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Repair of acute Achilles tears with plantaris augmentation

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Abstract

Purpose

To determine the benefits associated with using the fanned out plantaris tendon as a membrane to cover and augment the acute Achilles tendon midportion end-to-end suture repair.

Methods

Between 2014 and 2018, 31 (67.4%) patients had plantaris augmented reconstruction and 15 simple end-to-end suture. The clinician filled out the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scale and the patient the Achilles tendon total rupture score (ATRS). Examination included clinical examination, limb symmetry index (LSI) using the heel rise test, and ultrasound determination of cross-sectional area (CSA).

Results

80.4% were males, mean age 41 (SD 6.7, range 29–57), of which 82.6% were sports accidents. 39/46 were operated in less than two weeks from injury. 82.6% were available at the two year follow-up. Duration of surgery (62.3 min vs 58, p = 0.45), AOFAS (89.6 vs 88.4, p = 0.61 and 97.2 vs 96.8, p = 0.72), ATRS (86.3 vs 83.8, p = 0.33 and 95.6 vs 93.6, p = 0.12), LSI (60.8% vs 58.75, p = 0.24 and 80.5 vs 79, p = 0.29), CSA (3.39cm2 vs 3.36, p = 0.82 and 2.57 vs 2.59, p = 0.87), return to sport (80% vs 57, p = 0.15 and 84.6 vs 85.7, p = 1.00), and complications at six months and two years were comparable between the two techniques.

Conclusion

Fanned out plantaris augmentation of acute Achilles tendon tears yields excellent and comparable clinical and ultrasonographic results to end-to-end suture at mid-term follow-up

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Authors and Affiliations

  1. Department of Orthopedics and Trauma, ‘Victor Babes’ University of Medicine and Pharmacy, No 2 Eftimie Murgu Square, 300041, Timisoara, Romania

    Radu Prejbeanu, Dinu Vermesan, Mihail Lazar Mioc & Horia Haragus

  2. Premiere Hospital, No 113 Aradului Str., 300643, Timisoara, Romania

    Andrei Balanescu

Authors
  1. Radu Prejbeanu
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  2. Dinu Vermesan
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  3. Andrei Balanescu
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  4. Mihail Lazar Mioc
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  5. Horia Haragus
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Contributions

Conceptualization: Radu Prejbeanu. Methodology: Dinu Vermesan, Horia Haragus. Formal analysis and investigation: Horia Haragus, Mihail Lazar Mioc. Writing—original draft preparation: Mihail Lazar Mioc. Writing—review and editing: Horia Haragus. Resources: Andrei Balanescu. Supervision: Radu Prejbeanu.

Corresponding author

Correspondence to Mihail Lazar Mioc.

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Ethics approval

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Institutional Review Board (or Ethics Committee) of “Pius Branzeu” University Emergency County Hospital (registration number 237).

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Informed consent was obtained from all subjects involved in the study.

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Patients signed informed consent regarding publishing their data and photographs.

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The authors declare no competing interests.

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Prejbeanu, R., Vermesan, D., Balanescu, A. et al. Repair of acute Achilles tears with plantaris augmentation. International Orthopaedics (SICOT) 45, 2285–2290 (2021). https://doi.org/10.1007/s00264-021-05169-0

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  • DOI: https://doi.org/10.1007/s00264-021-05169-0

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