title: Achilles tendon lengthening by triple hemisection in adult.
abstract: BACKGROUND
  The purpose of this study was to investigate the adequate distance between hemisections to prevent complete rupture in a triple hemisection Achilles tendon lengthening.
  
  
  METHODS
  Achilles tendon lengthenings by open triple hemisection were done in 18 patients (25 ankles) with spastic paralysis and were followed for more than 1 year.
  
  
  RESULTS
  There was a significant correlation between the sum of the gaps (partial thickness defects) after sliding and the amount of corrected angles. When the distal gap was regarded as 1, the ratio of the distal gap to the middle gap to the proximal gap was 1:1.3 (range 0.8 to 3.3):1.6 (range 0.8 to 4.0), and the ratio of the distal connecting portion to the proximal portion was 2.1 (range 0.3 to 8.8):1.9 (range 0 to 8.3). There were marked differences of this ratio in individual cases. There were no complete ruptures. There were two recurrences at the last followup.
  
  
  CONCLUSIONS
  When the angle of correction is more than 30 degrees, there is a risk of complete rupture even though the distance between the hemisections are more than 4 cm.
authors.affiliation: Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University, 85, 2-Ka, Jur-dong, Chung-ku, Seoul 100-032, Korea. lwsk980@unitel.co.kr
authors.forename: Woo-Chun
authors.initials: WC
authors.lastname: Lee
authors.forename: Han-Suk
authors.initials: HS
authors.lastname: Ko
mesh_terms: D000125:Achilles Tendon / Q000601:surgery*; D000328:Adult; D004863:Equinus Deformity / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D012008:Recurrence; D012421:Rupture / Q000517:prevention & control; D016896:Treatment Outcome