title: Management of insertional Achilles tendinopathy through a Cincinnati incision.
abstract: 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.
authors: Department of Trauma and Orthopaedics, University Hospital of North Staffordshire, Keele University School of Medicine, Stoke on Trent, UK. mcarmont@hotmail.com
authors: Michael R
authors: MR
authors: Carmont
authors: Nicola
authors: N
authors: Maffulli
mesh_terms: D000125:Achilles Tendon / Q000473:pathology / Q000601:surgery*; D019468:Disease Management; D006801:Humans; D019637:Orthopedic Procedures / Q000379:methods*; D052256:Tendinopathy / Q000473:pathology / Q000601:surgery*
references: Knee Surg Sports Traumatol Arthrosc. 2003 Sep;11(5):327-33
references: 12942235
references: Foot Ankle Int. 2003 Feb;24(2):119-21
references: 12627617
references: J Bone Joint Surg Am. 1982 Dec;64(9):1355-8
references: 7142243
references: Am J Sports Med. 1987 Jul-Aug;15(4):308-15
references: 3661810
references: Orthop Rev. 1988 May;17(5):487-93
references: 3174216
references: Am J Sports Med. 1988 Nov-Dec;16(6):616-23
references: 3071152
references: Foot Ankle. 1992 May;13(4):199-202
references: 1634152
references: Foot Ankle. 1992 Oct;13(8):482-7
references: 1483611
references: Am J Sports Med. 1994 Sep-Oct;22(5):611-9
references: 7810784
references: Foot Ankle Int. 2004 Nov;25(11):800-4
references: 15574239
references: Foot Ankle Clin. 2005 Jun;10(2):309-20
references: 15922921
references: Foot Ankle Int. 2006 Apr;27(4):245-50
references: 16624213
references: Am J Sports Med. 2006 May;34(5):733-40
references: 16627628
references: Foot Ankle Int. 2006 Sep;27(9):677-84
references: 17038277
references: Foot Ankle Int. 2007 Feb;28(2):149-53
references: 17296130
references: Am J Sports Med. 2000 Jan-Feb;28(1):77-82
references: 10653548
references: Foot Ankle Int. 2000 Jun;21(6):475-7
references: 10884105
references: Foot Ankle Int. 2000 Aug;21(8):638-42
references: 10966360
references: Foot Ankle Int. 2002 Jan;23(1):19-25
references: 11822688
references: Am J Sports Med. 2002 May-Jun;30(3):318-21
references: 12016069
references: Am J Sports Med. 2004 Jan-Feb;32(1):174-82
references: 14754741