title: Surgical Strategy for the Chronic Achilles Tendon Rupture.
abstract: Background. Chronic Achilles tendon rupture is usually misdiagnosed and treated improperly. This study aims to better understand the treatment of chronic Achilles tendon rupture.Methods. Patients who were not able to perform a single-limb heel rise were chosen. Pre- and postoperative magnetic resonance imaging (MRI) were conducted. By evaluating the presence or absence of Achilles tendon stumps and the gap length of rupture, V-Y advancement, gastrocnemius fascial turndown flap, or flexor halluces longus tendon transfer were selected for tendon repair. The function of ankle and foot was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores and Achilles Tendon Total Rupture Score (ATRS).Results. Twenty-nine patients were followed up. One patient had superficial incision infection, which was healed after debridement and oral antibiotics. Three months postoperatively, MRI showed some signs of inflammation, which disappeared at one or two years postoperatively. All patients were able to perform a single-limb heel rise. Mean AOFAS scores and ATRS scores were increased at the latest follow-up.Conclusion. Surgical options can be determined by evaluating the presence of the Achilles tendon stumps and the gap length, which can avoid using the nearby tendon and yield satisfactory functional results.
authors.affiliation: Center for Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Yangjing
authors.identifier: 0000-0001-6907-2844
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Center for Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Yang
authors.affiliation: Center for Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Li
authors.initials: L
authors.lastname: Yin
authors.affiliation: Center for Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Xiaojun
authors.identifier: 0000-0001-7644-2452
authors.initials: X
authors.lastname: Duan
mesh_terms: D000125:Achilles Tendon / Q000601:surgery*; D000328:Adult; D000368:Aged; D000842:Ankle / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D005528:Foot / Q000601:surgery; D006365:Heel / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012189:Retrospective Studies; D012421:Rupture / Q000601:surgery*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents