Muscle embedment spacer for large segmental exposed Achilles tendon: a preliminary report

Abstract

Objective to access the therapeutic methods and results of muscle embedment spac-er for large segemental exposed achilles tendon. Methods There were 21 patients diagnosed as Achil-les tendon rupture combined with local cutaneous deficiency, of whom 16 patients were combined with comminuted tibial fractures and artery and nerve injury, 13 combined with shock, six combined with pel-vic fractures, two combined with open homolateral femoral fractures and three combined with hepatorrhexis and splenic rupture. All patients received fracture fixation and treatment for vascular and nural injuries, hepatorrhexis and splenic rupture. The ruptured Achilles tendons were embedded in the triceps surae muscle at one stage. The Achilles tendons and cutaneous deficiency were repaired at second stage. Re-suits The embedded Achilles tendons assumed a relatively fresh and tramosericeous adventitious coat and retained good tenacity, with no signs of necrosis, colliquation or infection. The follow-up time after second operation was 15-27 months (average 18 months), which showed excellent results in 15 patients, good in four and poor in two, with excellence rate of 90%. All skin flaps and residual wounds were pri-marily healed and no repaired Achilles tendons disrupted again. Conclusion The muscle embedment spacer method can largely avoid the ischemic necrosis of Achilles tendon due to long time exposure and hence provide adequate conditions for second stage operation. Key words: Wounds and injuries; Muscles; Tissue embedding; Achilles tendon