Comparison of the open primary repair with augmentation and without augmentation in acute achilles tendon rupture

To compare the clinical and the functional efficiency of 2 surgical methods that are used in open primary repair of acute Achilles tendon ruptures: one that utilizes the augmentation of the plantaris tendon and one that does not. Materials and methods: Data were evaluated from 41 patients that underwent surgical repair for acute Achilles tendon ruptures with these 2 different surgery methods. In the first group, which included 21 patients (19 male, 2 female; mean age: 36.8 years; age range: 22 to 49), we performed augmentation with the plantaris tendon after an end-to-end primary repair with a modified Kessler technique. In the second group, which included 20 patients (19 male, 1 female; mean age: 41.4 years; age range: 23 to 52), we did not perform augmentation after the end-to-end primary repair with a modified Kessler technique. For both groups, we used polydioxanone suture (PDS) materials in Kessler knots. Results: The mean American Orthopedic Foot and Ankle Society (AOFAS) hindfoot clinical outcome score was 94 ± 6.4 (range: 73-100) in the first group. In the second group, the mean AOFAS score was 94.4 ± 6.1 (range: 76-100). The first group's mean Achilles tendon assessment score was 81.7 ± 10.9 (good, range of 60-96); the mean Achilles tendon assessment score of the second group was 82.4 ± 6.1 (good, range of 71 to 94). There was no statistically significant difference between these 2 groups in terms of functional scores (P > 0.05). In the first group, 2 patients (9.5%) had superficial skin infections and 1 patient (4.7%) had hypertrophic scar tissue. In the second group, 3 patients (15%) had superficial skin infections and 1 patient (5%) experienced a partial rerupture. Conclusion: Clinical and functional results did not show any statistically significant difference between methods with or without augmentation when appropriate and progressive rehabilitation programs were applied in treating acute Achilles tendon ruptures.

Comparison of the open primary repair with augmentation and without augmentation in acute achilles tendon rupture

To compare the clinical and the functional efficiency of 2 surgical methods that are used in open primary repair of acute Achilles tendon ruptures: one that utilizes the augmentation of the plantaris tendon and one that does not. Materials and methods: Data were evaluated from 41 patients that underwent surgical repair for acute Achilles tendon ruptures with these 2 different surgery methods. In the first group, which included 21 patients (19 male, 2 female; mean age: 36.8 years; age range: 22 to 49), we performed augmentation with the plantaris tendon after an end-to-end primary repair with a modified Kessler technique. In the second group, which included 20 patients (19 male, 1 female; mean age: 41.4 years; age range: 23 to 52), we did not perform augmentation after the end-to-end primary repair with a modified Kessler technique. For both groups, we used polydioxanone suture (PDS) materials in Kessler knots. Results: The mean American Orthopedic Foot and Ankle Society (AOFAS) hindfoot clinical outcome score was 94 ± 6.4 (range: 73-100) in the first group. In the second group, the mean AOFAS score was 94.4 ± 6.1 (range: 76-100). The first group's mean Achilles tendon assessment score was 81.7 ± 10.9 (good, range of 60-96); the mean Achilles tendon assessment score of the second group was 82.4 ± 6.1 (good, range of 71 to 94). There was no statistically significant difference between these 2 groups in terms of functional scores (P > 0.05). In the first group, 2 patients (9.5%) had superficial skin infections and 1 patient (4.7%) had hypertrophic scar tissue. In the second group, 3 patients (15%) had superficial skin infections and 1 patient (5%) experienced a partial rerupture. Conclusion: Clinical and functional results did not show any statistically significant difference between methods with or without augmentation when appropriate and progressive rehabilitation programs were applied in treating acute Achilles tendon ruptures.

