Abstract
The treatment of neglected or chronically ruptured Achilles tendon is challenging.
Various treatments for large defects associated with chronic Achilles ruptures have
been described. Many surgeons recommend the use of a tendon transfer, turndown rotational
flap, advancement flap, or reconstruction with Achilles tendon allograft with calcaneal
bone block. Long-term outcomes of these procedures are unknown. We present 2 cases
with the use of an Achilles tendon with calcaneus bone block allograft. At >8-year
follow-up duration, both patients are afforded satisfactory levels of activity and
are without pain or gait disturbance. This procedure is a viable option for Achilles
ruptures with large defects, ruptures with small intact distal tendon portions, or
re-ruptures of previously repaired Achilles tendons. The long-term outcomes of these
case reports suggest that Achilles tendon reconstruction with bone block allograft
is a viable option.
Level of Evidence
Keywords
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References
- Management of chronic ruptures of the achilles tendon.J Bone Joint Surg Am. 2008; 90: 1348-1360
- Chronic Achilles tendon rupture reconstruction using a modified flexor hallucis longus transfer.Int Orthop. 2010; 34: 1187-1192
- Ruptures of the tendo Achilles: an objective assessment of surgical and non surgical treatment.J Bone Joint Surg Am. 1976; 58: 990-993
- Reconstruction of the Achilles tendon with a composite anterolateral thigh free flap with vascularized fascia lata: a case report.J Bone Joint Surg Am. 2010; 92: 2598-2603
- Reconstruction of an Achilles tendon defect utilizing an Achilles tendon allograft.J Foot Ankle Surg. 1996; 35: 144-148
- Reconstruction of a neglected Achilles tendon rupture with an Achilles tendon allograft: a case report.J Foot Ankle Surg. 2006; 45: 351-355
- Achilles tendon reconstruction after sural fasciocutaneous flap using Achilles tendon allograft with attached calcaneal bone block.J Foot Ankle Surg. 2010; 49: 86.e5-86.e10
- Complex Achilles reconstruction for massive soft tissue loss: allograft, autograft, and use of a temporary cement spacer.J Orthop Trauma. 2010; 24: e78-e80
- Chronic Achilles rupture repair by allograft with bone block fixation.Foot Ankle Int. 2013; 35: 168-174
- Classification of tendo Achillis rupture with consideration of surgical repair techniques.J Foot Surg. 1990; 29: 361-365
- Operative versus nonoperative treatment of Achilles tendon rupture: a prospective randomized study and review of the literature.Am J Sports Med. 1995; 23: 571-574
- Reconstruction of neglected Achilles’ tendon defect with peroneus brevis tendon allograft: a case report.J Foot Ankle Surg. 2006; 45: 42-46
- Reconstruction of a total Achilles tendon and soft-tissue defect using an Achilles allograft combined with a rectus muscle free flap.Plast Reconstr Surg. 2001; 107: 1807-1811
- The myth of muscle balance. A study of relative strengths and excursions of normal muscles about the foot and ankle.J Bone Joint Surg Br. 1985; 67: 432-437
- Treatment of chronic Achilles tendinopathy and ruptures with flexor hallucis tendon transfer: clinical outcome and MRI findings.Foot Ankle Int. 2008; 29: 794-802
- Achilles tendon ruptures.Instr Course Lect. 1999; 48: 219-230
Article info
Publication history
Published online: April 20, 2019
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2018 by the American College of Foot and Ankle Surgeons. All rights reserved.
