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

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 Technique Bosworth, JBJS, 38A, 1956.

Mike are you really going to use this tiny FHL? GAP

Repair Chronic Achilles Tendon Rupture with Allograft

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

STRENGTH IS THE ISSUE GASTROCNEMIUS 6.3 SOLEUS 4.0 FHL 2.3 FDL 1.8

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

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.

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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