The Percutaneous Achilles Tendon Lengthening by Triple Hemisection for the Management of Fixed Feet Equinus Deformity: Results of 12 Cases with Literature Review

Hatim Abid

doi:10.19070/2470-4520-2000018

Abstract

The Percutaneous Achilles Tendon Lengthening by Triple Hemisection for the Management of Fixed Feet Equinus Deformity: Results of 12 Cases with Literature Review

Highlights

Achilles tendon contracture, which affects ankle dorsiflexion, is a common clinical symptom that can be most often encountered in the context of neurological pathology and traumatic sequelae [1]
Surgical treatment involves open Z-lengthening which provides enough lengthening with fairly frequent complications such as adhesion, pain, scarring, and infection [2]. It is in this sense that the percutaneous Achilles tendon lengthening by triple hemisection, first employed by Hoke in 1931 [3], finds its interest because of its multiple advantages
We share through this article our experience concerning the management of Achilles tendon contracture by percutaneous tendon lengthening performed in 12 young patients

Summary

Introduction

Achilles tendon contracture, which affects ankle dorsiflexion, is a common clinical symptom that can be most often encountered in the context of neurological pathology and traumatic sequelae [1]. Surgical treatment involves open Z-lengthening which provides enough lengthening with fairly frequent complications such as adhesion, pain, scarring, and infection [2] It is in this sense that the percutaneous Achilles tendon lengthening by triple hemisection, first employed by Hoke in 1931 [3], finds its interest because of its multiple advantages. Achilles tendon lengthening by triple hemisection was performed in 12 patients between 2017 and 2020. All patients were placed at prone position, with feet a little away from the edge of the table to achieve the ankle dorsiflexion movement (Figure 1). In the case of ankle varus deformity, the most distal incision was placed at the medial site 0.5 cm away from the proximal calcaneus. The dorsiflexion strength of ankle was gradually increased (Figure 3), and Achilles tendon lengthening was accomplished by the sliding tendon. The function of ankle was assessed by the American Orthopedic Foot and Ankle Score (AOFAS) (Table 1)

Results

Discussion

Conclusion