer cuál de ellos ofrece mayor efectividad. Se realizaron búsquedas de artículos científicos sobre la marcha en equino idiopática infantil y sobre su tratamiento en las bases de datos Medline, CINAHL, Pubmed, Web of Science y Cochrane Library. Se seleccionaron dos revisiones sistemáticas que cumplían con los criterios de inclusión. Analizando los resultados obtenidos con cada tipo de tratamiento se concluye que no existe uno con mayor efectividad que otro, debido a la imposibilidad de encontrar diferencias significativas entre ellos. Aunque la normalización de la marcha no se produjo en la mayoría de los casos, la cinética y la cinemática de la marcha mejoraron en todos los grupos de tratamiento. También se observó un aumento en el rango de flexión dorsal de tobillo, pero sólo se conservaría a largo plazo en aquellos grupos de pacientes tratados quirúrgicamente. El número de complicaciones que se presentan después del tratamiento conservador y del quirúrgico fue mínimo. En conclusión no se puede determinar qué tratamiento proporciona mayor efectividad haciendo necesario promover la realización de más estudios. Palabras clave: Marcha en equino; Marcha en equino idiopática infantil; Tratamiento para la marcha en equino idiopática infantil.[en] Idiophatic toe walkers: sistematic review Abstract. The idiopathic toe walking march is characterized by the sole support of the forefoot area during the march. It is a disease developed in children from 2 years-age without any neurological or orthopedic impairment. This revision consists in the comparison of multiple studies including different treatments, such as serial casting, physical therapy, botulinum toxin type A or surgical solutions. The aim is to clarify which of the treatments would be most efficient. The study performed searches of scientific articles on the march in infantile idiopathic toe walking and its treatment in Medline, CINAHL, PubMed, Web of Science and Cochrane Library data base. Two systematic reviews that met the inclusion criteria were selected. After having analysed all results of the different treatments the conclusion is, that there is no difference in effectiveness between them, mainly due to no important difference of treatment. Although there has been no major improvement walking in any of the treatment, the kinetics and the kinematic has improved with all treatments. An increase in the ankle dorsiflexion range of motion was also observed, but only it will be longterm retained in those groups of surgically treated patients. The num...

show abstract

Section: Alargamiento Del Tendón De Aquilesunclassified

Marcha en equino idiopática infantil: revisión sistemática

González¹

2017

Rev. Int. Cienc. Podol.

View full text Add to dashboard Cite

show abstract

“…The equinus deformity seems to recur more oftenly with the percutaneous sliding lengthening than with the open Z-lengthening 7). The percutaneous sliding technique requires two or three hemi-cuts in the tendon 8,9,10,11). However, there is a danger of the total transection of the tendon 12,13).…”

mentioning

confidence: 99%

Z-lengthening of the Achilles Tendon with Transverse Skin Incision

Kim

Lee

et al. 2014

Clin Orthop Surg

View full text Add to dashboard Cite

BackgroundThe risk of various complications after Achilles tendon lengthening is mainly related to the length of surgical exposure and the lengthening method. A comprehensive technique to minimize the complications is required.MethodsThe treatment of Achilles tendon tightness in 57 patients (95 ankles) were performed by using a short transverse incision on a skin crease of the heel and by Z-lengthening of the tendon. In the severe cases, two or three transverse incisions were required for greater lengthening of the tendon, and a serial cast or Ilizarov apparatus was applied for the gradual correction. The results of these 95 ankles were compared to those of 18 ankles, which underwent percutaneous sliding lengthening, and to the 19 ankles, which received Z-lengthening with a medial longitudinal incision.ResultsThe functional and cosmetic satisfaction was achieved among those who underwent the tendon lengthening with the new technique. The mean American Orthopaedic Foot & Ankle Society (AOFAS) score improved from 56.1 to 81.8. The second operations to correct recurrence were performed in the two cerebral palsy patients.ConclusionsThe new technique has a low rate of complications such as scarring, adhesion, total transection, excessive lengthening, and recurrence of shortening. The excellent cosmesis and the short operation time are the additional advantages.

show abstract

“…Today the percutaneous triple hemisection is most often performed in the transverse plane, however not without risks. Those risks most readily identified are weak plantarflexion, neurovascular injury, musculotendious injury, Achilles tendon rupture, and Achilles tendon over lengthening or under lengthening (9, 28, 29). The anatomic relationships that were found to be the most at risk were associated with cut number two (7.9 mm to sural nerve) and three (5.8 mm to FHL and 8.3 mm to tibial nerve) (29).…”

mentioning

confidence: 99%

“…Those risks most readily identified are weak plantarflexion, neurovascular injury, musculotendious injury, Achilles tendon rupture, and Achilles tendon over lengthening or under lengthening (9, 28, 29). The anatomic relationships that were found to be the most at risk were associated with cut number two (7.9 mm to sural nerve) and three (5.8 mm to FHL and 8.3 mm to tibial nerve) (29). A study of percutaneous TAL performed by Salamon et al (28) on 15 cadavers, measured the accuracy of the three cuts.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Recurrence of Diabetic Pedal Ulcerations Following Tendo-Achilles Lengthening

Weiner

Hlad

McKenna

2011

Diabetic Foot & Ankle

View full text Add to dashboard Cite

Foot and ankle surgeons are frequently challenged by the devastating systemic consequences of diabetes mellitus manifested through neuropathy, integumentary and joint breakdown, delayed healing, decreased ability to fight infection, and fragile tendon/ligaments. Diabetic neuropathic pedal ulcerations lead to amputations at an alarming rate and also carry a high mortality rate. This article will discuss causes of diabetic pedal ulcerations that persist or recur after tendo-Achilles lengthening and will highlight areas that need to be addressed by the practitioner such as infection, vascular and nutritional status, glucose control, off-loading, biomechanics, and patient compliance.

show abstract

Percutaneous Achilles tendon lengthening: A cadaver-based study of failure of the triple hemisection technique

Cited by 29 publications

References 9 publications

Marcha en equino idiopática infantil: revisión sistemática

Marcha en equino idiopática infantil: revisión sistemática

Z-lengthening of the Achilles Tendon with Transverse Skin Incision

Recurrence of Diabetic Pedal Ulcerations Following Tendo-Achilles Lengthening

Contact Info

Product

Resources

About