Skip to main content
SpringerLink
Log in

Augmented repair of acute Achilles tendon ruptures using gastrocnemius-soleus fascia

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Fifty-four consecutive acute Achilles tendon ruptures were treated with end-to-end suture augmented with gastrocnemius fascial flaps. Surgery was performed within 24 h. Mean patient age was 35 (23–57) years, and 46 were men. Mean follow-up time was 4.8 (2–8) years. At follow-up, the mean visual analogue scale for pain was 0.49, and the mean AOFAS ankle–hindfoot score was 95 (74–100) points. Fifty-three patients were able to stand on their tiptoes for 30 s and perform repeated toe raises, and 50 patients were able to perform single-limb hopping. Complications included rerupture in one case, deep infection in three cases, delayed wound healing in eight cases, and deep venous thrombosis in one case. Reconstruction of acute ruptures of the Achilles tendon augmented with gastrocnemius-soleus fascial flaps provided a good outcome but was associated with a high complication rate.

Résumé

Cinquante-quatre ruptures récentes, consécutives, du tendon d’achille ont été traitées par suture bout à bout augmentée par un lambeau fascial du muscle jumeau. La chirurgie a été exécutée dans les vingt-quatre heures suivant la rupture. L’âge moyen des malades était de 35 ans (23–57) et 46 étaient de sexe masculin. Le temps de suivi moyen était de 4,8 ans (2–8). Au dernier examen la cotation visuelle moyenne pour la douleur était 0,49 et le score moyen de cheville AOFAS était de 95 points (74–100). Cinquante-trois malades étaient capables de se tenir sur la pointe des pieds trente secondes et d’exécuter des extensions d’orteils répétées, et 50 malades étaient capables d’exécuter un sautillement monopodal. Les complications ont été une rupture itérative dans un cas, une infection profonde dans trois cas, un retard de cicatrisation cutanée avec évolution favorable dans huit cas, et une thrombose veineuse profonde dans un cas. La reconstruction des ruptures récentes du tendon d’achille avec utilisation d’un lambeau du fascia des jumeaux a fourni un bon résultat mais avec un taux élevé de complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Aracil J, Pina A, Lozano JA, Torro V, Escriba I (1992) Percutaneous suture of Achilles tendon ruptures. Foot Ankle 13:350–351

    CAS  PubMed  Google Scholar 

  2. Assal M, Jung M, Stern R, Rippstein P, Delmi M, Hoffmeyer P (2002) Limited open repair of Achilles tendon ruptures: a technique with a new instrument and findings of a prospective multicenter study. J Bone Joint Surg Am 84:161–170

    Google Scholar 

  3. Bradley JP, Tibone JE (1990) Percutaneous and open surgical repairs of the Achilles tendon rupture. Am J Sports Med 18:188–195

    CAS  PubMed  Google Scholar 

  4. Cetti R, Henriksen LO, Jacobsen KS (1994) A new treatment of ruptured Achilles tendons. A prospective randomized study. Clin Orthop 308:155–165

    PubMed  Google Scholar 

  5. Fernandez-Fairen M, Gimeno C (1997) Augmented repair of Achilles tendon ruptures. Am J Sports Med 25:177–181

    CAS  PubMed  Google Scholar 

  6. Kaplan MJ, Howe JG, Fleming B, Johnson RJ, Jarvinen M (1991) Anterior cruciate ligament reconstruction using quadriceps patellar tendon graft. Part II. A specific sport review. Am J Sports Med 19:458–462

    CAS  PubMed  Google Scholar 

  7. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux and lesser toes. Foot Ankle Int 15:349–353

    CAS  PubMed  Google Scholar 

  8. Kitaoka HB, Wikenheiser MA, Shaughnessy WJ, An KN (1997) Gait abnormalities following resection of talocalcaneal coalition. J Bone Joint Surg Am 79:369–374

