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Surgical Considerations for the Neglected or Chronic Achilles Tendon Rupture: A Combined Technique for Reconstruction
Institution:1. Postgraduate Year 3, Chief Resident, Division of Foot and Ankle Surgery, Western Pennsylvania Hospital, Pittsburgh, PA;2. Postgraduate Year 2 Resident, Division of Foot and Ankle Surgery, Western Pennsylvania Hospital, Pittsburgh, PA;3. Residency Director, Western Pennsylvania Hospital, Pittsburgh, PA;4. Student, Washington and Jefferson College, Washington, PA;5. Foot and Ankle Surgeon, OhioHealth Orthopedic Surgeons, Hilliard, OH; Faculty, Surgical Residencies, Western Pennsylvania Hospital, Pittsburgh, PA and Grant Medical Center, Columbus, OH;1. UnityPoint Clinic Foot and Ankle, Trinity Regional Medical Center; Adjunct Professor, Des Moines University College of Podiatric Medicine and Surgery, Fort Dodge, IA;2. Assistant Professor, Des Moines University College of Podiatric Medicine and Surgery, Des Moines, IA;3. Resident, UnityPoint Clinic Foot and Ankle, Trinity Regional Medical Center, Fort Dodge, IA;4. Podiatric Medical Student, Des Moines University College of Podiatric Medicine and Surgery, Des Moines, IA;5. Assistant Professor, Des Moines University College of Health Sciences, Des Moines, IA;1. Division of Foot and Ankle Surgery, West Penn Hospital, Allegheny Health Network, 4800 Friendship Avenue, Pittsburgh, PA 15224, USA;2. Private Practice, Associated Foot and Ankle Centers of Northern Virginia, 1721 Financial Loop, Lake Ridge, VA 22192, USA;1. Professor, Department of Orthopaedics and Trauma, University of Gazi, Ankara, Turkey;2. Professor, Academy of Health Sciences, Physiotherapy and Rehabilitation, University of Hacettepe, Ankara, Turkey;3. Associate Professor, Department of Orthopaedics and Traumatology, Private Guven Hospital, Ankara, Turkey;4. Professor, Department of Physical Therapy and Rehabilitation, Private Guven Hospital, Ankara, Turkey;1. Lower Limb Extended Scope Practitioner, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, United Kingdom;2. Foot and Ankle Surgeon, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, United Kingdom
Abstract:The Achilles tendon is among the most commonly injured tendons in the human body. The most common reason for delayed treatment is a missed diagnosis or a deficiency in presentation. The neglected or chronically ruptured Achilles tendon presents a unique treatment challenge. The surgical approach varies greatly depending on the extent of degeneration and the resultant gap between the opposing tendon ends. Most surgeons have recommended the use of a tendon transfer or augmentation to strengthen the Achilles tendon repair. The following technique uses a flexor hallucis longus tendon transfer with gastrocnemius aponeurosis turndown flap augmentation. This technique has been commonly performed by us with success.
Keywords:ankle  flexor hallucis longus  injury  leg  popliteal block  tendon transfer  triceps surae
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