[Achilles tendon ruptures and tibialis anterior tendon ruptures].
Achilles tendon ruptures (ATR) are becoming the most frequent tendon rupture of the lower extremity, whereas less than 100 cases of tibialis anterior tendon ruptures (TATR) have been reported. Common in both tendons are the degenerative causes of ruptures in a susceptible tendon segment, whereas traumatic transections occur at each level. Triceps surae and tibialis anterior muscles are responsible for the main sagittal ankle range of motion and ruptures lead to a distinctive functional deficit. However, diagnosis is delayed in up to 25% of ATR and even more frequently in TATR. Early primary repair provides the best functional results. With progressive retraction and muscle atrophy delayed tendon reconstruction has less favourable functional results. But not all patients need full capacity, power and endurance of these muscles and non-surgical treatment should not be forgotten. Inactive patients with significant comorbidities and little disability should be informed that surgical treatment of TATR is complicated by high rates of rerupture and surgical treatment of ATR can result in wound healing problems rarely necessitating some kind of transplantation.
Behandlungszentrum Bewegungsapparat, Orthopädische Universitätsklinik, Universitätsspital Basel, Spitalstraße 21, CH-4031 Basel, Schweiz. geert.pagenstert@unibas.ch
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Pagenstert
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Leumann
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Frigg
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Valderrabano
D000125:Achilles Tendon / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery; D001174:Arthrodesis / Q000379:methods; D019643:Arthroplasty, Replacement / Q000379:methods; D001265:Athletic Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002111:Calcaneus / Q000601:surgery; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology; D007593:Joint Instability / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D017844:Lateral Ligament, Ankle / Q000293:injuries / Q000503:physiopathology / Q000601:surgery; D010027:Osteotomy / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D012421:Rupture; D012422:Rupture, Spontaneous; D052256:Tendinopathy / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D013708:Tendon Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D053656:Tenodesis / Q000379:methods; D013977:Tibia