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  • Lui TH. Fixation of tendo Achilles avulsion fracture. Foot and Ankle Surg 2009; 15: 58-61.
  • Bhandari M, Guyatt GH, Siddiqui F, Morrow F, Buse J. Treatment of acute Achilles tendon ruptures: a systematic overview and metaanalysis. Clin Orthop Relat Res 2002; 400: 190-200.
  • Wong MW, Ng VW. Modifi ed fl exor hallucis longus transfer for Achilles insertional rupture in elderly patients. Clin Orthop Relat Res 2005; 431: 201-6.
  • Maff ulli N. Rupture of the Achilles tendon. J Bone Joint Surg [Am] 1999; 81: 1019-36.
  • Moller M, Movin T, Granhed H, Lind K, Faxen H. Acute rupture of tendon Achilles. A prospective randomised study of comparison between surgical and non-surgical treatment. J Bone Joint surg [Br] 2001; 83: 843-48.
  • Winter E, Weise K, Weller S, Ambacher T. Surgical repair of Achilles tendon rupture. Comparison of surgical with conservative treatment. Arch Orthop Trauma Surg 1998; 117: 364-7.
  • Yel M, Memik R, Arazi M, Öğün TC. Akut aşil tendon rüptürlerinde cerrahi tedavi sonuçları. Acta Ortop Traumatol Turc 1999; 33: 313-16.
  • Aktas S, Kocaoglu B, Nalbantoglu U, Seyhan M, Guven O. End-to-end versus augmented repair in the treatment of acute Achilles tendon ruptures. J Foot Ankle Surg 2007; 46: 336-40.
  • Mann RA, Holmes GB, Seale KS, Collins DN. Chronic rupture of the Achilles tendon: a new technique of repair. J Bone Joint Surg [Am] 1991; 73: 214-219.
  • DeCarbo WT, Hyer CF. Interference screw fi xation for fl exor hallucis longus tendon transfer for chronic Achilles tendonopathy. J Foot Ankle Surg 2008; 47: 69-72.
  • Gerdes MH, Brown TD, Bell AL, Baker JA, Levson M. A fl ap augmentation technique for Achilles tendon repair. Postoperative strength and functional outcome. Clin Orthop Relat Res 1992; 280: 241-6.
  • Lynn TA. Repair of the torn Achilles tendon, using the plantaris tendon as a reinforcing membrane. J Bone Joint Surg [Am] 1966; 48: 268-72.
  • Kitaoka HB, Alexander IJ, Adellaar RS, Nunley JA, Myerson MS. Clinical rating systems for ankle-hindfoot, midfoot, hallux and lesser toes. Foot Ankle Int 1994; 15: 349-353.
  • Th ermann H, Zwipp H, Tscherne H. Functional treatment concept of acute rupture of the Achilles tendon. 2 years results of a prospective randomized study. Unfallchirurg 1995; 98: 21- 32.
  • McComis GP, Nawoczenskı DA, DeHaven KE. Functional bracing for rupture of the Achilles tendon. Clinical results and analysis of ground-reaction forces and temporal data. J Bone Joint Surg [Am] 1997; 79: 1799-808.
  • Nistor L. Surgical and non-surgical treatment of Achilles tendon rupture. A prospective randomized study. J Bone Joint Surg [Am] 1981; 63: 394-99.
  • Kellam JF, Hunter GA, McElwain JP. Review of the operative treatment of Achilles tendon rupture. Clin Orthop Relat Res 1985; 201: 80-3.
  • Garden DG, Noble J, Chalmers J, Lunn P, Ellis J. Rupture of the calcaneal tendon. Th e early and late management. J Bone Joint Surg [Br] 1987; 69: 416-20.
  • Vega J, Cabestany JM, Golano P, Perez-Carro L. Endoscopic treatment for chronic Achilles tendinopathy. Foot and Ankle Surg 2008; 14: 204-10.
  • Leppilahti J, Forsman K, Puranen J, Orava S. Outcome and prognostic factors of Achilles rupture repair using a new scoring method. Clin Orthop Relat Res 1998; 346: 152-61.
  • Akgün U, Erol B, Karahan M. Primary surgical repair with the Krackow technique combined with plantaris tendon augmentation in the treatment of acute Achilles tendon ruptures.Acta Orthop Ttraumatol Turc 2006; 40: 228-33.
  • Naim F, Şimşek A, Sipahioğlu S, Esen E, Çakmak G. Evaluation of the surgical results of Achilles tendon ruptures by gait analysis and isokinetic muscle strength measurements. Acta Orthop Traumatol Turc 2005; 39: 1-6.
  • Dalton GP, Wapner KL, Hecht PJ. Complications of Achilles and posterior tibial tendon surgeries. Clin Orthop Relat Res 2001; 391: 133-39.
  • Yıldırım Y, Saygı B, Kara H, Çabukoğlu C, Esemenli T. Tendon holding capacities of the suture materials used in repairing Achilles tendon rupture.Acta Orthop Traumatol Turc 2006; 40: 164-68.
  • Miskulin M, Miskulin A, Klobucar H, Kuvalja S. Neglected rupture of the Achilles tendon treated with peroneus brevis transfer: A functional assessment of 5 cases. J Foot Ankle Surg
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

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