TREATMENT OPTIONS FOR NEGLECTED ACHILLES TENDON RUPTURED: WETHER SPONTANEOUS HEALING IS POSSIBLE?

Abstract

The paper considers cases of spontaneous healing of achilles tendon with elongation. In such condition the tendon defect is not palpable, active plantar flexion is preserved and patients are complaining for strength diminution. Purpose — to study features of spontaneous achilles tendon healing with elongation and to analyze the shortening tenoplasty option as a procedure primarily aimed at restoration of strength for gastrocnemius-soleus complex.Material and Methods. The paper presents features and outcomes of surgical treatment of 25 patients who underwent a shortening tenoplasty of various types: crimping (3 patients), Z-type (2 patients), oblique (1 patient) and transverse (19 patients).Results. No re-ruptures or other serious complications were observed in the patients of the present study. Treatment outcomes were evaluated by j. leppilahti scale in 304,7±8,9 days after the procedure. postoperative leppilahti scores were statistically significantly better than prior to surgery — 82,4±5,6 and 62,2±7,7, respectively, (p<0,0001). Conclusion. Shortening tenoplasty can be indicated in cases of spontaneous achilles tendon healing with elongation. at relatively early stages of the injury with rather elastic scars the crimping tenoplasty can be applied. At later stages a resection shortening tenoplasty is recommended through a minimal incision with transverse resection of tendon and removal of scar block.

Keywords

• neglected achilles tendon rupture
• tenoplasty
• spontaneous healing