title: Reconstruction of neglected achilles tendon ruptures with gastrocnemius flaps: excellent results in long-term follow-up.
abstract: OBJECTIVE
  Repair of the neglected achilles tendon ruptures can be challenging due to retraction of tendon stumps. Different repair and augmentation techniques were described. This study aims to investigate long-term results of neglected achilles tendon rupture repair with gastrocnemius flaps.
  
  
  METHODS
  Between 1995 and 2005, 21 neglected achilles tendon rupture reconstructions were performed with using gastrocnemius fascial flaps. Mean age was 32.1 years. Mean period between rupture and operation was 8.4 weeks. Ankle range of motion, calf circumference, heel raise test, Visual Analog Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) hindfoot and Foot and Ankle Disability Index (FADI) scores were checked.
  
  
  RESULTS
  The average gap length was 6.4 cm. Mean follow-up was 145.3 months. Median dorsiflexion/plantar flexion values for operated and uneffected sides were 18°/30° and 19°/30°, respectively. The mean values for AOFAS and FADI scores were 98.5 points and 98.9 %, respectively. VAS score was 0 point for all patients. With the numbers available, no significant difference could be detected in terms of ankle range of motion, calf circumference measures and dynamometric analysis. Mean time for return to daily activities was 11.1 (8-16) weeks after surgery. Prerupture activity level was achieved 14.1 months postoperatively. All patients were able to perform heel raise test.
  
  
  CONCLUSIONS
  Repair of neglected achilles tendon ruptures with gastrocnemius flaps has satisfactory long-term results.
authors.affiliation: Department of Orthopaedics and Traumatology, Istanbul Medipol University, Istanbul, Turkey. aliseker@doctor.com.|Medipol Mega Hastane, TEM Avrupa Otoyolu Goztepe Cikisi No: 1, Bagcilar, Istanbul, Turkey. aliseker@doctor.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Seker
authors.affiliation: Department of Orthopaedics and Traumatology, Medipol Mega Hastane, Istanbul, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Kara
authors.affiliation: Orthopaedics and Traumatology Clinic, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Raffi
authors.initials: R
authors.lastname: Armagan
authors.affiliation: Orthopaedics and Traumatology Clinic, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Yunus
authors.initials: Y
authors.lastname: Oc
authors.affiliation: Orthopaedics and Traumatology Clinic, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Varol
authors.affiliation: Orthopaedics and Traumatology Clinic, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Hasan Basri
authors.initials: HB
authors.lastname: Sezer
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000818:Animals; D002417:Cattle; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012421:Rupture / Q000601:surgery*; D013524:Surgical Flaps; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Achilles tendon; Gastrocnemius flap; Neglected; Reconstruction; Rupture