Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon.

This study aims to provide a new therapeutic theory which bases on the percutaneous sliding technique with three hemi-cuts in the tendon. In this study, Achilles tendon parenchymal at distal level is hemisected through the most distal incision, Achilles tendon parenchymal at proximal level is hemisected through the middle incision, then Achilles tendon lengthening is accomplished by the sliding tendon under forceful dorsiflexion. It can better achieve soft tissue balance and reduce the recurrence of Achilles tendon contracture when Achilles tendon strength in plantarflexion is weakened. Thus in this study, the partial aponeurosis of gastrocnemius is cut off at most proximal incision in order to weaken Achilles tendon strength in plantarflexion.

Inclusion Criteria:

• Patients older than three years old;
• Severe Achilles tendon contracture and equinus;
• The time after Achilles tendon contracture more than 6 months ;
• Initial Achilles tendon lengthening.

Exclusion Criteria:

• Patients younger than 3 years;
• The course of Achilles tendon contracture is within 6 months;
• Patients who have suffered from the Achilles tendon lengthening;
• Obvious contracture of other soft tissues occurs in combination, such as compartment syndrome or extensive scar tissues in calf;
• Osteotomy or tendon transposition is needed.
• Ankle joint is damaged obviously, such as Charcot's joint or Hemophilic arthritis;
• Skin soft-tissue infection in the lower limb.
• Initial Achilles tendon lengthening.