title: Surgical considerations for the neglected or chronic Achilles tendon rupture: a combined technique for reconstruction.
abstract: The Achilles tendon is among the most commonly injured tendons in the human body. The most common reason for delayed treatment is a missed diagnosis or a deficiency in presentation. The neglected or chronically ruptured Achilles tendon presents a unique treatment challenge. The surgical approach varies greatly depending on the extent of degeneration and the resultant gap between the opposing tendon ends. Most surgeons have recommended the use of a tendon transfer or augmentation to strengthen the Achilles tendon repair. The following technique uses a flexor hallucis longus tendon transfer with gastrocnemius aponeurosis turndown flap augmentation. This technique has been commonly performed by us with success.
authors.affiliation: Postgraduate Year 3, Chief Resident, Division of Foot and Ankle Surgery, Western Pennsylvania Hospital, Pittsburgh, PA.
authors.forename: Kyle S
authors.initials: KS
authors.lastname: Peterson
authors.affiliation: Postgraduate Year 2 Resident, Division of Foot and Ankle Surgery, Western Pennsylvania Hospital, Pittsburgh, PA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Hentges
authors.affiliation: Residency Director, Western Pennsylvania Hospital, Pittsburgh, PA.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Catanzariti
authors.affiliation: Student, Washington and Jefferson College, Washington, PA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Mendicino
authors.affiliation: Foot and Ankle Surgeon, OhioHealth Orthopedic Surgeons, Hilliard, OH; Faculty, Surgical Residencies, Western Pennsylvania Hospital, Pittsburgh, PA and Grant Medical Center, Columbus, OH. Electronic address: rmendicino@faiwp.com.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Mendicino
mesh_terms: D000125:Achilles Tendon / Q000601:surgery*; D002908:Chronic Disease; D003951:Diagnostic Errors; D004210:Dissection; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods*; D012421:Rupture; D013524:Surgical Flaps; D013708:Tendon Injuries / Q000175:diagnosis / Q000601:surgery*; D013710:Tendons / Q000601:surgery* / Q000637:transplantation
keywords: ankle; flexor hallucis longus; injury; leg; popliteal block; tendon transfer; triceps surae