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The traumatic rupture of the Achilles' tendon - an analysis of the modern methods of evaluation and treatment.

BardaĹź C, Benea H, Martin A, Tomoaia G - Clujul Med (2013)

Bottom Line: The Ultrasound was performed in 65.2% of the patients (15 patients) for confirming the extension of the lesion and it served for pre-operative planning.In most of the cases, the classical methods of Achilles tendon reconstruction were used (18 cases).The complications rate was about 8%.

View Article: PubMed Central - PubMed

Affiliation: Emergency County Hospital Cluj-Napoca, Romania. Ortopaedics and Traumatology Clinic Cluj-Napoca, Romania.

ABSTRACT

Aims: The main aim of this article is an analysis of both advantages and disadvantages of the modern solutions of treatment - percutaneous surgery, in comparison with the classic methods of treatments described in the surgery of Achilles' tendon.

Patients and method: The study was conducted on 23 patients admitted to the Orthopedics and Traumatology Clinic of Cluj-Napoca between January 2011-June 2012. Nineteen (19) patients were diagnosed with a complete rupture of the Achilles tendon and 4 patients with a partial rupture. The diagnosis of traumatic Achilles tendon ruptures was usually clinical, the Ultrasound (common or 3D) and the MRI confirmed the lesion and determined its location and extension. We analyzed the diagnostic methods, the elapsed time before surgery, the treatment options depending on lesion's location, technical difficulties, costs, postoperative care, the average healing time, complications.

Results: The Ultrasound was performed in 65.2% of the patients (15 patients) for confirming the extension of the lesion and it served for pre-operative planning. In most of the cases, the classical methods of Achilles tendon reconstruction were used (18 cases). The complications rate was about 8%. We diagnosed an iterative Achilles tendon rupture (the patient was initially treated using the percutaneous methods) and a delay in cicatrisation.

Conclusions: The percutaneous surgical techniques are a viable alternative for the acute ruptures of Achilles tendon, the classic intervention has clear indications in lesions diagnosed late, in the recurrent tendon ruptures.

No MeSH data available.


Related in: MedlinePlus

Intra-operative reperation of the rupture of Achilles’ tendon.
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f2-cm-86-128: Intra-operative reperation of the rupture of Achilles’ tendon.

Mentions: In the following we will describe the technique used for the percutaneous treatment of Achilles tendon, according to the recommendations of the producer of the “Tenolig” system. The surgical interventions were performed under rachianesthesia, the patient being positioned in ventral decubitus, without using a tourniquet at the level of the limb. I repaired the two parts of the broken tendon, the proximal and distal by palpation (fig. 2). The entrance point is situated at about 6 cm proximal to the rupture area, postero-lateral and postero-medial. The exit point was located at about 4–5 cm distal to the tendon rupture, within the retromalleolar space. The introduction of the needle of the tenosynthesis material was made perpendicular on the tendon body, careful not to affect the sural nerve. The foot was held in an neutral position in order to ensure the suture system penetration correctly. After that, the foot was positioned in equinus in order to reduce the two fragments of the broken tendon. The sutures would be blocked by the provided buttons, thus maintaining the fragments of the tendon in contact.


The traumatic rupture of the Achilles' tendon - an analysis of the modern methods of evaluation and treatment.

BardaĹź C, Benea H, Martin A, Tomoaia G - Clujul Med (2013)

Intra-operative reperation of the rupture of Achilles’ tendon.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4462436&req=5

f2-cm-86-128: Intra-operative reperation of the rupture of Achilles’ tendon.
Mentions: In the following we will describe the technique used for the percutaneous treatment of Achilles tendon, according to the recommendations of the producer of the “Tenolig” system. The surgical interventions were performed under rachianesthesia, the patient being positioned in ventral decubitus, without using a tourniquet at the level of the limb. I repaired the two parts of the broken tendon, the proximal and distal by palpation (fig. 2). The entrance point is situated at about 6 cm proximal to the rupture area, postero-lateral and postero-medial. The exit point was located at about 4–5 cm distal to the tendon rupture, within the retromalleolar space. The introduction of the needle of the tenosynthesis material was made perpendicular on the tendon body, careful not to affect the sural nerve. The foot was held in an neutral position in order to ensure the suture system penetration correctly. After that, the foot was positioned in equinus in order to reduce the two fragments of the broken tendon. The sutures would be blocked by the provided buttons, thus maintaining the fragments of the tendon in contact.

Bottom Line: The Ultrasound was performed in 65.2% of the patients (15 patients) for confirming the extension of the lesion and it served for pre-operative planning.In most of the cases, the classical methods of Achilles tendon reconstruction were used (18 cases).The complications rate was about 8%.

View Article: PubMed Central - PubMed

Affiliation: Emergency County Hospital Cluj-Napoca, Romania. Ortopaedics and Traumatology Clinic Cluj-Napoca, Romania.

ABSTRACT

Aims: The main aim of this article is an analysis of both advantages and disadvantages of the modern solutions of treatment - percutaneous surgery, in comparison with the classic methods of treatments described in the surgery of Achilles' tendon.

Patients and method: The study was conducted on 23 patients admitted to the Orthopedics and Traumatology Clinic of Cluj-Napoca between January 2011-June 2012. Nineteen (19) patients were diagnosed with a complete rupture of the Achilles tendon and 4 patients with a partial rupture. The diagnosis of traumatic Achilles tendon ruptures was usually clinical, the Ultrasound (common or 3D) and the MRI confirmed the lesion and determined its location and extension. We analyzed the diagnostic methods, the elapsed time before surgery, the treatment options depending on lesion's location, technical difficulties, costs, postoperative care, the average healing time, complications.

Results: The Ultrasound was performed in 65.2% of the patients (15 patients) for confirming the extension of the lesion and it served for pre-operative planning. In most of the cases, the classical methods of Achilles tendon reconstruction were used (18 cases). The complications rate was about 8%. We diagnosed an iterative Achilles tendon rupture (the patient was initially treated using the percutaneous methods) and a delay in cicatrisation.

Conclusions: The percutaneous surgical techniques are a viable alternative for the acute ruptures of Achilles tendon, the classic intervention has clear indications in lesions diagnosed late, in the recurrent tendon ruptures.

No MeSH data available.


Related in: MedlinePlus