Journal of Foot and Ankle Surgery (Asia Pacific)

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VOLUME 11 , ISSUE 1 ( January-March, 2024 ) > List of Articles


Primary End-end Tendo-Achilles Repair for Defect of 7 cm: A Case Report with Literature Review

Vishnu Senthil

Keywords : Creep phenomenon, End-end repair, Tendo-Achilles tear, Ultrabraid suture, V-Y plasty

Citation Information : Senthil V. Primary End-end Tendo-Achilles Repair for Defect of 7 cm: A Case Report with Literature Review. J Foot Ankle Surg Asia-Pacific 2024; 11 (1):38-41.

DOI: 10.5005/jp-journals-10040-1276

License: CC BY-NC 4.0

Published Online: 30-12-2023

Copyright Statement:  Copyright © 2024; The Author(s).


Achilles tendon evolved in humans as a consequence of bipedal gait. We report a case of neglected tendo-Achilles injury in a 32-year-old female. Magnetic resonance imaging (MRI) showed a defect of 3.5 cm, about 5.5 cm from the calcaneal attachment. On debridement, a defect of 7 cm was found intraoperatively. It was repaired end-to-end with ultra braid suture with Krackow 90° locking stitch with gift box configuration along with V-Y plasty. Paratenon suturing was done to reinforce the repair. Now the patient is at an 18-month follow-up, showing intact repair in MRI and full weight-bearing. In our case, we want to bring out the mechanical properties of tendo-Achilles. Mechanical properties of tendo-Achilles with emphasis on its viscoelastic nature and repair in a high amount of tension produced good strong repair and functional outcome at final follow-up.

  1. Myerson MS. Achilles tendon ruptures. Instr Course Lect 1999;48: 219–230. PMID: 10098047.
  2. Gulati V, Jaggard M, Al-Nammari SS, et al. Management of Achilles tendon injury: a current concepts systematic review. World J Orthop 2015;6(4):380–386. DOI: 10.5312/wjo.v6.i4.380
  3. Maquirriain J. Achilles tendon rupture: avoiding tendon lengthening during surgical repair and rehabilitation. Yale J Biol Med 2011;84(3):289–300. PMID: 21966048; PMCID: PMC3178860.
  4. Kuwada G T. Diagnosis and treatment of Achilles tendon rupture. Clin Podiatr Med Surg 1995;12(4):633–652. PMID: 8536203.
  5. Buda R, Castagnini F, Pagliazzi G, et al. Treatment algorithm for chronic Achilles tendon lesions: review of the literature and proposal of a new classification. J Am Podiatr Med Assoc 2017;107(2):144–149. DOI: 10.7547/15-099
  6. Periasamy M, Venkatramani H, Shanmuganathan RS. Management of chronic Achilles tendon injuries—review of current protocols and surgical options. Indian J Plast Surg 2019;52(1):109–116. DOI: 10.1055/s-0039-1687923
  7. Maffulli N, Ajis A, Longo UG, et al. Chronic rupture of tendo Achillis. Foot Ankle Clin 2007;12(4):583–596. DOI: 10.1016/j.fcl.2007.07.007
  8. Komi PV, Fukashiro S, Järvinen M. Biomechanical loading of Achilles tendon during normal locomotion. Clin Sports Med 1992;11(3):521–531. PMID: 1638639.
  9. Maffulli N, Ewen SW, Waterston SW, et al. Tenocytes from ruptured and tendinopathic Achilles tendons produce greater quantities of type III collagen than tenocytes from normal Achilles tendons. An in vitro model of human tendon healing. Am J Sports Med 2000;28(4):499–505. DOI: 10.1177/03635465000280040901
  10. Järvinen M, Józsa L, Kannus P, et al. Histopathological findings in chronic tendon disorders. Scand J Med Sci Sports 1997;7(2):86–95. DOI: 10.1111/j.1600-0838.1997.tb00124.x
  11. Den Hartog BD. Surgical strategies: delayed diagnosis or neglected Achilles’ tendon ruptures. Foot Ankle Int 2008;29(4):456–463. DOI: 10.3113/FAI.2008.0456
  12. Saxena A, Maffulli N, Nguyen A, et al. Wound complications from surgeries pertaining to the Achilles tendon: an analysis of 219 surgeries. J Am Podiatr Med Assoc 2008;98(2):95–101. PMID: 18347116.
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