Surgical considerations for the neglected or chronic Achilles tendon rupture: a combined technique for reconstruction

J Foot Ankle Surg. 2014 Sep-Oct;53(5):664-71. doi: 10.1053/j.jfas.2013.10.001. Epub 2013 Nov 22.

Abstract

The Achilles tendon is among the most commonly injured tendons in the human body. The most common reason for delayed treatment is a missed diagnosis or a deficiency in presentation. The neglected or chronically ruptured Achilles tendon presents a unique treatment challenge. The surgical approach varies greatly depending on the extent of degeneration and the resultant gap between the opposing tendon ends. Most surgeons have recommended the use of a tendon transfer or augmentation to strengthen the Achilles tendon repair. The following technique uses a flexor hallucis longus tendon transfer with gastrocnemius aponeurosis turndown flap augmentation. This technique has been commonly performed by us with success.

Keywords: ankle; flexor hallucis longus; injury; leg; popliteal block; tendon transfer; triceps surae.

MeSH terms

  • Achilles Tendon / surgery*
  • Chronic Disease
  • Diagnostic Errors*
  • Dissection
  • Humans
  • Plastic Surgery Procedures / methods*
  • Rupture
  • Surgical Flaps
  • Tendon Injuries / diagnosis
  • Tendon Injuries / surgery*
  • Tendons / surgery*
  • Tendons / transplantation