Orthopadie (Heidelb)
October 2024
Introduction: The Achilles tendon is the strongest tendon in the human body and has the function of plantar ankle flexion. When the tendon is exposed, the peritendineum has been breached and the thick avascular tendon colonized with bacteria, a complete resection of the tendon may be indicated to achieve infection control and facilitate wound closure. The Achilles tendon reconstruction is not mandatory, as the plantar flexion of the ankle joint is assumed by the remaining flexor hallucis longus, flexor digitorum longus and tibialis posterior muscles.
View Article and Find Full Text PDFOper Orthop Traumatol
December 2022
Objective: Reduction of pain and swelling over the Achilles tendon insertion while maintaining function.
Indications: Strong, intolerable pain over the Achilles tendon insertion with chronic, calcifying insertional tendinopathy that does not respond to non-operative treatment over a minimum of 6 months.
Contraindications: Chronic wounds or severe circulatory deficits at the foot or ankle, irradiating or projected pain, complex regional pain syndrome (CRPS).
Oper Orthop Traumatol
December 2022
Objective: Bridging the defect in chronic ruptures of the Achilles tendon via a turn-down flap of the aponeurosis sparing the skin of the rupture zone.
Indications: Chronic Achilles tendon rupture with a defect distance ≤ 6 cm.
Contraindications: Extended Achilles tendon defect interval ≥ 7 cm, chronic wounds or infections near the surgical approach, higher degrees of arterial or venous malperfusion, complex regional pain syndrome.
Methods: 60 patients with THFs were randomly and equally divided into the CPM group and non-CPM group. Both groups immediately received CPM and conventional physical therapies during hospitalization. After discharge, the non-CPM group was treated with conventional physical therapy alone, while the CPM group received conventional physical training in combination with CPM treatment.
View Article and Find Full Text PDFBackground: This study aims at evaluating a substantial number of patients treated with a percutaneous, paratenon preserving technique for Achilles tendon repair using three different incisions with clinical follow-up and magnetic resonance imaging (MRI).
Methods: Ninety patients with percutaneous Achilles tendon repair using the Dresden technique for acute rupture were evaluated. Fifteen patients were treated using a central approach, 15 patients using a posterolateral approach and the original posteromedial approach was used in 60 patients.
JBJS Essent Surg Tech
December 2017
Introduction: Less invasive restoration of joint congruity and calcaneal shape in displaced intra-articular calcaneal fractures via a sinus tarsi approach followed by percutaneous internal fixation with an interlocking nail results in a low rate of soft-tissue complications and good short-term outcomes (Video 1).
Step 1 Patient Placement: Place the patient in the lateral decubitus position, supporting the involved extremity with a soft radiolucent pillow, flex the contralateral knee, check with fluoroscopy before draping, and obtain lateral radiographs.
Step 2 Incision: Use a sinus tarsi approach for control of the articular reduction.
Objectives: To reduce the complication rate associated with open reduction and internal fixation of displaced intraarticular calcaneal fractures through extensile approaches, a locking nail system (C-Nail) was developed for internal fixation.
Design: Prospective case-control study.
Setting: Two level I trauma centers (university hospital) and 1 large regional hospital in the Czech Republic and Germany.
Background: Transfer of the flexor hallucis longus (FHL) tendon is an established method to replace a dysfunctional Achilles tendon. When using a single incision, the FHL tendon has to be transferred as a single stranded graft into the calcaneus and the distal FHL stump cannot be directly attached to the flexor digitorum longus tendon (FDL). Another concern with tendon retrieval is neurovascular damage.
View Article and Find Full Text PDFPurpose. This work introduces a distinct sonographic classification of Achilles tendon ruptures which has proven itself to be a reliable instrument for an individualized and differentiated therapy selection for patients who have suffered an Achilles tendon rupture. Materials and Methods.
View Article and Find Full Text PDFClin Orthop Relat Res
April 2010
Unlabelled: Percutaneous treatment of calcaneal fractures is intended to reduce soft tissue complications and postoperative stiffness of the subtalar joint. We assessed the complications, clinical hindfoot alignment, motion, functional outcome scores, and radiographic correction of percutaneous arthroscopically assisted reduction and screw fixation of selected, less severe fractures. We performed percutaneous reduction and screw fixation in 61 patients with Type II (Sanders et al.
View Article and Find Full Text PDFBackground: A standard ilioinguinal approach is often insufficient for reduction and stabilization of the medial acetabular wall and the dorsal column in acetabular fractures. To avoid extended approaches, we have used a medial extension of the approach by transverse splitting of the rectus abdominis muscle. We have thus been able to reduce and stabilize transverse and oblique fractures of the dorsal column and the medial acetabular wall and to fix plates in a mechanically better position below the pelvic brim.
View Article and Find Full Text PDFPurpose: The aim of this study was to define the outcome after dorsal or volar plating of Association for Osteosynthesis (AO) type C3 distal radius fractures based on the fracture morphology.
Methods: Twenty-nine patients with AO type C3 distal radius fractures were surgically managed between 1996 and 2005. Group 1 (n = 15) had volar plating.
Oper Orthop Traumatol
October 2006
Objective: Minimally invasive suture of the torn Achilles tendon without opening the rupture site, reduction in the risk of a sural nerve lesion, and optimization of stump apposition.
Indications: Fresh Achilles tendon rupture.
Contraindications: Chronic achillodynia, local corticoid injections, immunosuppressive therapy, old Achilles tendon ruptures, rerupture.
Percutaneous reduction methods play an important role in the management of calcaneal fractures with severe soft tissue compromise, particularly open fractures, and they offer a treatment alternative in patients with local or systemic contraindication to open reduction. Percutaneous reduction by pin leverage (Westhues or Essex-Lopresti maneuver) followed by minimally invasive screw fixation is a treatment option that yields good to excellent results in tongue-type fractures with posterior facet displacement as a whole (Sanders-type IIC). This method can be applied to selected Sanders-type IIA or IIB fractures if the quality of joint reduction is controlled arthroscopically.
View Article and Find Full Text PDF