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A retrospective review of Tendoachilles repair in complete avulsion rupture with lengthening of Achilles tendon and suture anchor with immediate post operative neutral ankle immobilization

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Abstract

Background

This is a retrospective review of tendoachilles repair by the senior author in complete avulsion rupture with lengthening of Achilles tendon and suture anchor with immediate post op neutral ankle immobilization cast and to evaluate its positive impact on postoperative healing and functional recovery.

Objective

The objective of this study is to evaluate the surgical results of a new technique of tendoachilles repair in complete avulsion rupture and to evaluate its positive impact on wound healing and functional recovery.

Methods

A retrospective review evaluated 30 patients with complete avulsion rupture of Achilles tendon who underwent lengthening by Z-plasty or by turnplasty and suture anchor in MIOT, a trauma speciality hospital in Chennai between January 2013 and April 2019. The mean injury-to-surgery time was 22 days (range, 4 days–4 months). Patients with complete avulsion rupture of tendoachilles usually present with a history of misstep, jump, or push off. These patients report a sensation of snap followed by onset of acute pain, swelling in the ankle region, difficulty walking, and weakened dorsiflexion power. Typically on examination, ecchymosis and swelling with a palpable gap at the rupture site felt as a posterior indentation overlying the tendon defect can be noted; also a patient with Achilles tendon rupture is unable to stand on tiptoes on the involved side. However, with 24 h, these findings are difficult to evaluate due to soft tissue swelling and tenderness. The acute pain experienced initially and pain on palpation immediately after rupture will subside rapidly and be characterized by a vague dull ache in due course of time. The Matles test and an improved Thompson test was used to examine Achilles tendon rupture.

Conclusions

This method yields satisfactory functional results and low complication rates. The advantage of this procedure is that it is an easy and effective method with low complication rates enabling lesser period of hospitalization and early recovery. Tendoachilles lengthening and suture anchor with postoperative neutral ankle cast immobilization should be considered an acceptable first choice of treatment for complete avulsion ruptures of Achilles tendon.

Level of evidence: Level IV, therapeutic study.

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Authors and Affiliations

  1. HOD, Department of Plastic & Reconstructive Surgery, MIOT Hospital, Chennai, India

    Senthil Kumaran Subbannan

  2. Department of Burns, Plastic and Reconstructive Surgery, Kilpauk Medical College & GH, Kilpauk, Chennai, India

    Charumathy N

Authors
  1. Senthil Kumaran Subbannan
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  2. Charumathy N
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Corresponding author

Correspondence to Senthil Kumaran Subbannan.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional ethical committee, MIOT hospitals, Chennai, India (Reference Number MIOTIEC/2021/06).

Informed consent

Informed consent was obtained from all individual participants included in the study. Patients signed informed consent regarding publishing their data and photographs.

Conflict of interest

Both the authors Dr. Senthilkumaran Subbannan & Dr.N Charumathy, declare that they have no conflict of interest.

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Subbannan, S.K., N, C. A retrospective review of Tendoachilles repair in complete avulsion rupture with lengthening of Achilles tendon and suture anchor with immediate post operative neutral ankle immobilization. Eur J Plast Surg 45, 779–786 (2022). https://doi.org/10.1007/s00238-021-01896-0

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