Repair of neglected Achilles tendon rupture using gastrocnemius fascial flaps.
BACKGROUND
Neglected Achilles tendon rupture is a rare disorder. In this article, we discuss the results of 10 patients with neglected Achilles tendon ruptures who were treated surgically.


METHODS
Between 1980 and 1997, we treated 10 patients (6 men and 4 women) using gastrocnemius fascial flaps according to the method described by Lindholm. The mean age of the patients at the time of the operation was 51 years (range 38-57 years). They were followed-up for 26-192 months.


RESULTS
There were significant differences between the American Orthopaedic Foot and Ankle Society (AOFAS) scale score before the operation (72.6+/-5.3) and the score at the most recent follow-up (98.1+/-2.5) (p<0.0001). On Cybex isokinetic strength testing, the peak torque deficiencies in plantar flexion ranged from 8% to 68% at the low setting and from 19% to 33% at the high setting preoperatively, and ranged from -9% to 17% at the low setting and from -13% to 23% at the high setting postoperatively. There were no re-ruptures.


CONCLUSIONS
Our data indicate that the reconstructive technique using gastrocnemius fascial flaps can result in an excellent clinical and functional outcome.
Takao
M
M
Department of Orthopaedics, Shimane Medical University, 89-1, Enya-cho, Izumo, Shimane 693-8501, Japan. mtakao@shimane-med.ac.jp
Ochi
M
M
Naito
K
K
Uchio
Y
Y
Matsusaki
M
M
Oae
K
K
D000125:Achilles Tendon / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D005205:Fascia / Q000637:transplantation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D019651:Plastic Surgery Procedures; D012421:Rupture; D013524:Surgical Flaps; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome