Reconstruction for missed or neglected achilles tendon rupture with V-Y lengthening and flexor hallucis longus tendon transfer through one incision

Ilan Elias, Marcus Peter Besser, Levon N. Nazarian, Steven M. Raikin

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Background: The purpose of this study was to introduce a novel operative technique and to evaluate the clinical outcomes in a cohort of patients with missed or neglected Achilles tendon ruptures. Methods: Fifteen consecutive patients with missed complete Achilles tendon ruptures and 5-cm or larger gaps had reconstruction with V-Y lengthening and flexor hallucis longus tendon transfer through a single incision. The patients were evaluated at an average of 106 weeks after surgery. At the time of followup, all patients were assessed with regard to their self-reported level of satisfaction and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale. Ankle strength and active range of motion were evaluated using Biodex® (Biodex Medical Systems, Shirley, NY) isokinetic dynamometry. In addition, seven patients were evaluated using diagnostic ultrasound. Results: We found a 7.7 N-m (-22.3%) loss of plantarflexion torque at 60 degrees/sec and a 3.5 N-m (-13.5%) loss of plantarflexion torque at 120 degrees/sec, as well as a 5 degrees loss of active range of motion. AOFAS scores were all good to excellent, with an average score of 94.1 of 100. All patients were satisfied with their outcomes (rated good or very good). Excellent exposure of the Achilles tendon repair was obtained with ultrasound. Conclusions: For patients with missed or neglected Achilles tendon rupture with a rupture gap of at least 5 cm, operative repair using V-Y lengthening and flexor hallucis longus tendon transfer through a single incision technique achieved a high percentage of satisfactory results.

Original languageEnglish (US)
Pages (from-to)1238-1248
Number of pages11
JournalFoot and Ankle International
Volume28
Issue number12
DOIs
StatePublished - Dec 1 2007

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Tendon Transfer
Achilles Tendon
Rupture
Ankle
Torque
Articular Range of Motion
Orthopedics
Foot
Ultrasonography

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

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title = "Reconstruction for missed or neglected achilles tendon rupture with V-Y lengthening and flexor hallucis longus tendon transfer through one incision",
abstract = "Background: The purpose of this study was to introduce a novel operative technique and to evaluate the clinical outcomes in a cohort of patients with missed or neglected Achilles tendon ruptures. Methods: Fifteen consecutive patients with missed complete Achilles tendon ruptures and 5-cm or larger gaps had reconstruction with V-Y lengthening and flexor hallucis longus tendon transfer through a single incision. The patients were evaluated at an average of 106 weeks after surgery. At the time of followup, all patients were assessed with regard to their self-reported level of satisfaction and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale. Ankle strength and active range of motion were evaluated using Biodex{\circledR} (Biodex Medical Systems, Shirley, NY) isokinetic dynamometry. In addition, seven patients were evaluated using diagnostic ultrasound. Results: We found a 7.7 N-m (-22.3{\%}) loss of plantarflexion torque at 60 degrees/sec and a 3.5 N-m (-13.5{\%}) loss of plantarflexion torque at 120 degrees/sec, as well as a 5 degrees loss of active range of motion. AOFAS scores were all good to excellent, with an average score of 94.1 of 100. All patients were satisfied with their outcomes (rated good or very good). Excellent exposure of the Achilles tendon repair was obtained with ultrasound. Conclusions: For patients with missed or neglected Achilles tendon rupture with a rupture gap of at least 5 cm, operative repair using V-Y lengthening and flexor hallucis longus tendon transfer through a single incision technique achieved a high percentage of satisfactory results.",
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Reconstruction for missed or neglected achilles tendon rupture with V-Y lengthening and flexor hallucis longus tendon transfer through one incision. / Elias, Ilan; Besser, Marcus Peter; Nazarian, Levon N.; Raikin, Steven M.

In: Foot and Ankle International, Vol. 28, No. 12, 01.12.2007, p. 1238-1248.

Research output: Contribution to journalArticle

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T1 - Reconstruction for missed or neglected achilles tendon rupture with V-Y lengthening and flexor hallucis longus tendon transfer through one incision

AU - Elias, Ilan

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AU - Raikin, Steven M.

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N2 - Background: The purpose of this study was to introduce a novel operative technique and to evaluate the clinical outcomes in a cohort of patients with missed or neglected Achilles tendon ruptures. Methods: Fifteen consecutive patients with missed complete Achilles tendon ruptures and 5-cm or larger gaps had reconstruction with V-Y lengthening and flexor hallucis longus tendon transfer through a single incision. The patients were evaluated at an average of 106 weeks after surgery. At the time of followup, all patients were assessed with regard to their self-reported level of satisfaction and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale. Ankle strength and active range of motion were evaluated using Biodex® (Biodex Medical Systems, Shirley, NY) isokinetic dynamometry. In addition, seven patients were evaluated using diagnostic ultrasound. Results: We found a 7.7 N-m (-22.3%) loss of plantarflexion torque at 60 degrees/sec and a 3.5 N-m (-13.5%) loss of plantarflexion torque at 120 degrees/sec, as well as a 5 degrees loss of active range of motion. AOFAS scores were all good to excellent, with an average score of 94.1 of 100. All patients were satisfied with their outcomes (rated good or very good). Excellent exposure of the Achilles tendon repair was obtained with ultrasound. Conclusions: For patients with missed or neglected Achilles tendon rupture with a rupture gap of at least 5 cm, operative repair using V-Y lengthening and flexor hallucis longus tendon transfer through a single incision technique achieved a high percentage of satisfactory results.

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