A prospective study on gastrosoleus turn down flap augmentation repair with v-y plasty of neglected tendo achilles rupture
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2017, Vol 3, Issue 2
Abstract
Introduction: The Achilles tendon is subjected to both extensive static and dynamic loads, 2-3 times the body weight while walking and 10 times while athletic activities. The Achilles tendon is one of the most common tendon to rupture spontaneously. Without appropriate treatment, the tendon either heals in an elongated position or fails to heal altogether. At our centre most of neglected Achilles tendon tear are repaired with Gastrosoleus turn down flap augmentation repair with v-y plasty. The purpose of the study was to assess the results, patient satisfaction and complications of our case series. Materials and methods: A prospective Study was performed Between 2015 to 2017, 12 patients were included in the study. The inclusion criteria were chronic neglected tear (> 4 weeks), age more than 20 years, no bony avulsion, unilateral injury, good functional activity before injury, patient following regular with rehabilitation and minimum 6 months of follow up. The exclusion criteria were previous tendon surgery or injury and patient not following rehabilitation protocol. Results: At the most recent follow up, in objective assessment, calf diameter only decreased by mean 1 cm in operated side as compared to normal side. Each patient regained average 10* of dorsiflexion. 10 of 12 patient regained normal plantarflexion. Subjective assessment done using modified Rupp score, 6 patients had excellent, 5 patients had good, and 1 patient had fair results. Mean VAS for pain was 1.5 and VAS for Satisfaction was 8.5. All patients returned to their pre-injury functional status and job. All patient are able to do their activities with no or minimal restrictions. Conclusion: Combined technique for repairing old large defect of the Achilles tendon is a safe and effective method. Repairs are strong enough to allow early weight bearing ambulation with good results.
Authors and Affiliations
Suresh Padya, PTV Kiran Kumar
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