Treatment of the Chronic Elongated Achilles Tendon with Anatomic Reconstruction

  • Beat Hintermann
  • Markus Knupp

Although ruptures of the Achilles tendon are relatively common, a delayed or missed diagnosis by the primary treating physician is a frequent occurrence. Inglis and Sculco1reported that 38 (23%) of 167 Achilles tendon ruptures were initially misdiagnosed. This consequently leads to an inappropriate primary treatment that results in an incomplete or deficient healing, typically associated with elongation and either a partial or complete chronic rupture of the tendon. Similar disabling conditions may also result from a degenerative disease of the tendon.

Treatment of the resulting condition is often demanding, and bridging the resulting gap may require extensive surgical approaches. For this purpose, various procedures have been described that can be divided into three groups:

  1. 1.

    Primary repair, which may be possible for defects up to 2 cm

  2. 2.

    Augmentation with either a fascia advancement (V-Y-plasty or gastroc-soleus fascia turn-down graft) or a local tendon transfer

  3. 3.

    Synthetic or...


Achilles Tendon Suture Anchor Longus Tendon Achilles Tendon Rupture Soft Tissue Condition 
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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Beat Hintermann
    • 1
  • Markus Knupp
    • 1
  1. 1.Clinic of OrthopaedicsUniversity of BaselKantonsspital, RheinstrasseSwitzerland

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