Achilles Tendon Rupture: How to Make Up for the Gap James A. - - PowerPoint PPT Presentation

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Achilles Tendon Rupture: How to Make Up for the Gap James A. - - PowerPoint PPT Presentation

Mar 08, 2024 476 likes •794 views

Achilles Tendon Rupture: How to Make Up for the Gap James A. Nunley MD DISCLOSURES Consultant for Wright, Stryker,Tornier,Orthofix,Acumed, Exactech,DTMedSurg Royalties from Wright Fellowship support from Breg, Synthes, Integra Turndown

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Achilles Tendon Rupture: How to Make Up for the Gap

James A. Nunley MD

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DISCLOSURES

Consultant for Wright, Stryker,Tornier,Orthofix,Acumed, Exactech,DTMedSurg Royalties from Wright Fellowship support from Breg, Synthes, Integra

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Turndown Technique

Bosworth, JBJS, 38A, 1956.

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Mike are you really going to use this tiny FHL?

GAP

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Repair Chronic Achilles Tendon Rupture with Allograft

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STRENGTH IS THE ISSUE

Calf Muscle Performance Deficits Remain 7 Years After an Achilles Tendon Rupture

Brorsson A, Grävare Silbernagel K, Olsson N, Nilsson Helander K. Am J Sports Med. 2017 Oct

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STRENGTH IS THE ISSUE

GASTROCNEMIUS 6.3 SOLEUS 4.0 FHL 2.3 FDL 1.8

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STRENGTH IS THE ISSUE

MIKE, ARE YOU REALLY GOING TO SEND A BOY TO DO A MANS WORK? IF SO, THEN USE THE WEAK FHL BUT AS LONG AS THE PROXIMAL MUSCLE IS NORMAL THEN BRIDGE THE GAP WITH AN ALLOGRAFT

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Case Presentation

67 year old female on whom I repaired her Achilles tendon 20 years ago is doing well until hiking in India 6 weeks ago. She feels a snap in he posterior calf and has immediate pain. Exam 6 weeks later shows a slightly swollen calf and a positive Thompson test.

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REFERENCES

Ciefuegos A, et al, Chronic Achilles rupture reconstruction with Achilles tendon allograft: a case report. J Foot Ankle Surg 2013 Haraguchi, N Reconstruction of chromic Achilles tendon disorders with Achilles allograft Tech Foot Ankle Surg 2005 Nunley, J Treatment of Neglected Achilles tendon Ruptures with Interpositional Allograft Foot and Ankle Clinics of North America, 2017

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Thank You