    CAS  PubMed  Google Scholar 

  9. Kocher MS, Bishop J, Marshall R, Briggs KK, Hawkins RJ (2002) Operative versus nonoperative management of acute Achilles tendon rupture: expected-value decision analysis. Am J Sports Med 30:783–790

    PubMed  Google Scholar 

  10. Krueger-Franke M, Siebert CH, Scherzer S (1995) Surgical treatment of ruptures of the Achilles tendon: a review of long-term results. Br J Sports Med 29:121–125

    CAS  PubMed  Google Scholar 

  11. Lim J, Dalal R, Waseem M (2001) Percutaneous vs. open repair of the ruptured Achilles tendon—a prospective randomized controlled study. Foot Ankle Int 22:559–568

    CAS  PubMed  Google Scholar 

  12. Nistor L (1981) Surgical and non-surgical treatment of Achilles tendon rupture. A prospective randomized study. J Bone Joint Surg Am 63:394–399

    CAS  PubMed  Google Scholar 

  13. Nyyssonen T, Saarikoski H, Kaukonen JP, Luthje P, Hakovirta H (2003) Simple end-to-end suture versus augmented repair in acute Achilles tendon ruptures: a retrospective comparison in 98 patients. Acta Orthop Scand 74:206–208

    Article  PubMed  Google Scholar 

  14. Pajala A, Kangas J, Ohtonen P, Leppilahti J (2002) Rerupture and deep infection following treatment of total Achilles tendon rupture. J Bone Joint Surg Am 84:2016–2021

    Google Scholar 

  15. Rippstein PF, Jung M, Assal M (2002) Surgical repair of acute Achilles tendon rupture using a “mini-open” technique. Foot Ankle Clin 7:611–619

    PubMed  Google Scholar 

  16. Soldatis JJ, Goodfellow DB, Wilber JH (1997) End-to-end operative repair of Achilles tendon rupture. Am J Sports Med 25:90–95

    CAS  PubMed  Google Scholar 

  17. Vivaldi AS (2000) Percutaneous repair of ruptured tendo Achillis. J Bone Joint Surg Br 82:619

    Article  CAS  Google Scholar 

  18. Webb JM, Bannister GC (1999) Percutaneous repair of the ruptured tendo Achillis. J Bone Joint Surg Br 81:877–880

    Article  CAS  PubMed  Google Scholar 

  19. Webb J, Moorjani N, Radford M (2000) Anatomy of the sural nerve and its relation to the Achilles tendon. Foot Ankle Int 21:475–477

    CAS  PubMed  Google Scholar 

  20. Weber M, Niemann M, Lanz R, Muller T (2003) Nonoperative treatment of acute rupture of the Achilles tendon: results of a new protocol and comparison with operative treatment. Am J Sports Med 31:685–691

    PubMed  Google Scholar 

  21. Wong J, Barrass V, Maffulli N (2002) Quantitative review of operative and nonoperative management of Achilles tendon ruptures. Am J Sports Med 30:565–575

    PubMed  Google Scholar 

  22. Zell RA, Santoro VM (2000) Augmented repair of acute Achilles tendon ruptures. Foot Ankle Int 21:469–474

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Sugery, Hospital “La Paz”, Madrid, Spain

    Agustin Garabito, Jesus Martinez-Miranda & Joaquin Sanchez-Sotelo

  2. Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 550905, USA

    Joaquin Sanchez-Sotelo

Authors
  1. Agustin Garabito
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jesus Martinez-Miranda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joaquin Sanchez-Sotelo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joaquin Sanchez-Sotelo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Garabito, A., Martinez-Miranda, J. & Sanchez-Sotelo, J. Augmented repair of acute Achilles tendon ruptures using gastrocnemius-soleus fascia. International Orthopaedics (SICOT) 29, 42–46 (2005). https://doi.org/10.1007/s00264-004-0598-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-004-0598-2

Keywords

Search

Navigation