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Surgical technique of treatment breaks or iterative neglected the Achilles tendon hamstring graft

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New surgical technique of treating neglected or iterative rupture of the Achilles tendon hamstring graft: report of 3 cases.

In patients with a rupture or iterative neglected Achilles tendon, the recommended treatment is usually surgical. Many surgical techniques have been reported in the literature with varying functional results.
We propose a novel technique using a registry of domestic law, half tendon (hamstring) free transplant creating a transplant to 6 or 8 beams.

Clinical case

We treated three men with neglected or iterative rupture of the Achilles tendon:
- The first case was a 50 year old man with an old neglected rupture of more than a year with a tendon retraction and a tendon defect of 12 cm.
- The second is a 35 year old man originally operated by a percutaneous technique with early failure and re-rupture at 6 months with a loss of tendon substance of approximately 6 cm.
- The third case is a 60 year old patient, who had a distal old achilles tendon rupture operated by transosseous rehabilitation with early recurrent tears to 3 months require a transplant of 6 cm.

surgical Technique

The surgical technique was the same for all 3 patients: removal of domestic law and the half tendon by a short incision at the knee and graft preparation self transplant length for the defect creating a registry of good caliber with 6-8 beams, graft suture directly to the proximal and distal Achilles tendon banks of the two cases and transosseous reintegration by anchors in the third case.

operative:

The postoperative need immobilization in a cast for a minimum of 2 months and gradual recovery of walking accompanied by rehabilitation.
At 5 years, 2 years, 6 months follow-up functional results are satisfactory with good engraftment in 3 cases (controlled by MRI), a satisfactory functional recovery: a perimeter unlimited walking, mobility normal ankle a stable support. In both cases a return to sport recreation was possible after the 6th month.

Conclusion:

In conclusion this original technique to cover major losses of substance of Achilles tendon with a quality graft (hamstring tendon) free transplant, limiting the local disease grafts nearby.

authors:

Nicolas Lefevre, Martine Bloch, Serge Herman

Doctor Nicolas LEFEVRE, Doctor Serge HERMAN. - 25 janvier 2009.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.

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