Abstract
Introduction: Tendo Achilles rupture is one of the most common ruptured tendons. Late presentations are not uncommon due to negligence or misdiagnosis and can affect daily living activities. Management of such neglected ruptures are difficult with multiple treatment options depending on rupture gap and tissue status. We present the results of managing such cases with technique of reconstruction with gastrosoleus turn down flap.
Patients and Methods: 18 patients of neglected tendo achilles rupture were operated between 2010 to 2015 and considered for the study after meeting inclusion criteria. We reconstructed with harvesting of gastrosolues turn down flap with variable gaps. Post operatively immobilised in below knee cast, followed by ankle strengthening exercises. AOFAS score and modified Rupp scores were used to evaluate the results
Results: At final follow-up, all the patients could return to their daily activities. The AOFAS scores increased from an average of 65.6 preoperatively to 95.2 postoperatively. Modified Rupp score was excellent in 9 patients. One case had superficial skin necrosis which healed with secondary suturing. None of the case had re rupture with a mean follow up of 46.9 months.
Conclusion: Achilles tendon is one of the most common ruptured tendons and can be debilitating if left untreated. Management of neglected ruptures is difficult with multiple treatment options depending on the rupture gap and state of the remaining tissue. Reconstructing with turning down the harvested gastrosoleus flap can bridge the ruptured gap of varying size, restore length, sparing the foot & ankle muscles with reasonable good outcome
Key Words: Tendo Achilles, Neglected, Rupture, Gastrosoleus, Turn Down Flap.
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Corresponding Author
Dr Basanta Kumar Behera
Professor, Dept of Orthopaedics,
Kalinga Institute of Medical Sciences, Bhubaneswar, KIIT University
Phone: 9437248843, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.150
