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Augmented repair of acute tendo Achilles ruptures with gastrosoleus turn down fap

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Abstract

Background

We present the results of primary repair of acute tendo Achilles (TA) rupture augmented with gastrosoleus turn down fap technique.

Patients and Methods

78 consecutive patients with a complete acute rupture of the Achilles tendon operated between 1993 and 2004 were included in study. We performed a modifcation of the Lindholm technique in which the primary Kessler suture repair of the tendon was augmented by a turn-down ≈3 cm × 10 cm gastrosoleus aponeurosis fap. In all cases, a short-leg circular walking cast was applied at 90° of the ankle dorsifexion for 3 weeks and all the patients were encouraged to full weightbearing ambulation immediately. After removal of the cast, isometric and isokinetic ankle exercises were performed for 3 weeks. Modifed Rupp Score was used to evaluate the subjective satisfaction.

Results

All of patients returned to daily activity and 54 (69%) of them returned to previous sport activity. The tendon repair failed in two patients and they were reoperated with an allograft. Three patients developed infection and one of them required débridement. One developed deep venous thrombosis and two permanent sural nerve injuries were encountered. One of the patients had a severe skin necrosis, which was treated with rotation fap. The mean Rupp score was 29 (3-33).

Conclusion

Primary repair of acute tendo Achilles rupture augment with gastrosoleus turn down fip technique in combination of immediate weightbearing ambulation provides a good outcome, but is associated with similar complication rates to the previous literature.

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Authors and Affiliations

  1. Department of Orthopaedics, Zonguldak Karaelmas University, School of Medicine, Zonguldak, Turkey

    Egemen Turhan

  2. Orthopaedic Surgeon, Magnet Medical Center, Ankara, Turkey

    Ferit Dereboy

  3. Department of Orthopaedics and Traumatology, and Traumatology, Dr. Ankara University Faculty of Medicine, Ankara, Turkey

    Tarik Yazar

  4. Orthopaedic Surgeon, Bayındır Private Hospital, Ankara, Turkey

    Murat Demirel

Authors
  1. Murat Demirel
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  2. Egemen Turhan
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  3. Ferit Dereboy
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  4. Tarik Yazar
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Correspondence to Murat Demirel.

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Demirel, M., Turhan, E., Dereboy, F. et al. Augmented repair of acute tendo Achilles ruptures with gastrosoleus turn down fap. IJOO 45, 45–52 (2011). https://doi.org/10.4103/0019-5413.73654

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  • DOI: https://doi.org/10.4103/0019-5413.73654

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