Augmented Repair of Achilles Tendon Ruptures

Abstract

Objectives: Augmented repair techniques are used in defective Achilles tendon ruptures and provide excellent functional results in active individuals, but it carries an incidence of wound complications like tendon adhesion to the skin. Tendon adhesion is an important minor complication. We present an augmentation technique for Achilles tendon rupture that we believe prevents tendon adhesion to the skin. Material and methods: Four male patients with a mean age of 38 (29 to 56) were diagnosed as having a ruptured Achilles tendon. Duration of ruptures was 1, 2, 35 and 45 days. We used a new flap technique in these patients with defective acute and chronic Achilles tendon ruptures. A strip of aponeurotic flap, 8 cm long and 2cm wide, was elevated proximally from the median raphe of gastrocnemius, and twisted 180 degrees on itself from medial sides, so its smooth external surface lies next to the skin and covers the rupture site, and the plantaris tendon was incorporated in the repair site. Results: The mean follow-up period was 42 months (23 to 60). There were no reruptures. One had skin necrosis and healed satisfactorily with debridement and secondary sutures. None of them had tendon adhesion to the skin. Satisfactory overall results and very good functioning was achieved in four patients. Conclusion: If augmented repair of Achilles tendon rupture is preferred, this technique can be used satisfactorily and tendon adhesion to the skin is prevented.©2006, Fırat Üniversitesi, Tıp Fakültesi

Keywords

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Aşil tendon yırtığının desteklenmiş tamiri

Öz

Amaç: Defektif Aşil tendon yırtığının desteklenmiş tamiri aktif kişilerde başarılı fonksiyonel sonuçlar vermektedir, fakat tendonun cilde yapışıklığı gibi önemli bir minör komplikasyon karşımıza çıkmaktadır. Bu desteklenmiş tamir yöntemi ile tendonun cilde yapışıklığını önlemeyi amaçladık. Gereç ve Yöntem: Ortalama yaşları 38 (29 – 56) olan 4 erkek hastada Aşil tendon yırtığı tanısı kondu. Yırtık süresi 1, 2, 35 ve 45 gündü. Defektif akut ve kronik Aşil tendon yırtığı olan bu hastalarda yeni flep tekniğimizi uyguladık. Sekiz cm uzunluğunda ve 2 cm genişliğindeki gastrokinemius aponevrotik flebi medialden 180 derece döndürülerek, pürtüksüz olan yüzeyi cilde bakacak şekilde tamir sahasının üzerine getirilip dikildi ve tamir plantaris tendonu ile de desteklendi. Bulgular: Ortalama takib süresi 42 ay (23 – 60) idi. Hastalarda tekrardan yırtık oluşmadı. Bir hastada gelişen cilt nekrozu, debridman ve sekonder dikiş ile iyileşti. Hiçbir hastada tendonun cilde yapışıklığı yoktu. Dört hastada fonksiyonel olarak çok iyi sonuç alındı. Sonuç: Aşil tondon yırtığında destekli tamir yapılacaksa, bu teknik başarı ile uygulanabilir ve tendonun cilde yapışıklığı da önlenmiş olur.©2006, Fırat Üniversitesi, Tıp Fakültesi

Anahtar Kelimeler

• Asil Tendon Yırtığı, Desteklenmiş Tamir, Tendon Yapışıklığı

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25. Kabul Tarihi: 01.05.2006