Abstract
Purpose: Purpose of that paper is the presentation of our experience and the evaluation of the results we had, using our method in the treatment of acute raptures of the Achilles tendon.
Methods-materials: A total of 27 patients (26m-1f) were treated in our clinic during the years 1996–2002. There was an age width from 21 to 67 y.o. with an average of 36, 8 years. 70.3% of the cases concerned patients in their 3rd decade of life and 92.2% of the cases involved injuries after participation in acceleration – deceleration pattern sports. All but one (he asked for treatment after a week), underwent an operation within 48 hours. The restoration of tendon’s continuity was achieved with a modified Kessler end to end suture, with plantaris use (24 cases) for repair covering as it was described by Lynn, gastrocnemius fascia use (2 cases), and tendon’s sheath use (1 case). Cordell 1,5mm and Vicryl sutures were used for tendon’s repair. In 4 cases an ABC medium suture and in 1 case a synthetic graft LARS were used. In all cases we applied immobilization with the use of a full length cast from upper thigh to metatarsal necks with the foot in gravity equinus for 3 weeks and then an additional 3 weeks immobilization in a shorter (bellow the knee) cast with the foot gradually brought to the plantigrade position. Physical therapy for 2 weeks followed the immobilization. The average follow up was 3.75 years.
Results: In the majority of the cases the postoperative period was untroubled. Two complications were noted: a case of skin necrosis which necessitate the intervention of plastic surgeons for reconstruction and a case in which the sutures came out through the incision but with preservation of an excellent functional outcome. Subjectively, 87% of the patients were very satisfied, while objectively and after a clinical examination and strength – motion tests this ratio was found higher. The return in their previous activities was clearly influenced by a phobic feeling towards the possibility of a rerapture and not at all by our intervention’s efficiency.
Conclusions: Based on very good results we had using Lynn’s technique for the surgical treatment of acute raptures of the Achilles tendon, in combination with the postoperative rehabilitation program we use, we concluded that this method ensures a curing approach of that injuries in a very efficient and effective way.
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
