Percutaneous Z Tendon Achilles Lengthening

  • Bradley M. Lamm
  • Dror Paley


Achilles tendon lengthening is a delicate procedure whereby the risk of over lengthening (creating calcaneus), rupture, and weakening of the gastrocnemius-soleus muscle is devastating. The Silfverskiöld test is clinically performed to differentiate gastrocnemius equinus from gastrocnemius-soleus equinus. Many surgical techniques have been developed to treat negative results of the Silfverskiöld test. The authors prefer a gastrocnemius-soleus recession in order to preserve muscle strength. However, when a large amount of equinus deformity is present, an Achilles tendon lengthening is performed in order to achieve an adequate amount of length.1 The authors present a percutaneous technique for Achilles tendon lengthening.2


Surgical Technique Achilles Tendon Adequate Amount Tendon Sheath Percutaneous Technique 
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  1. 1.
    Lamm BM, Paley D, Herzenberg JE. Gastrocnemius soleus recession: a simpler, more limited approach. J Am Podiatr Med Assoc 95:18−25, 2005PubMedGoogle Scholar
  2. 2.
    Paley D. Principles of Deformity Correction. 2nd edition, Springer, Berlin, 2003.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Rubin Institute for Advanced OrthopedicsSinai Hospital of BaltimoreBaltimoreUSA

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