Abstract
Achilles tendinopathy affects athletes at all levels. While tendinopathy is usually found in either the midsubstance or the Achilles insertion, it is rarely seen in both areas of the tendon concomitantly. We report on a rare case of bilateral chronic insertional Achilles tendinosis and chronic midsubstance Achilles tendinosis with Haglund deformity treated with central tendon debridement, flexor hallucis longus (FHL) transfer, Haglund resection, and reattachment of the Achilles insertion using the Arthrex Speedbridge® system. To our knowledge, this case report is the first for the treatment of combined midsubstance and insertional Achilles tendinosis. Our method allows us to reapproximate the Achilles to its normal anatomy while eliminating the need for bulky suture knots and simultaneously giving an excellent clinical result.
Résumé
La tendinopathie du tendon d’Achille touche les sportifs de tous niveaux. En général, les tendinopathies affectent soit le corps du tendon, soit l’insertion du tendon d’Achille, et il est très rare de les rencontrer dans ces deux zones simultanément. Dans cette étude de cas, nous décrivons un cas rare de tendinose chronique d’insertion du tendon d’Achille doublée d’une tendinose chronique du corps du tendon avec déformation de Haglund traitées avec un débridement du tendon central, un transfert du muscle long fléchisseur de l’hallux, une résection de la déformation de Haglund et un rattachement de l’insertion du tendon avec le système Arthrex Speedbridge®. À notre connaissance, cette étude de cas est la première qui décrit le traitement combiné de tendinoses du corps et de l’insertion du tendon d’Achille. Notre méthode nous permet de rendre au tendon d’Achille une anatomie à peu près normale, tout en éliminant le besoin de points de suture épais et en donnant de plus un excellent résultat clinique.
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Macias, D.M., Trakas, A. & Coughlin, M.J. Reconstruction of concurrent chronic insertional Achilles tendinosis and chronic midsubstance Achilles tendinosis with Haglund deformity: A case report. Med Chir Pied 31, 53–58 (2015). https://doi.org/10.1007/s10243-015-0406-2
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DOI: https://doi.org/10.1007/s10243-015-0406-2