Management of insertional Achilles tendinopathy through a Cincinnati incision.
BACKGROUND
About 10% of patients not responding to 3-6 months of conservative management for insertional Achilles tendinopathy undergo surgery. Traditionally, surgery of the Achilles tendon is performed through longitudinal extensile incisions. Such surgery is prone to the complications of wound healing, wound breakdown and iatrogenic nerve injury.


METHODS
We describe our current method of exposure of the Achilles tendon insertion and debridement of the peritendinous and tendon tissue with osteotomy of the calcaneum through a transverse skin incision at the level of the Achilles insertion.


RESULTS
This method has been used since 2002 on over 40 patients for exposure of the Achilles tendon insertion and the distal Achilles tendon.


CONCLUSIONS
The Cincinnati incision allows adequate exposure, has minimal risk of symptomatic iatrogenic nerve injury, and has minimal problems related to the scar.
Carmont
Michael R
MR
Department of Trauma and Orthopaedics, University Hospital of North Staffordshire, Keele University School of Medicine, Stoke on Trent, UK. mcarmont@hotmail.com
Maffulli
Nicola
N
D000125:Achilles Tendon / Q000473:pathology / Q000601:surgery*; D019468:Disease Management; D006801:Humans; D019637:Orthopedic Procedures / Q000379:methods*; D052256:Tendinopathy / Q000473:pathology / Q000601:surgery*
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