Treatment Algorithm for Chronic Achilles Tendon LesionsReview of the Literature and Proposal of a New Classification.
Chronic Achilles tendon lesions (CATLs) ensue from a neglected acute rupture or a degenerated tendon. Surgical treatment is usually required. The current English literature (PubMed) about CATLs was revised, and particular emphasis was given to articles depicting CATL classification. The available tr...
| Published in: | Journal of the American Podiatric Medical Association (American Podiatric Medical Association, Inc.) Vol. 107; no. 2; pp. 144 - 150 |
|---|---|
| Main Authors: | , , , |
| Format: | review Journal Article |
| Published: |
American Podiatric Medical Association, Inc.
Mar2017
|
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=122476254&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 122476254 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 87507315 20R jtl: Journal of the American Podiatric Medical Association (American Podiatric Medical Association, Inc.) issn: 87507315 maglogo: N pubinfo: dt: Mar2017 vid: 107 iid: 2 pid: 5137 pub: American Podiatric Medical Association, Inc. place: Bethesda, Maryland artinfo: ui: 122476254 122476254 NLM28394684 122476254 10.7547/15-099 NLM28394684 122476254 ppf: 144 ppct: 6 formats: tig: atl: Treatment Algorithm for Chronic Achilles Tendon LesionsReview of the Literature and Proposal of a New Classification. aug: au: Buda, Roberto Castagnini, Francesco Pagliazzi, Gherardo Giannini, Sandro affil: I Clinic, Rizzoli Orthopedic Institute, Bologna, Italy sug: subj: Algorithms Tendon Injuries Surgery Tendon Injuries Classification Achilles Tendon Injuries Rupture Trauma Severity Indices Surgery, Reconstructive Methods Achilles Tendon Surgery Tendon Injuries Rupture Surgery Male Achilles Tendon Risk Assessment Prognosis Female Magnetic Resonance Imaging Methods Orthopedic Surgery Methods Chronic Disease Treatment Outcomes Ferrans and Powers Quality of Life Index Male Female ab: Chronic Achilles tendon lesions (CATLs) ensue from a neglected acute rupture or a degenerated tendon. Surgical treatment is usually required. The current English literature (PubMed) about CATLs was revised, and particular emphasis was given to articles depicting CATL classification. The available treatment algorithms are based on defect size. We propose the inclusion of other parameters, such as tendon degeneration, etiology, and time from injury to surgery. Partial lesions affecting less than (I stage) or more than (II stage) half of the tendon should be treated conservatively for healthy tendons, within 12 weeks of injury. In II stage complex cases, an end-to-end anastomosis is required. Complete lesions inferior to 2 cm should be addressed by an end-to-end anastomosis, with a tendon transfer in the case of tendon degeneration. Lesions measuring 2 to 5 cm require a turndown flap and a V-Y tendinous flap in the case of a good-quality tendon; degenerated tendons may require a tendon transfer. Lesions larger than 5 cm should be treated using two tendon transfers and V-Y tendinous flaps. A proper algorithm should be introduced to calibrate the surgical procedures. In addition to tendon defect size, tendon degeneration, etiology of the lesion, and time from injury to surgery are crucial factors that should be considered in the surgical planning. pubtype: Academic Journal doctype: review Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|